FOOD INTOLERANCE NETWORK FACTSHEET
Food additives and asthma
A month after Jamie Oliver
introduced additive free meals at
It’s the same at the Food
Intolerance Network. Over many years, we have seen that when families go on an elimination
diet to help a child with behaviour problems, any asthmatics in the family are
likely to improve as well. This is because the food chemicals that can be
associated with asthma are the same as those that can cause behaviour problems
in susceptible children.
Sulphites are the additives most associated with
asthma
In 1999 the World Health
Organisation decided that:
·
many more asthmatic children are
affected by sulphite preservatives (up to 20-30 per cent) than previously
thought (4 per cent). This is still a conservative estimate considering
Australian research showed that over 65 per cent of asthmatic children were
affected by sulphites.
·
alternative preservatives other
than sulphites should be used where possible
·
appropriate labeling can help consumers
who are sensitive to sulphites
Why don't asthmatics notice the connection between
their asthma and foods?
People usually only make a
connection between foods and symptoms if the reaction occurs within 30 minutes.
A few asthmatics will react
to sulphites with an immediate asthma attack but for most asthmatics, sulphites
will cause irritable airways with no obvious symptoms.
When the child or adult
with irritable airways is exposed to an asthma trigger such as:
• a cold or flu (or other
virus)
• running around outside
(or other exercise), or
• cold air
they will have asthma. If
you avoid the sulphites - and other irritating food chemicals - that person can
be exposed to asthma triggers without developing asthma.
The effect is related to the size of the dose
Sulphites are used in
varying levels. The ADI (Acceptable Daily Intake) for sulphites can be exceeded
by a two year old who eats more than half a dried apricot in a day or a ten
year old who eats more than one and a half dried apricots in a day, although
the ADI is no guarantee of safety for asthmatics. A seven-year-old with no
known asthma who reported ‘it was a bit hard to breathe’ after eating ten dried
apricots in a day could be an asthmatic on daily medication if he ate that
level of sulphites every day, as some do. High consumers of highly sulphited
foods are particularly at risk or asthma or chronic cough.
Major sources of sulphites
in the diet include:
• dried fruit and dried
fruit in fruit bars, muesli bars, fruit rolls and other processed foods
• sausages
• cordials, some fruit
juice drinks, flavoured water, some soft drinks
Children in the 2-5 year
old age range are the highest consumers of sulphites by far with high-consuming
boys eating nearly three times the ADI. This age group also has the highest
asthma rates
Adults can be affected by
sulphites too. A Dutch woman who developed adult onset asthma within three
months of starting a weight loss program had been snacking on dried fruit and
nut trail mix. After her doctor advised her to drop the dried fruit, her asthma
disappeared. For adults, sulphites in wine and beer can be a major source of
sulphites. There are preservative-free wines and beer available.
Other food chemicals that can be associated with
asthma
Preservatives
Benzoates (210-218 but especially sodium benzoate 211) are another
asthmagenic preservative. They are commonly found in drinks, icecream toppings,
milkshake syrups and syrup medications sometimes consumed in very high amounts
by young children. A case history reported in a French medical journal describes a child
diagnosed with asthma by her first birthday and treated with continuous
medication for almost six years. At that time her condition worsened, requiring
hospitalisation about once a month. Challenges showed that the girl was
sensitive to benzoate preservatives (211) in her asthma medication. After 12
months of avoiding benzoates in foods, drinks and medications, she remained
asthma-free. In
Benzoates can affect adults too. One woman noticed that her diagnosis
of adult-onset asthma coincided with a switch to diet cola. After three months,
she needed daily asthma preventers and relievers. The diet cola is preserved
with benzoates, regular cola is not. When she reverted to regular cola, her
asthma disappeared.
MSG
During a series of talks to school students last year, several primary
students talked about parents or siblings who get asthma after eating Chinese
food. See MSG factsheet for more on the link between
asthma and MSG.
Salicylates
Salicylates are natural chemicals in many ‘healthy’ foods including
most fruit (some of the highest are citrus fruits, avocado, pineapple, plums,
grapes and sultanas); some vegetables (highest are tomatoes/sauce/paste,
broccoli), mint flavouring, licorice, herbs and spices, perfumes and many
medications. Aspirin contains salicylate but many salicylate-sensitive
asthmatics have never realized their sensitivity because reactions can be
delayed or build up slowly. About 20 per cent of asthmatics are thought to be
sensitive to salicylates. Nasal polyps can be associated with
salicylate-sensitive asthma.
