All about Sausage and Cold Cuts

History of Sausages

Sausage is one of the oldest types of ultra-processed foods, with its exact origin unknown. However, historical evidence suggests that sausage originated about 5,000 years ago in Mesopotamia (between the Tigris and Euphrates rivers) by the ancient Sumerian civilization. The Sumerians were at war, and sausages were important because they helped preserve leftover meat. In fact, making sausage was a way to utilize all edible parts of meat, with salt added to extend its shelf life. Back then, sausages were made from any available meat, stuffed with salt and other seasonings into animal intestines or stomachs, resulting in a cylindrical shape. The word "sausage" is derived from the Latin word "salsus," meaning salt, or refers to minced meat preserved with salt to prevent spoilage.

Around 2,800 years ago, in ancient Greece, sausages were made by pounding meat with garlic in a mortar and then mixing it with special spices imported from India. This mixture was placed in thin reeds or hollowed-out tree trunks, sealed at both ends, and boiled in water to cook the sausage inside. Over time, sausages became so popular that they were sold at theaters in ancient Greece, much like modern-day popcorn at cinemas.

Around 2,200 years ago, the Romans learned from the Greeks how to use salt to preserve food and began adding various meats, including pork, and exotic spices to make sausage. The Romans loved sausage, using it in their Lupercalia and Floralia festivals, which were pre-Christian and considered immoral. Constantine, the first Christian Roman emperor, and the Church banned sausage consumption in the fourth century due to its association with these festivals. Despite this prohibition, sausage production and consumption continued illegally, eventually growing even more popular, and the authorities later rescinded the ban, acknowledging its unenforceability.

Sausage production and consumption were once again banned in the 10th century by Byzantine Emperor Leo VI due to an increase in food poisoning cases caused by blood sausages, which shortly after consumption caused paralysis and death.

In the late 18th century, reports of deadly diseases from sausage consumption in southern Germany, particularly in Württemberg, increased due to poor hygiene standards in food production, exacerbated by poverty caused by war. One food poisoning outbreak in a village in Württemberg caused 13 illnesses and six deaths, prompting extensive investigations by physicians. These incidents were often linked to housewives who, to prevent sausages from bursting, did not boil them long enough.

Dr. Justinus Kerner, a German physician, carefully examined several cases of food poisoning and discovered that improper and unsanitary sausage preparation was to blame. Kerner examined the ingredients and preparation methods of all the sausages that caused poisoning and found that fat and salt were the common factors, although salt did not appear to play a role in creating toxins. Kerner concluded that something had likely altered the fat, rendering the sausages toxic. He named the suspected substance "fat poison" or "sausage poison" (wurst gift) in German, where "wurst" means sausage and "gift" means poison. Over time, the disease caused by sausage poisoning was named botulism, derived from the Latin word "botulus," meaning sausage. Botulism is caused by toxins from the bacterium Clostridium botulinum, the same toxin found in canned tuna that is now used in Botox.

In the late 19th century, during the height of the British Empire and the Victorian era, mass production of sausages began. Cheaper sausages were produced by replacing meat with large amounts of fillers such as grains and bread.

During the early 20th century and throughout the world wars, meat supplies in Europe were scarce, forcing producers to use more breadcrumbs, fat, and water in sausage production. Excess water under the tough sausage casing would turn into steam during cooking, causing the sausage to burst with an explosive sound, leading to the nickname "bangers." This term became popular during World War II.

Sausage and cold cut production in Iran began around 1300 AH (circa 1921 CE) by Polish immigrants. In Polish, sausage is called "Kielbasa," derived from the Old Slavic word "klbasa," meaning "something swollen and convex." It is believed that the word "Kalbas" commonly used in Iran originated from this term.

During times of war and food scarcity, sausages were produced for survival, and due to their low cost, they initially gained popularity among the lower social classes. The higher price of fresh meat meant that wealthier people usually roasted large cuts of fresh meat, while the poorer people preserved and consumed leftover meats, which might have been of lower quality. Over time, sausages became popular across various social classes, and today, different types are produced and widely enjoyed.

Classification of Meat Products

Meat products are classified into three categories based on their processing method: cooked, raw, and cured. Raw meat products are not common in Iran.

Cooked

Most types of sausages and salamis produced in Iran are cooked products, which are processed at a temperature of around 78°C. The primary ingredients include meat, fat, and water, which are mixed thoroughly with other additives to create a uniform paste. During the heating process, the structure of the product is preserved, making it easy to slice. These sausages and salamis are made from various types of red meat, poultry, or a combination of both, in different proportions. Additionally, mushrooms, cheese, and chicken paste can also be used in their preparation. The use of chopped meat pieces can improve the appearance of the final product.

