Salicylates are necessary exclusions in diet investigation for suspected sensitivity. But issues related to all the natural food chemicals are complex. I have made a summary of key ideas in Chapter 3 in my book: Are You Food Sensitive?
In this chapter I am going to do something difficult. I am going to summarise why reactions to foods do not follow neat charts providing analysis of amounts in foods of the suspect natural chemicals: salicylates, amines, natural monosodium glutamate, and natural flavours.
The data from various researchers varies.
Fortunately providing information on foods to minimise when designing your own elimination diet is less difficult to do as it can be based on the research as well as my clinical research findings on what diet-responding families using the diet have found.
Deciding what to exclude has changed since the 1980s and 1990s.
There have been three big steps in how my thinking has changed.
First I relied on analysis data showing how much of those chemicals were in particular foods.
Then I tested this out by recommending exclusion or inclusion to patients and hearing if reactions followed the expected similarities to the analysed amounts. Sometimes it did but often did not, so I adjusted the diet. This adjustment happened again when new analysis data became available, and my patients reported on their tolerance or not, and diet advice was adjusted again.
Thirdly I listened to my thousands of patients describe how they felt about particular foods particularly their smell and taste, and, importantly, noted how this matched their food tolerance.
This has meant that in 2014 I am more confident that we should use a blend of analysis data with factors that families notice in the food, particularly flavour and smell. This confidence has come more from patients testing their tolerance of different foods than from data analysis charts.
Following are pages of notes covering all of the important groups of natural chemicals –
salicylates, amines, natural monosodium glutamate, and natural flavours.
I want to emphasize that these do need to be minimised as well as additives in any diet investigation to obtain the maximum benefit. Otherwise you may have symptoms vary but not be able to understand why.
Important note. You can read just the top of the summary on each food chemical for the main take-away message about the exclusions for that group. You need only read the rest if you wonder why we need to review thinking in 2014. There is a summary of how the early analysis helped, where the analysis did not agree with what families investigating diet found. You can learn about the taste and smell that will help you decide if you should exclude particular foods in that group. In the first edition of this book I was the first to say that flavour was important. Now I am certain of this. Further research may be able to say why this is so.
You may already have noted that charts from different sources do not agree with each other. This shows that suspect food chemicals vary. The summaries on each natural food chemical give some reasons for that. All of this adds up to why I wrote the detail on over 300 foods food in my latest book, Tolerating Troublesome Foods, for you to read.
What are the important salicylate exclusions?
Herbs, spices, tomato concentrate, peppermint, dried fruit, tea, bitter coffee. See Chapter 5 for more diet detail.
How can you use taste and smell to detect salicylates in foods?
It makes sense that the more “spicy” or “herby” a food is the more salicylate it has.
One research team suggests the amount of acidity is linked to salicylate. The latest team says that bitter flavours correlate with salicylate content.
Why should salicylates be excluded during the diet trial?
Eighty percent of those who reacted to additives also reacted to tomato sauce. Most diet-responders report reactions to spicy foods, which all analyses results agree contain salicylates. A history of aspirin sensitivity in a family member of food sensitive people is surprisingly frequent given that aspirin sensitivity is rare in the population.
Why do salicylates need revision in 2014?
Worldwide research has shown that the amounts of salicylate in food vary widely and do not agree with what patients report as causing reactions. For example, the latest research shows tomatoes containing less than apples or pears.
How did the early analysis help?
The early analyses helped greatly, especially in showing that exclusion of compounds closely related to salicylate helped relieve symptoms in aspirin sensitive people. The data gave us security that there were compounds that could cause clear reactions.
Why is there variation in the concentration of salicylate in foods?
The concentration of salicylate in foods varies with varieties. Granny Smith apples are reported to cause more reactions than Golden Delicious, and other mild apples. The amount also decreases as fruit ripens. As well, tangy, bitter or strong favours can vary with where the fruit or vegetable is grown, or the season. Researchers also comment on growing conditions, environmental stressors, pesticide use, and harvesting times. Carrots and broccoli can be mild or have a strong flavour. Plants produce salicylates to prevent insect infestation so organic foods can contain more.
Does the amount of salicylate correspond with taste and smell of the food?
At first it was thought that salicylate amounts increased with acidic taste but this conflicts with cucumbers analysed as high. Most food sensitive people dislike foods when they are strong or bitter but are happy to eat those with mild flavour. What is certain is that stronger spicy flavours do correlate with higher salicylate content.
Where has the analysis differed from what families investigating diet have found?
Initial analysis found apple to be low in salicylate but reactions still occurred. Pineapple was excluded yet fresh good quality pineapple had rarely been reported a problem except for canned juice. Peeled cucumber is rarely reported causing reactions.
Stories about how this group of natural chemicals is important
In the 1970s before I had the results of any salicylate analyses I found it curious that if families used six different low risk foods over six days they had less reaction than if they used any one of them continuously for six days. I was working in central Queensland so these included persimmons, custard apples, rosella jam, sweet lemon, quinces, guava and lychees, with similar salicylate content but different flavours. This was the beginning of my suspicion that the flavour itself may be part of what people react to.
A useful reference
Adrian Wood, Gwen Baxter, Frank Thies, Janet Kyle, & Garry Duthie. A systematic review of salicylates in foods: Estimated daily intake of a Scottish population., Molecular Nutrition & Food Research. 2011 55, S7-S14.
Salicylates should not be excluded on their own. For further information read Are You Food Sensitive? available for $5.50 from www.amazon.com.au/Are-You-Food-Sensitive-investigate-ebook/dp/B00J7PC5VQ or from this site. Joan Breakey dietitian specialising in food sensitivity