Allergies
and food sensitivities
Any or all of the above food chemicals can be associated with
asthma as well as dairy products and possibly wheat in some cases. Some
asthmatics are extremely sensitive, some only mildly so. Allergy testing by a
hospital allergy clinic can reveal true allergies to both foods and
environmental factors such as dust mites. For food intolerance, you need to do
an elimination diet. Unlike IgE-mediated allergies, there are no scientifically
proven laboratory tests for food intolerance.
Some reader stories (excerpts – more stories at http://www.fedupwithfoodadditives.info/stories/storyasthma1.htm)
Criminal. It's the only word that comes to mind when I realise
that, from the age of 10, I have suffered terribly from asthma; and yet, over
the next 23 years, not a single - I repeat NOT A SINGLE - so-called "doctor"
ever once asked if my condition might be due to environmental factors", or
that it might be caused by the food that I eat... All they ever did was pop a
stethoscope on my back, and fill out a prescription for ventolin... "See
ya next time, Mark!"
I am so angry and frustrated at the modern medical establishment
for their open neglect. For years, almost every morning I would wake with an
awful wheeze and a fit of coughing... And it only got worse as my 20's
progressed!
When I think back to those days (although I never made the precise
connection myself at the time), it got to the point where I would need my
puffer after almost every meal! Macca's.. Pizza... Pies... even good 'ole home
cooked meals like curries, stews & roasts! As you can imagine, I became
very depressed.
I will also confess that I was indeed a smoker as well (I know, I
know), but I gave them up around 3 years ago thinking that IT was the main
*cause* of my asthma... Oddly enough, I was wrong ... the daily ritual
wheezing-fest continued unabated. I was, by then, needing up to 20 puffs a day
and my depression worsened. I remember thinking: "I've given up the damn
ciggies, so why aren't I any better?! What's wrong with me?" I began to
accept that I would NEVER recover from this ailment.
Then I discovered your website, "Fedup!" ... And oh what
a life changer!
I bought the video a few months back and have read much of the
material on the website, and with what I now know about salicylates, amines,
preservatives and additives of all kinds, it finally all makes sense!
So far, my family and I have managed to stop the intake of
preservatives and additives (That's the EASY part!) with noticeable
improvements too, I might add, especially for my asthma! However, I have not
completely recovered yet, and my eldest son - although improved - still has
temper problems; so, over the last two days we have finally started tackling
the salicylate/amine issue... It's harder I'll admit, BUT, I can already see
definite positive-changes from my first-born son, and in my own well-being as
well.
It's been around 6 months now since we actively started amending
our diet, and overall, my asthma is now highly manageable... (I now use the
ventolin only rarely, and the morning-wheeze is completely gone!) But, it's not
just that: I finally feel "in control" for the first time ever; I
feel that there is now real hope that it could perhaps, go altogether! I really
do.
Thank God for you, Sue. Thank you for caring enough about human
beings in general, to do what you do. Alright, I'm falling to tears now... so I
best go - Mark & family, Vic
We have had excellent results with diet for our five-year-old daughter
who had severe asthma attacks with daily singulair, ventolin, atrovent and also
3 lots of prednisilone within the space of about 3 or 4 months at the beginning
of 2006. Since going failsafe in August, not even a cough. I attribute a big
part of this success to eliminating both sulphites and artificial colours in
particular.
I always felt that there was something more we could do, but just
didn't know where to start. My children had what I thought to be such a healthy
diet, no cordials, lollies and lots of fruit and dried fruit for snacks. Now I
know better.
If telling our story assists in being a catalyst for positive
change for other families in situations like ours, that will be wonderful - Monica, NSW
Without sounding corny, it is like my daughter has been given a
second lease on life.
Our youngest daughter was diagnosed with asthma at 3 years of age
and we then spent many times in and out hospital, with still no improvement.
She missed so many days of Preschool, could not run without puffing and
requiring her asthma puffer all the time, she also had permanent grey colour
under her eyes. We really did not think we would be able to send her to
school.....it was that bad.
