Could your rhinitis and asthma be caused by food? ! “Low salicylic acid diet” may be the answer

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Could your rhinitis and asthma be caused by food? ! “Low salicylic acid diet” may be the answer

Have you heard of “salicylic acid intolerance”?

Recently, a reader asked me which foods contain more salicylic acid because he is allergic to salicylic acid.

Today Xiaolizi is here to talk about this topic.

Salicylic acid: plant growth assistant and self-defense army

For skin care experts or friends who are troubled by acne, salicylic acid should not be an unfamiliar term. It has exfoliating and antibacterial effects, so it is added to many skin care products.

It is also used as a preservative and is added to personal care products such as toothpaste , shower gel , shampoo , and lipstick .

In addition, it can also be found in certain medications that reduce inflammation and relieve pain , such as aspirin, ibuprofen, wintergreen oil, safflower oil, etc.

Note that it is illegal to add salicylic acid to food for preservation . It is not a “food additive” permitted by regulations, nor is it an edible food ingredient.

However, plant foods—that is, vegetables, fruits, onions, ginger, garlic, grains, nuts, etc. grown in the ground—naturally contain salicylic acid .

For plants, salicylic acid is a natural defense mechanism that helps plants fight off pathogens and insect pests.

When plants become injured or infected, they produce salicylic acid in response. Salicylic acid helps plants send signals that tell cells to beef up their defenses, just as the body generates heat to fight infection. This helps the plants stay healthy and free from harmful bacteria and insects.

At the same time, as a plant hormone , salicylic acid affects plant growth and development, photosynthesis, immune system, etc. In agriculture, supplementing crops with a certain concentration of salicylic acid can improve the crop’s ability to withstand stress, increase yield, and improve fruit quality.

Picture: Karolina Grabowska, https://www.pexels.com/photo/4022586/

▲Garlic grows into such a beautiful shape, and salicylic acid plays a role in it.

Salicylic acid: People with rhinitis may be more sensitive

Large doses of salicylic acid can be toxic.

▲The instruction manual for topical medicines containing salicylic acid reminds: It should not be used in large areas to avoid absorption poisoning.

However, this amount is quite large. It is unlikely to eat this amount by eating natural foods. It is usually accidental poisoning caused by oral medicine or external medicine, such as wintergreen oil and analgesic patches .

For most adults, normal consumption/use of salicylic acid is safe; they can safely eat foods rich in salicylic acid, and it doesn’t matter if they take a few aspirin when they have a headache or fever;

However, some people are sensitive to salicylic acid, and exposure to salicylic acid may cause a series of physical discomfort symptoms. Typical symptoms appear in the respiratory tract [4], such as asthma.

As early as the 1900s, scientists noticed that some patients taking aspirin developed severe asthma, accompanied by nasal polyps and sinusitis, a condition known as “aspirin intolerance . ” (‘Allergies’ involve the immune system, ‘food intolerances’ do not

Original picture: Reference 4

Scientists also found that among normal people, the incidence of aspirin intolerance is 0.3% to 0.9%, while among people with asthma and rhinitis, the incidence of aspirin intolerance can be as high as 43.7% [12].

What foods are rich in salicylic acid?

Before giving a specific food list, a few caveats.

1

Intolerance is often dose-related, and finding an intolerance to aspirin does not necessarily mean that foods rich in salicylates must be avoided.

Medications like aspirin contain much more salicylic acid than food.

A study in Poland showed that dietary intake of salicylates ranges from 10 to 200 mg, while a single dose of aspirin contains 325 to 650 mg [3].

A low-salicylate diet is not a routinely recommended treatment for aspirin intolerance, and some authorities have even stated that it is not recommended .

For example, the Food Allergy Working Group of the German Society of Allergy and Clinical Immunology stated in a 2020 statement: When treating aspirin intolerance, reducing salicylate intake has no pathophysiological basis and may lead to the risk of nutritional deficiencies. , therefore, this type of diet is not recommended [15].

As shown in the picture, many of the foods we eat daily may be rich in salicylic acid. You’ll find that it’s not easy to follow a strict low-salicylic acid diet; simply cutting out a group of foods, such as all vegetables and fruits, to save yourself the trouble is not good for your overall health. .

2

Furthermore, tools and databases on salicylate content in food are very limited and data from different sources vary greatly , which further complicates implementation.

The amount of salicylates in foods can vary depending on a variety of factors, including variety, growing conditions, ripeness, processing, part eaten, etc. for example

● Peeling and boiling can reduce the salicylic acid content

● Compared to fresh vegetables, pickled vegetables (such as pickles and kimchi) have higher levels of salicylic acid

● Tomato paste has higher salicylic acid content than fresh tomatoes (concentrated)

● Leafy vegetables have a relatively higher salicylic acid content; root vegetables, such as lotus roots and potatoes, have a relatively lower salicylic acid content.

I hope that friends in need can refer to the following table with these two prerequisites, for reference only.

