You may have a long history of asthma or allergies to food or environmental triggers — and perhaps a “sensitive stomach” to boot. Which is why when you have an occasional attack of asthma, rashes, hives or sudden abdominal cramping and diarrhea while eating, you’ve chalked it up to accidental exposure to one of your food triggers. But which trigger it is always remains elusive. Sound familiar?
If so, consider the possibility of a sulfite sensitivity.
Sulfites describe a family of food additives with names like sodium or potassium bisulfite, sodium or potassium sulfite, and sulphur dioxide. They’re used as a preservative to prevent bacterial fermentation and spoilage — most famously in wines, so that your merlot doesn’t turn to vinegar before you are able to enjoy it. But many other foods can contain sulfites as well — from fresh grapes, dried fruit, shelf-stable lemon and lime juices and sriracha sauce to frozen foods, including potato products, mushrooms, doughs and seafood. The Food and Drug Administration’s food labeling regulations mandate that any food containing sulfites include this information on the label, either in the ingredient list or in a special allergen disclosure statement that the food “contains sulfites” immediately following the ingredient list.
[See: Foods That Cause Bloating.]
For the majority of people, sulfites don’t pose any issues. In fact, sulfite sensitivity is estimated to affect only about 1 percent of the general population, though it may be somewhat higher — up to 5 percent — among people who have asthma. Sulfite sensitivity can also develop later in life, so people may find themselves reacting to foods that they had previously tolerated.
Experts aren’t entirely clear as to why certain people have adverse reactions to ingesting sulfites. Nor is there an objective clinical test to diagnose sulfite sensitivity. As such, sulfite sensitivity is generally diagnosed as the result of a thorough food and symptom history to help isolate the likely triggers. It’s treated with a lifelong avoidance of sulfite-containing foods and medicines.
Sulfite intolerance can be especially tricky to nail down, because sulfites are food additives — not foods themselves. Since many of us eat out with regularity, we lack visibility into the origin of ingredients used in our food and therefore don’t know whether they are likely to contain sulfites or not. I had one patient, for example, who developed severe abdominal pain and diarrhea after having mushroom pizza at a leading restaurant chain — where the mushrooms were most likely to be frozen — but he tolerated mushroom pizza from his local pizzeria just fine. At times, he thought he might just be allergic to mushrooms, but he couldn’t understand why he sometimes seemed to tolerate them and other times did not. Based on other observed adverse food reactions he had — including, most notably, to a shrimp pasta dish in wine sauce — we narrowed down sulfites as a likely culprit.
[See: Fresh Fish Shouldn’t Stink, and Other Rules of Thumb.]
If you suspect seemingly random attacks of symptoms affecting your skin, digestive system or breathing may be related to a sulfite sensivitity, here are some tips:
— Be cautious with wine (and grape juice). All wine has some naturally occurring sulfites, but red wines in particular tend to have added sulfites as well. You may be able to find a sulfite-free red wine in the organic section of your wine shop, but tolerance of even white wine or a sulfite-free red wine may not be a given.
— Scour the labels of all your packaged foods to see whether they contain sulfites, which should be declared as part of the allergen statement. Be especially vigilant for condiments; dried fruits (including coconut used for baking, and granolas, which can contain dried fruits); preserved fruits like maraschino cherries and commercial pie fillings; and frozen foods.
— Look for dried fruits labeled “unsulphured;” they may be browner and less aesthetically pleasing than their brightly-hued, sulfite-containing counterparts, but they should be well-tolerated. Trader Joe’s sells some unsulphured dried fruit products, as do many health food stores.
— Be especially cautious when ordering potatoes, seafood and fruit toppings or fillings from large chain restaurants or lower-quality establishments, like diners, as they are more likely to use frozen or preserved ingredients, rather than fresh ingredients.
— If inactive ingredients aren’t listed on your prescription medications, ask your pharmacist to help you verify that your meds are sulfite-free.
— Consider keeping a food and symptom journal to share with a registered dietitian, who can help you make sense of adverse food reactions that seem random — but may not be.
[See: 8 Questions to Ask Your Pharmacist.]
More from U.S. News
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Could a Sulfite Sensitivity Explain Your Mystery Food Reactions? originally appeared on usnews.com
