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