Then a friend of mine from work went to a Sue Dengate talk … and
the light went on. I contacted my husband immediately and told him about it,
cause we had been so worried and that night I cleaned out all my food cupboard
and fridge and made it additive-free.
Our daughter is now 6 and is going into Year 1 and has not been in
hospital since the month we stopped the additives. We have a liitle girl who
runs, jumps for ages on the trampoline, has lost the grey under her eyes and
very happy parents.
Abbey knows that she can't have food with additives and has had to
make a lot of sacrifices, but when she said to me a few months after stopping
all of that, that she feels better then I know it is all worth it - Kathy, NSW
I bought a copy of "Fed Up With Asthma" about 10 months
ago. Since then I have been avoiding the food additives highlighted on your
card and have had no significant asthma. You argument seems to fit in perfectly
with my history. I grew up in
I moved to
On returning to
This afternoon I was shocked to hear an expert on asthma and
allergies on Radio New
Since we discovered salicylates, my daughter doesn't need
preventative medication anymore although I have made a few slip ups with her
diet. Every time she has a reaction I look at what she has eaten and it is
always salicylates. For example, she had a reaction to rissoles in the early
stages of the diet before I had your books to help me. My dietitian said, 'Did
you put pepper in the rissoles?" I hadn't realised pepper was high in
salicylates and used it automatically. Last year I bought some "Kids
Bananas" from Coles because my daughter never ate more than half of the
usual big Cavendish bananas. Two days later her eczema had flared up and then
she got asthma. By this time she had eaten three of these bananas. They must have
been sugar bananas which are high in salicylates but I didn't know that at the
time. During that attack she had to go back on her preventer medication as well
as Ventolin but she hasn't needed it since.
- failsafer, Qld
After hearing about sodium benzoate in asthma
medication at your presentation recently I was a bit shocked, and sure enough
it was there in my son’s asthma syrup
used for under fives. My son had suddenly developed asthma when he was
two months old, just after his first immunisation shot - although at that age
they don't call it asthma. When the asthma finally went away we got the second
shot. After that, he frequently stopped breathing and was on so much medication
we took turns at sitting up with him through the night. Finally we decided that
the medication wasn't working constantly enough and took him off it without
telling the doctor – and our son slowly got better. He would still have small
attacks on occasions so after my husband read your book he decided we should
try diet … We were doing great and had almost six months free of any medication
then last week our son developed an ear infection and was put on antibiotic
syrup and paracetamol syrup for pain, both containing sodium benzoate. Within
three days he had an asthma episode.
After much enquiry I have found that sodium benzoate
is in almost every single baby medication including pain medication (often
along with artificial colours and flavours). Our pharmacist said that the small
amount of sodium benzoate couldn't possibly create a reaction like asthma, it's
unheard of, and as sodium benzoate is so effective as a preservative it is the
most commonly used preservative in medication today and likely to be in the
future. God help us!! – mother from Qld.
With the knowledge I gained from your books I was able to trace
which foods did what. The cause of my 3 year old's asthma became obvious
(sulphites) when he would eat something out of the ordinary such as two apricot
fruit bars (which he had not eaten in ages), come home, run around outside and
have an asthma attack, which he has not had in ages.
I am an adult with asthma. I went off milk and
sulphite preservatives about 6 months ago, I have not had asthma since (unless
I am 'naughty' and have some sulphite). – email,
ACT
[413] I was unaware of
the food-asthma connection (excerpt)
Ever since my son - now aged 10 - was a baby he would get a persistent
dry cough that would continue relentlessly throughout the day and all through
the night of only the winter months every year - at least 6 months every year
without fail. The doctors would all say that they couldn't hear wheezing, so
stopped short of diagnosing asthma no matter how sick he was. Finally a new
local doctor a few years ago suggested asthma and asked me to try a blue puffer
with ventolin. It fixed him immediately after 5 months of relentless coughing!
He is an extremely active, sporty child, who plays and trains hard every
season, but never got the asthma in the summer months.
Ventolin continued to control it, although he was worse after
soccer training and games - in recent years accompanied by acute chest pains
during games - and often had to come off. Last year, he participated in a
school cross country held in May and got into the next level (extremely hilly)
in June. After the race he could not stop coughing, had difficulty breathing
and was very ill, missing school for some time after, which was when we started
to make the exercise connection. We then started to observe and realised the
trigger was exercise. Once winter was over he was well again, right up until
March this year.
