Ham sandwiches are a favourite for a reason. They’re simple, cheap and a crowd-pleaser. 

But they may pose a risk for our health. A study from Cambridge University this week found that eating 50g of processed meat per day – the equivalent of two thick slices of ham – raises the risk of developing Type 2 diabetes within a decade by 15 per cent. 

It’s unclear exactly how ham, and other processed meat, could lead to Type 2 diabetes. Scientists believe harmful additives called nitrites could play a role. It’s thought they increase insulin resistance – a key factor in the development of Type 2 diabetes, explains Richard Hoffman, a nutritionist at the University of Hertfordshire. These meats are also high in salt and saturated, which some research has linked with the disease. 

Can we eat ham without worrying about ramping up the likelihood of being diagnosed with Type 2 diabetes? Dr Duane Mellor, a registered dietitian and senior lecturer at Aston University in Birmingham, runs through varieties from the most to least risky.

Billy Bear Ham

Imprinted with the face of a cartoon bear, Billy Bear slices were a staple in lunch boxes among children who grew up in the 1990s and are still available from supermarkets. While it’s often thought of as a ham, it’s technically classed as slices of pork sausage because of its low pork content (66 per cent).

In place of more meat is water and potato starch, explains Dr Mellor. In terms of nutrition, it’s the least healthy ham-like product due to its lower protein content (11.4g per 100g) and people would benefit from substituting it with lean meat, though it does have less salt than other types of ham (1.35g per 100g), he says. 

It contains sodium nitrite, a preservative which may be a risk factor for developing Type 2 diabetes. Thomas Sanders, a professor of nutritional sciences at King’s College London explains how it “can damage pancreatic beta cells that produce insulin”. But sodium nitrite is present in almost all types of ham, as it increases shelf life, adds flavour and enhances colour – ham would have a grey-ish hue without it. 

“It’s not as easy as just taking the salt and the nitrites out of processed meat because they stop it from going off,” Dr Mellor notes.

Reformed ham

The cheap, square-shaped ham slices available in supermarkets typically belong to a category called reformed ham.

It’s made using pieces of meat that are left over when other cuts are removed from the joint. These are then mixed with water to improve texture and add weight, meaning the meat content is around 80 per cent. Stabilisers, such as sodium triphosphate, are added to help the water bind with the meat. Nitrites are also added.

“It is a lower quality because it’s not carved off a piece of meat, like you’d see in a butchers, but it is still meat – it just may have more fat and a worse texture,” Dr Mellor says. Per 100g, it contains around 0.7g of saturated fat, 17.6g of protein and 1.62g of salt.

Wafer thin ham

“Leaner hams are made with better quality meat and have a higher meat content, typically around 98 per cent, which is a good thing,” Dr Mellor says.

“They will also have less fat, so that’s one potential Type 2 diabetes risk factor that is reduced.” Per 100g, wafer thin ham contains around 1g of saturated fat, 20g of protein and 2g of salt.

However, even if they’re more expensive or organic, they’re still made with salt and nitrites, the latter of which is thought to be the main risk factor for Type 2 diabetes, he says. “So it’s better on some factors but still contains the ingredients that make ham, ham.”

The addition of honey or breadcrumbs is unlikely to add any additional risk, he adds.

Parma ham

“Parma ham only contains pork leg and sea salt, which is used to preserve it, so it doesn’t contain nitrites,” explains Dr Mellor. 

This means that, if research shows that nitrites is the ingredient in ham that heightens a person’s Type 2 diabetes risk, parma ham would be a risk-free option.

“Parma ham is more expensive, however you can use less of it,” because its flavour is more concentrated, notes Dr Mellor. This may benefit our health as it cuts back the quantity of meat that is being eaten, he says. Per 100g, it is higher in saturated fat (5g) and salt (4.5g), though it does contain more protein as well (27g).

Butcher’s ham

“Deli counter ham on the bone is probably the least processed type” of ham and may just be preserved in salt, rather than nitrites, says Frankie Phillips, a registered dietitian and spokesperson for the British Dietetic Association (BDA).

However, you would need to check with the butcher to confirm that this is the case, Dr Mellor says. 

Should you worry about ham?

Ultimately, smaller amounts of better quality ham, such as Parma ham or butcher’s ham that are free from nitrites, will be better for health, says Dr Mellor. 

The NHS recommends that people who eat more than 90g of processed meat per day cut their intake down to no more than 70g. As well as Type 2 diabetes, it has also been linked with heart disease, dementia, some cancers and high blood pressure.

However, it’s worth bearing in mind that the risk of developing Type 2 diabetes because of eating ham, or other processed meat, is far smaller than the risk of developing it from being overweight, notes Hoffman. “So weight control should be the top priority for reducing the risk of Type 2 diabetes,” he says.

Dr Daniel Commane, an associate professor of nutritional sciences at Northumbria University recommends focusing on your wider diet rather than individual food items.

“The healthiest and longest lived communities pursue diets built around whole grains, fruits and vegetables,” he says. “Our western food plate is dominated by meat, most, though certainly not all of us could do with reducing how much meat we eat, and to integrate a one or two more meat-free options both when we eat out of the home and in our own cooking repertoire.”

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