Cured Meat Products

The production of cured meat products involves two stages: curing and cooking. First, the meat is chopped, and then the curing process begins. Curing involves the addition of curing agents, such as water, nitrite, and salt, which are mixed into the meat through methods like injection or tumbling. The mixture is then stored in the refrigerator for 24 to 48 hours to complete the curing process. The goal is to create a suitable texture, flavor, and aroma while also increasing the shelf life of the final product. After the curing stage, depending on the type of product, the cooking process is carried out to eliminate microorganisms and achieve the desired texture and consistency. For smoked products, smoking is done to enhance flavor, aroma, color, and shelf life. In some cases, cooking and smoking can occur simultaneously in the cooking room. Therefore, the main difference between cured meat products and sausages/salamis lies in their production methods, as no paste is formed in these products, and the primary components are meat and curing agents.

Types of Sausages

• Salami

Salami is a cooked sausage made from fermented and air-dried meat. The word "salami" comes from the Italian word salame, which refers to European-style (especially Italian) cooked meats.

• Pepperoni

Pepperoni is a meat product from the United States, inspired by Italian salami. The name "pepperoni" comes from the Italian word for bell pepper (peperone), which in Italian means pepper. Therefore, some consumers may mistakenly identify pepperoni as a spicy version of salami. Compared to salami, pepperoni contains more spices.

• Chorizo

Chorizo is a Spanish-Portuguese sausage, called chourico in Portuguese and chorizo in Spanish, while in Iran, it is known as choritso. Chorizo is originally Spanish, and in Spain, it often refers to a specific type of pork sausage with many regional variations. This sausage is fermented, cooked, and results in a dry sausage similar to salami or pepperoni. Chorizo is typically coiled and produced in a dark red color. In most countries, except Iran, chorizo is made from pork. However, due to the prohibition on pork in the country, producers make this sausage using pure beef.

• Hunting Sausage (Cacciatore)

Hunting sausage generally contains a high percentage of meat and is typically made from pork or permissible meats such as beef or veal, along with seasonings. The preparation method involves drying the meat on smoke to give it a mild smoky flavor. The name "Cacciatore," meaning "hunter" in Italian, was given because hunters made this sausage with various ingredients, which were rich in protein, fat, salt, and energy. These characteristics helped hunters continue their journeys in difficult conditions. The size of the Cacciatore sausages depended on the length of the hunters' trips; for longer journeys, larger sausages were made.

• Bulgarian Sausage

Bulgarian sausage was first produced in Bulgaria, based on the traditions and dietary principles of the local people, and it takes its name from the country. The original Bulgarian version of this sausage is a type of salami, dried and spiced, in a rectangular shape with medium volume and surface area. In Iran, Bulgarian sausage is produced in larger sizes and with varying proportions of beef, veal, and chicken.

• Cocktail Sausage

Cocktail sausages are produced almost everywhere in small and bulk sizes compared to other types of sausages. Like other meat and protein products, cocktail sausages are made with varying percentages of white and red meat.

• German Sausage

In Iran, sausages with a low meat content (usually 40%) are commonly referred to as German sausage.

• Frankfurter or Hot Dog

The hot dog is the American version of the German Frankfurter sausage. The exact origin of the hot dog is disputed. Some believe the sausage was first made in the German city of Frankfurt, while others say it originated with a butcher from Coburg, Germany, who introduced the sausage to Frankfurt. The term "hot dog" came into use in the U.S. due to the resemblance between the Frankfurter sausage and the Dachshund dog breed, a small, long, and slender dog from Germany. Since pronouncing the word "Dachshund" was difficult for Americans, the term "dog" was used instead. Street food vendors selling hot dogs from carts would shout, "They're hot! Get your hot sausages while they're hot!" Over time, this led to the popular name "hot dog."

• Krakow Sausage

Krakow sausage, or Kielbasa Krakowska, is a type of Polish sausage named after the city of Krakow in Poland. Traditional Krakow sausage was made from a combination of pork and various herbs and spices. However, the more popular version in Iran is cheese-filled and known as "Cheese Krakow."

Types of cold cuts

• Dry cold cut

The name "dry sausage" refers to its low moisture content compared to other types of sausages.