The beginning of March coincided with my reading your books - for
other problems, I had forgotten about the asthma as it was controlled with
ventolin and seasonal - and the gradual reduction in non failsafe foods in our
house in the lead up to going failsafe. During this time he participated in the
soccer training and school cross country practices and came first twice - no
coughing, no problems. About 90 per cent failsafe, he went to a two day school
camp this year – we don’t know what he ate. The next day (Saturday) at soccer
he had severe chest pains throughout the game.
After the game his father bought him a sausage sandwich. He
started coughing sometime that afternoon and continued for several days. On the
Monday and Tuesday at school he came last in the cross country practices on both
days, and came home extremely ill on the Tuesday, still coughing continuously.
He stayed at home on the Wednesday with ventolin and the vaporizer and
gradually recovered.
He was still coughing a little but much better the following
Sunday, when we were unavoidably delayed whilst out. The kids were starving at
lunchtime and begging for hot chips. At this point I was not aware of the
food-asthma connection nor of the sulphites in hot chips. Later that afternoon
he quickly began to get much worse again and needed the puffer and vaporiser
again on the Sunday and Monday night. By the Tuesday night he didn't need the
puffer or vaporiser anymore and went to soccer training on the Wednesday night
without coughing or chest pains. He has eaten 100 per cent failsafe since then
(4 weeks later) with absolutely no sign of the asthma cough despite plenty of
exercise and sport. He actually won his school cross country - no reactions at
all afterwards or during, whilst plenty of kids were, in his words,
"dropping like flies with asthma attacks all around him" - some quite
seriously so! Of course, as usual, the school had a sausage sizzle going all
that day to raise money - bizarre isn't it?
- reader, NSW.
What you can do
- cut
down on food additives, especially sulphites in dried fruit, sausages,
processed meats, drinks and some hot chips
- keep
a daily diary of your asthma symptoms, foods you eat (with the additives
they contain) and environmental factors - it may become very obvious that
you are affected by sulphites, benzoates or MSG
- join
our asthma group, email failsafeasthma-subscribe@yahoogroups.com
with ‘subscribe’ in the subject line - between them, the members in this small,
supportive group have many years of experience dealing with asthma and the
effects of food chemicals
- see
a dietitian with an interest in allergy and food intolerance through the
Dietitians Association of Australia (http://www.daa.asn.au/find_a_dietitian/index.asp?pageID=2145835649)
or write for our list of supportive dietitians (confoodnet@ozemail.com.au)
- never discontinue asthma
medication without consulting your doctor
- always carry asthma
medication when eating because if you inadvertently break your diet you
will be affected
- if
trialling the elimination diet, do your challenges with the supervision of
a doctor or dietitian
- see Factsheets: Dangers of dried fruit Sulphite
preservatives
Conclusion
The
World Health Organisation recommends it, Jamie Oliver recommends it, the Centre
for Science in the Public interest recommends it: “the obvious public health
response would be to remove the irritants from the foods that children
eat.” While food regulators
procrastinate, you can send a vote against additives to the food manufacturers
with every dollar you spend. The message is clear: REFUSE TO BUY!
References
(See abstracts at www.pubmed.com, more scientific references at
www.fedup.com)
Jamie Oliver at
·
See the DVD Jamie’s School
Dinners, http://www.jamieoliver.com/dvd/jamie_s_school_dinners_1
The dinners that children had been eating included well-known sources of
sulphites such as manufactured meats, hot chips and soft drinks. Drinks – even
the new flavoured waters - are also a source of benzoate preservatives.
Sulphites are the additives most
associated with asthma
·
Fifty-first meeting of the Joint
FAO/WHO Expert Committee on Food Additives. Safety Evaluation of Certain Food
Additives: evaluation of national assessments of sulfur dioxide and sulfites
and addendum,
·
Towns SJ, Mellis CM. Role of
acetyl salicylic acid and sodium metabisulfite in chronic childhood asthma.
Pediatrics 1984;73(5):631-7. This study found that over 65 per cent of
asthmatic children were sensitive to sulphites.