▲Reference materials[2,6,7,11,12]

Since the incense is a dry product with concentrated ingredients, the content is particularly high. However, considering the dosage (usually just a handful), the actual intake will not be too large;

Of course, for some people who have a lot of spices in their daily diet, such as those who eat curry for three meals, the total amount may be relatively large.

One final reminder:

Although the medical community has clarified the condition of “aspirin intolerance”, there is relatively little research on food-related salicylic acid intolerance, and there is no clear detection method .

The health benefits of a diet based mainly on plant foods are recognized; a diverse diet is also recommended by current mainstream nutrition; long-term implementation of a highly restrictive diet will increase the risk of nutritional deficiencies. Therefore, Xiaolizi’s suggestion is:

If drug treatment is insufficient to diagnose or suppress symptoms, you can try a low-salicylate diet for a short period of time (take away one type of food, observe whether symptoms are relieved, and keep a record of your diet and symptoms), preferably under the guidance and supervision of an experienced nutritionist proceed below.

References

[1]IWASAWA M, SAGAMI K, YOKOYAMA S, et al.Adherence to guidelines for antiulcer drug prescription in patients receiving lowdose aspirin therapy in Japan［J］.Int J Clin Pharmacol Ther, 2019, 57(4): 197-206 .DOI:10.5414/CP203370]

[2]Kęszycka PK, Szkop M, Gajewska D. Overall Content of Salicylic Acid and Salicylates in Food Available on the European Market. J Agric Food Chem. 2017 Dec 20;65(50):11085-11091. doi: 10.1021/acs .jafc.7b04313. Epub 2017 Dec 7. PMID: 29182277.

[3]Kęszycka PK, Lange E, Gajewska D. Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study. Nutrients. 2021 Mar 19;13(3):991. doi: 10.3390/nu13030991. PMID: 33808619; PMCID: PMC8003553.

[4]Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int. 2008 Feb;105(8):137-42. doi: 10.3238/arztebl.2008.0137. Epub 2008 Feb 22. PMID: 19633779 ; PMCID: PMC2696737.

[5]Hofer SJ, Davinelli S, Bergmann M, Scapagnini G, Madeo F. Caloric Restriction Mimetics in Nutrition and Clinical Trials. Front Nutr. 2021 Sep 6;8:717343. doi: 10.3389/fnut.2021.717343. PMID: 34552954; PMCID: PMC8450594.

[6]Paterson JR, Srivastava R, Baxter GJ, Graham AB, Lawrence JR. Salicylic acid content of spices and its implications. J Agric Food Chem. 2006 Apr 19;54(8):2891-6. doi: 10.1021/jf058158w . PMID: 16608205.

[7]Wood A, Baxter G, Thies F, Kyle J, Duthie G. A systematic review of salicylates in foods: estimated daily intake of a Scottish population. Mol Nutr Food Res. 2011 May;55 Suppl 1:S7-S14. doi: 10.1002/mnfr.201000408. Epub 2011 Feb 23. PMID: 21351247.

[8]https://www.slhd.nsw.gov.au/rpa/allergy/research/salicylatesinfoods.pdf

[9] Li Zhiqiang, Sun Linhai, Dong Wanqing. Research progress on aspirin intolerance [J]. Journal of Practical Cardiocerebral and Pulmonary Vascular Diseases, 2021, 29(1):5.DOI:10.12114/j.issn.1008-5971.2021. 01.001.

[10]Cunningham E. Are there foods that should be avoided if a patient is sensitive to salicylates? J Am Diet Assoc. 2010 Jun;110(6):976. doi: 10.1016/j.jada.2010.04.020. PMID: 20497789.

[11]https://www.royalberkshire.nhs.uk/media/o1um3drj/salicylates_mar22.pdf

[12]Chiang, Hui-Ling et al. “Which Fruits and Vegetables Should Be Excluded from a Low-Salicylate Diet? An Analysis of Salicylic Acid in Foodstuffs in Taiwan.” International archives of allergy and immunology vol. 176,3-4 (2018): 198-204. doi:10.1159/000488348

[13] Li Zhiqiang, Sun Linhai, Dong Wanqing. Research progress on aspirin intolerance [J]. Journal of Practical Cardio-Cerebral and Pulmonary Vascular Diseases, 2021, 29(1):5.DOI:10.12114/j.issn.1008-5971.2021. 01.001.

[14] Li Chunxiang, Yang Jun, Wang Shucai, et al. The role of salicylic acid in garlic bulb expansion [J]. Acta Horticulturae Sinica, 2000, 27(3):3.DOI:10.3321/j.issn:0513-353X. 2000.03.017.

[15]Dölle-Bierke S., Plank-Habibi S., Schäfer C., Ahrens B., Ballmer-Weber B., Beyer K., Blümchen K., Huttegger I., Jappe U., Kleine-Tebbe J. , et al. Dietary implications in acetylsalicylic acid intolerance. Allergo J. Int. 2020;29:93–96. doi: 10.1007/s40629-020-00125-7.