• Mortadella

This type of sausage is suitable for people who enjoy the taste of sausage but are not fond of red meat, as it contains a very low percentage of red meat (around 30% to 50%) without compromising the flavor. Mortadella, also known as mortadella, is an Italian sausage that originated in Bologna, Italy, which is why it is sometimes called "bologna." There are two theories about the origin of the name "mortadella." The first theory refers to an ancient Roman stone displayed in the Archaeological Museum of Bologna, showing pigs grazing on one side and a mortar on the other. The word mortadella comes from the Latin word "mortar," which refers to the tool used to pound meat, similar to a mortar and pestle. The second theory suggests that in the past, a plant called myrtle was used as a spice in making mortadella, which gave it the name.

Vegetarian Sausages and Cold Cuts

These products are made from plant-based ingredients, including textured vegetable proteins and vegetables. Vegetarian sausages and cold cuts are made from a uniform paste consisting of plant proteins like soy and wheat, edible fats and oils, vegetables and fruits, salt, spices, water, and ice, along with fillers such as wheat flour and starch, and dairy products like cheese, caseinates, and powdered milk. In addition, a fully plant-based version is produced, which contains no animal products, including eggs or dairy.

Types of Cured Meat Products

• Ham (Jambon)

Ham (jambon in French) traditionally refers to processed pork thigh meat. However, today, ham is not limited to pork and can be made from other types of meat.

• Bacon

Like ham, bacon consists of meat that is processed and sliced into thin layers. However, the main difference between bacon and ham lies in the parts of the animal used. While ham is typically made from the thigh, bacon is produced from the belly or back of the animal. The word "bacon" comes from the Old German word "bakkon," meaning "back meat."

Disadvantages of Processed Meat Products

Processed meat products may be among the unhealthiest foods, as they can increase the risk of colon and stomach cancer, heart disease, diabetes, and early death. In 2015, the International Agency for Research on Cancer (IARC) classified processed meat products in Group 1 as carcinogenic to humans and concluded that consuming processed meat leads to colorectal cancer. There is also some evidence of an increased risk of stomach cancer.

It is estimated that around 34,000 cancer deaths worldwide each year are attributable to diets high in processed meat. Individuals who consume 50 grams of processed meat daily have an 18% higher risk of developing colorectal cancer compared to those who do not consume processed meat.

According to the NOVA classification system, processed meat products such as sausages and cold cuts fall into the category of ultra-processed foods. According to the Food and Agriculture Organization (FAO), ultra-processed foods contain additives not used in home cooking. Consuming these foods can negatively affect the microorganisms (microbiota) that live in our gut and contribute to our overall health.

Additives Used in Processed Meat Products

Additives are natural or chemical substances added during the production, processing, packaging, and storage of various foods to enhance color, flavor, and shelf life. Some additives used in processed meat products that may be harmful to human health when consumed excessively include:

1. Table Salt

Table salt (NaCl) consists of sodium (Na) and chlorine (Cl) and is a permitted food additive in the preparation of processed meat products.

Usage

Salt is one of the main flavorings used in the preparation of processed meat products, generally comprising between 1.8% to 2.2% of the sausage's weight. For example, in 60 grams of sausage (about one sausage), approximately 1 gram of salt (about 1.5 teaspoons) is present.

Disadvantages

The World Health Organization (WHO) recommends consuming less than 5 grams of salt (approximately one teaspoon) per day. Excessive salt consumption, due to its sodium content, can be harmful to health. The primary effect of a sodium-rich diet is high blood pressure, which increases the risk of cardiovascular diseases, stomach cancer, obesity, osteoporosis, middle ear disorders, and kidney disease. According to 2023 statistics, 1.89 million deaths per year are linked to excessive sodium consumption. This type of diet likely alters the quantity of microorganisms living in the gut, contributing to high blood pressure. It is important to note that sodium is not only found in table salt but also in other additives and even in the meat used to prepare sausage. Furthermore, some foods consumed throughout the day that do not taste salty, such as bread and pastries, may also contain sodium, potentially leading to an intake above the recommended limit.

2. Nitrate and Nitrite Salts

This group includes sodium nitrate (E251), sodium nitrite (E250), potassium nitrate (E252), and potassium nitrite (E249), which are permitted food additives used in processed meat products.

Usage

These additives prevent processed meat products from combining with oxygen and inhibit the growth of microorganisms, particularly Clostridium botulinum, thereby preventing spoilage. In addition, nitrate and nitrite additives can improve the flavor and enhance the bright red color of processed meat products.