The connection between diet and
asthma
·
Hoj L, Osterballe O, Bundgaard A,
Weeke B, Weiss M. A double-blind controlled trial of elemental diet in severe,
perennial asthma. Allergy 1981;36(4):257-62. Hospitalised asthmatics improved
on an additive free elemental diet, those in the control group on hospital food
made to look like an elemental diet failed to improve and in some cases
worsened in life-threatening ways
·
Hijazi N, Abalkhail B, Seaton A.
Diet and childhood asthma in a society in transition: a study in urban and rural
·
Hodge L,
·
Towns SJ, Mellis CM. Role of
acetyl salicylic acid and sodium metabisulfite in chronic childhood asthma.
Pediatrics 1984;73(5):631-7. This study has been widely misunderstood as saying
that diets do not work for asthma, which is not the same as saying there is no
connection. Diets for asthma do work if
patients get the diet right and stick
to it – as shown by the one child in the study. But supermarket foods are a
minefield of asthmagenic additives and our experience agrees with this study.
Some children and adults can get rid of asthma simply by avoiding sulphites in
dried fruit, drinks and sausages, but others are more sensitive than that and
most families are not prepared to stick to a diet for asthma unless their
children have behaviour problems too. This is why children should be protected
by removal from our food supply of additives that cause harm.
Why don’t asthmatics notice the
connection?
·
People usually only make a
connection between foods and asthma if the reaction occurs within 30 minutes -
McDonald JR, Mathison DA, Stevenson DD. Aspirin intolerance in asthma.
Detection by oral challenge. J Allergy Clin Immunol 1972;50(4):198-207.
Asthmatics were given an aspirin tablet they were told was not aspirin. Only
those who reacted within 30 minutes made the connection between tablet
ingestion and asthma symptoms.
·
A few asthmatics will react to
sulphites with an immediate asthma attack but for most asthmatics, sulphites
will cause irritable airways with no obvious symptoms. Corder EH, Buckley CE,
3rd. Aspirin, salicylate, sulfite and tartrazine induced bronchoconstriction.
Safe doses and case definition in epidemiological studies. J Clin Epidemiol
1995;48(10):1269-75.
Benzoate preservatives in asthma and
other drugs
·
Petrus M, Bonaz S, Causse E, Rhabbour
M, Moulie N, Netter JC, et al. Asthmé et intolérance aux benzoates. Arch
Pédiatr 1996;3(10):984-7. Case report of a child whose adverse reaction to
benzoates required avoidance of some drugs, including some of those classically
prescribed in the form of syrups for asthma
·
Balatsinou L, Di Gioacchino G,
Sabatino G, Cavallucci E, Caruso R, E. G. Asthma worsened by benzoate contained
in some antiasthmatic drugs. Int J Immunopathol Pharmacol 2004;17(2):225-6. Drug
and food additives are known to induce pseudo-allergic reactions such as
urticaria, eczema, asthma and rhinitis. These reactions are often
under-diagnosed, above all in allergic patients treated with additive
containing drugs.
Colours and asthma
·
Freedman BJ. Asthma induced by
sulphur dioxide, benzoate and tartrazine contained in orange drinks. Clin
Allergy 1977;7(5):407-15
MSG and asthma
·
Moneret-Vautrin DA. Monosodium
glutamate-induced asthma: study of the potential risk of 30 asthmatics and
review of the literature. Allerg Immunol (
Salicylates and asthma
·
Jenkins C, Costello J, Hodge L.
Systematic review of prevalence of aspirin induced asthma and its implications
for clinical practice. Brit Med J 2004;328(7437):434. This review found that
many more adult asthmatics are sensitive to salicylates than are aware of their
sensitivity. While only 3% reported aspirin sensitivity, 21% of adult
asthmatics reacted to oral challenges
·
Towns SJ, Mellis CM. Role of
acetyl salicylic acid and sodium metabisulfite in chronic childhood asthma.
Pediatrics 1984;73(5):631-7.
More
information:
"Fed Up with Asthma" by Sue Dengate,
published by Random House, 2003.
The information given
is not intended as medical advice. Always consult with your doctor for underlying
illness. Before beginning dietary investigation, consult a dietician with an
interest in food intolerance. You can find a supportive dietitian through the
Dietitians Association of
© Sue Dengate update January 2007
