Behold the sandwich, a beloved American icon. In fact, almost half of us eat one each day. But these days you may be thinking twice about grabbing a sandwich on your lunch break — and not just because of the carbs in the bread. With its processed reputation, deli meat (including sliced turkey, ham and roast beef) is not making many "clean eating" lists these days. But is it really that bad for you? The answer is, it depends. Let’s take a closer look.

Food safety

If you do a quick Google search on deli meats, you’ll find all kinds of articles that link the nitrites in these meats to certain types of cancer. OK, so why are nitrites in deli meat? According to the North American Meat Institute (NAMI), sodium nitrite is a salt and an antioxidant that is used to cure ham, bacon and hot dogs. It also stops the growth of botulism-causing bacteria, prevents spoilage and gives cured meats their color and flavor. Sodium nitrite also helps prevent the growth of Listeria monocytogenes, a bacteria that causes the foodborne illness listeriosis.

Listeriosis causes fever, headaches, fatigue, muscle aches, nausea and vomiting. It’s especially dangerous for pregnant women because even if it doesn’t make the mom feel sick, she can still pass it along to her baby, causing serious complications. Listeria is a tricky bacteria because it can grow under refrigeration. Deli meats and hot dogs are only safe for pregnant women if they are heated to 165°F, and that pretty much negates the idea of a quick sandwich.

You may be wondering how “natural” and organic deli meats stay fresh. They use plant-based, naturally occurring nitrites, such as those found in celery, beets and sea salt. The label will likely say “No nitrates or nitrites added” and then in smaller type, “Except for those naturally occurring in sea salt and celery powder.” So, you’re getting nitrites in traditional deli meats, as well as the better-for-you stuff.

Overall safety

When nitrites combine with amines in meat they create nitrosamines, which some studies have found to be carcinogenic. Only about 5% of the nitrites we eat come from meat. We actually get most of them from plants and water. However, according to the World Health Organization (WHO), the consumption of processed meat is associated with small increases in the risk of cancer. And the more you eat, the greater the risk is. But WHO has not been able to determine what it is in processed meat, like deli meat, that actually increases cancer risk.

Cold cuts are high in sodium

Processed foods tend to be high in sodium. The 2020-2025 Dietary Guidelines for Americans recommend eating less than 2300 milligrams of sodium per day. A 2-ounce serving of sliced roasted turkey breast contains between 360-590 milligrams of sodium. That's not so bad, but once you add two slices of bread (240 milligrams), a schmear of mustard (125 milligrams) and perhaps some mayo (85 milligrams), you’re looking at a sodium total of 810 to 1040 for your sammie. As long as you balance out the rest of your day with fresh produce and other foods that are low in sodium, you’re fine, but if dinner is take-out, you’re very likely to exceed the sodium limit.

If sodium is a concern for you, look for low sodium deli meat, which has about 115 milligrams per 2-ounce serving, or try no salt added, which only contains 35 milligrams per serving.

How long do deli meats last?

You buy a package of sliced ham at the grocery store, bring it home and put it in the refrigerator. Maybe you make a few sandwiches on the weekend and then you put the package back in the fridge. The clock is now ticking and you have three to five days to use them. They may not smell bad or look bad, but remember — listeria can grow in the refrigerator. If you purchase meat sliced fresh at the deli, it needs to be eaten within three days.

Bottom line:

If you enjoy deli meat, eat it occasionally and refrigerate it properly. And it’s safest to avoid eating it while pregnant.