Disadvantages

Both nitrate and nitrite consist of one nitrogen (N) atom and a number of oxygen (O) atoms. Nitrate has three oxygen atoms (NO₃) and nitrite has two oxygen atoms (NO₂). Studies indicate that nitrate remains relatively inactive until it is converted to nitrite. Nitrate is converted to nitrite by an enzyme found in the bacteria present in the human digestive system, including the mouth, esophagus, and stomach. In the stomach, nitrite reacts with stomach acid to form nitrous acid. Proteins in processed meat products break down into their components, amino acids, under the influence of enzymes and stomach acid. Nitrous acid reacts with amino acids in the stomach to produce nitrosamines, which are then converted into other compounds (such as diazonium) that can damage human genes (DNA), leading to genetic mutations or cancer.

3. Edible Polyphosphates

Edible polyphosphates, such as sodium polyphosphate (E339), are permitted additives used in the preparation of processed meat products.

Usage

Polyphosphates are added to processed meat products for several reasons. Nearly all phosphates and their compounds are alkaline, and their addition reduces the acidity of the product, helping it retain water and preventing weight loss during cooking. This group of additives also helps maintain the uniform texture, color, and freshness of the meat and extends shelf life by preventing spoilage.

Disadvantages

The U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) have identified polyphosphates as generally safe, with no significant safety concerns. However, there is evidence of serious and harmful effects on health from excessive consumption of these compounds. Polyphosphates contain phosphorus, and consuming too much phosphorus can raise the concentration of phosphorus in the blood, posing risks to consumers' health, including:

• Phosphorus binds with calcium in the bones, depleting the calcium available to the bones and leading to weakness and osteoporosis.
• Phosphorus combines with calcium to form deposits in the blood vessels, lungs, and eyes. Over time, these deposits may increase the risk of stroke, death, and heart attack. The risk of cardiovascular disease is higher in individuals with chronic kidney disease, who have difficulty excreting excess phosphorus from the body.
• Phosphorus can directly damage the kidneys, increasing the risk of kidney failure.
• Phosphorus can shorten the telomeres (the protective caps at the ends of chromosomes), which are essential for maintaining genetic stability and protection. Telomeres naturally shorten with age, increasing the risk of many diseases. Elevated phosphorus levels in the blood may accelerate the shortening of telomeres, leading to premature cellular aging.

4. Carrageenan

Carrageenan is a compound extracted from red seaweed and is a permitted food additive (E407) in processed meat products.

Usage

Processed meat products consist of various ingredients, including meat and fat. Carrageenan forms a gel structure, trapping water and preventing the ingredients of sausages from separating, giving the sausage a cohesive texture. This results in a softer, denser texture, improving sliceability and preventing cracking or breakage.

Disadvantages

Although the U.S. Food and Drug Administration (FDA) has approved carrageenan for use, it may increase the risk of type 2 diabetes, inflammation, digestive problems like bloating and irritable bowel syndrome, and even colorectal cancer. Individuals with inflammatory bowel disease are more susceptible to the harmful effects of carrageenan. Carrageenan can trigger inflammation in two ways:

• By altering the composition of gut bacteria (microbiota).
• By directly interacting with receptors on the cells of the intestinal epithelium, activating inflammatory pathways.

Carrageenan changes the microbiota composition by reducing the population of Akkermansia muciniphila (which plays a role in protecting the intestinal mucosal barrier) and short-chain fatty acid-producing bacteria (which produce compounds to strengthen the gut wall) while increasing the population of Bacteroidetes (normally beneficial bacteria, but they can enter the bloodstream and cause infection if the intestinal mucosal barrier is compromised by surgery, inflammation, or ulcers). These changes caused by carrageenan damage the intestinal mucosal barrier, allowing bacteria to enter the bloodstream, leading to inflammation, infection, and disease, which stimulate an inflammatory response.

Solutions to Reduce the Harmful Effects of Processed Meat Products

Processed meat products, such as sausages, are considered ultra-processed foods, and various additives are used in their preparation. On the other hand, some consumers are particularly fond of these products. To reduce the health risks associated with processed meats, the following points can be observed:

• It is best to limit the consumption of processed meat products and avoid excessive intake. According to the World Health Organization (WHO), the acceptable daily intake (ADI) of nitrite is 0.07 milligrams per kilogram of body weight. For example, a person weighing 70 kilograms can consume up to 4.9 milligrams of nitrite per day. Therefore, to manage the consumption of processed meat products, a person weighing 70 kilograms can safely consume approximately 60 grams of sausage (about one sausage) per day.
• Ingredients like vitamin C can be used, as they act as antioxidants and quickly react with nitrosamine precursors, producing other compounds that delay the nitrosamine formation cycle.