salicylates and Food-Hypersensitivity

This article is intended to provide a comprehensive overview of the role of dietary methods for treatment of children with attention-deficit/hyperactivity disorder (ADHD) when pharmacotherapy has proven unsatisfactory or unacceptable. Results of recent research and controlled studies, based on a PubMed search, are emphasized and compared with earlier reports. The recent increase of interest in this form of therapy for ADHD, and especially in the use of omega supplements, significance of iron deficiency, and the avoidance of the "Western pattern" diet, make the discussion timely. Diets to reduce symptoms associated with ADHD include sugar-restricted, additive/preservative-free, oligoantigenic/elimination, and fatty acid supplements. Omega-3 supplement is the latest dietary treatment with positive reports of efficacy, and interest in the additive-free diet of the 1970s is occasionally revived. A provocative report draws attention to the ADHD-associated "Western-style" diet, high in fat and refined sugars, and the ADHD-free "healthy" diet, containing fiber, folate, and omega-3 fatty acids. The literature on diets and ADHD, listed by PubMed, is reviewed with emphasis on recent controlled studies. Recommendations for the use of diets are based on current opinion of published reports and our practice experience. Indications for dietary therapy include medication failure, parental or patient preference, iron deficiency, and, when appropriate, change from an ADHD-linked Western diet to an ADHD-free healthy diet. Foods associated with ADHD to be avoided and those not linked with ADHD and preferred are listed. In practice, additive-free and oligoantigenic/elimination diets are time-consuming and disruptive to the household; they are indicated only in selected patients. Iron and zinc are supplemented in patients with known deficiencies; they may also enhance the effectiveness of stimulant therapy. In patients failing to respond or with parents opposed to medication, omega-3 supplements may warrant a trial. A greater attention to the education of parents and children in a healthy dietary pattern, omitting items shown to predispose to ADHD, is perhaps the most promising and practical complementary or alternative treatment of ADHD.

Topics: Anemia, Iron-Deficiency; Attention Deficit Disorder with Hyperactivity; Child; Combined Modality Therapy; Complementary Therapies; Diet, High-Fat; Dietary Fiber; Dietary Sucrose; Dietary Supplements; Fatty Acids, Omega-3; Feeding Behavior; Flavoring Agents; Folic Acid; Food Coloring Agents; Food Hypersensitivity; Humans; Nutritional Requirements; Salicylates; Treatment Outcome; Zinc

Alcoholic drinks are capable of triggering a wide range of allergic and allergic-like responses, including rhinitis, itching, facial swelling, headache, cough and asthma. Limited epidemiological data suggests that many individuals are affected and that sensitivities occur to a variety of drinks, including wine, beer and spirits. In surveys of asthmatics, over 40% reported the triggering of allergic or allergic-like symptoms following alcoholic drink consumption and 30 - 35% reported worsening of their asthma. Sensitivity to ethanol itself can play a role in triggering adverse responses, particularly in Asians, which is due mainly to a reduced capacity to metabolize acetaldehyde. In Caucasians, specific non-alcohol components are the main cause of sensitivities to alcoholic drinks. Allergic sensitivities to specific components of beer, spirits and distilled liquors have been described. Wine is clearly the most commonly reported trigger for adverse responses. Sensitivities to wine appear to be due mainly to pharmacological intolerances to specific components, such as biogenic amines and the sulphite additives. Histamine in wine has been associated with the triggering of a wide spectrum of adverse symptoms, including sneezing, rhinitis, itching, flushing, headache and asthma. The sulphite additives in wine have been associated with triggering asthmatic responses. Clinical studies have confirmed sensitivities to the sulphites in wine in limited numbers of individuals, but the extent to which the sulphites contribute to wine sensitivity overall is not clear. The aetiology of wine-induced asthmatic responses may be complex and may involve several co-factors.

Topics: Alcoholic Beverages; Asthma; Biogenic Amines; Ethanol; Food Hypersensitivity; Humans; Rhinitis; Salicylates; Sulfites

Background Food and chemical sensitivities have detrimental effects on health and the quality of life. The natural course of such sensitivities can potentially be altered through various types of allergen-specific immunotherapy, including low-dose immunotherapy. The molecular mechanism by which low-dose immunotherapy causes desensitization has not thus far been elucidated. While resting lymphocytes maintain a low cytosolic calcium ion concentration, antigen receptor signaling results in calcium ion influx, predominantly via store-operated calcium channels. We therefore hypothesized that desensitization by low-dose immunotherapy is associated with reduced influx of calcium ions into lymphocytes. The aim of this study was to test this hypothesis. Methods Intracellular lymphocytic calcium ion concentrations were assayed in a total of 47 patients, following incubation with picogram amounts of the test allergens, using a cell-permeable calcium-sensing ratiometric fluorescent dye and fluorescence spectroscopy, both at baseline and following successful provocation neutralization treatment with low-dose immunotherapy. Results Low-dose immunotherapy was associated with a reduction in lymphocytic intracellular calcium ion concentration following treatment of: 23 % for metabisulfite sensitivity (p<0.0004); 12 % for salicylate sensitivity (p<0.01); 23 % for benzoate sensitivity (p<0.01); 30 % for formaldehyde sensitivity (p<0.0001); 16 % for sensitivity to petrol exhaust (p<0.003); 16 % for natural gas sensitivity (p<0.001); 13 % for nickel sensitivity (p<0.05); 30 % for sensitivity to organophosphates (p<0.01); and 24 % for sensitivity to nitrosamines (p<0.05). Conclusions Low-dose immunotherapy may affect baseline levels of intracellular calcium in lymphocytes, supporting the premise that allergens affect cell signaling in immune cells and provocation neutralization immunotherapy helps to promote more normal immune cell signaling.

Topics: Adult; Allergens; Benzoates; Calcium; Desensitization, Immunologic; Environmental Illness; Female; Food Hypersensitivity; Formaldehyde; Humans; Lymphocytes; Male; Multiple Chemical Sensitivity; Natural Gas; Nickel; Nitrosamines; Organophosphates; Salicylates; Vehicle Emissions

Salicylate intolerance is defined as a nonspecific antigen-induced pseudo-allergic hypersensitivity reaction which can occur upon contact of an organism with salicylic acid, its derivatives or other related organic or inorganic acids of similar chemical structure. Since the effects of nonsteroidal anti-inflammatory drugs (NSAID) intolerance are by no means always severe or life-endangering but may just as well present as oligosymptomatic or local disorders (e.g. abdominal pain, diarrhea, we decided to evaluate the characteristics of patients with salicylate intolerance on the basis of gastroenterological case material of Medical Department I of Erlangen University. On the basis of the findings from the Erlangen interdisciplinary data register of chronic inflammatory gastrointestinal disease, the signs and symptoms of NSAID intolerance were found to constitute a diagnosis of great practical import to clinical medicine (allergology, dermatology, immunology, other disorders etc.) including gastroenterology. For approx. 2-7% of all patients with inflammatory bowel syndrome and food allergies this poses a new diagnostic and therapeutic challenge which may concern physicians from any of the disciplines involved. When presented with patients with chronic active disease who are suffering from these symptoms one should, therefore, in future give greater thought to the possibility of salicylate intolerance, all the more as there are meaningful dietetic, diagnostic and therapeutic options available for these persons.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Colitis, Ulcerative; Crohn Disease; Diet; Drug Hypersensitivity; Food Hypersensitivity; Gastrointestinal Diseases; Humans; Irritable Bowel Syndrome; Lower Gastrointestinal Tract; Malabsorption Syndromes; Mesalamine; Salicylates

Topics: Child; Child Behavior Disorders; Clinical Trials as Topic; Double-Blind Method; Food Hypersensitivity; Humans; Salicylates

A clear association between allergy and nasal polyposis (NP) is not determined and the role of food intolerance in patients with NP is not investigated by oral food challenge (OFC).. To investigate the relation of salicylate food intolerance and atopy in patients with NP according to recurrence and aspirin sensitivity.. A cross sectional multicenter study was done in two tertiary centers for allergy in Iran. Adult patients with NP were selected for the study that had been referred to allergy clinics. The oral aspirin challenge (OAC) test was performed to identify aspirin exacerbated respiratory disease (AERD) and the OFC test was used to investigate food intolerance. Atopic evaluation was performed by skin-prick tests, nasal smear and blood eosinophil count as well as serum total IgE.. One hundred and nineteen Iranian patients (female to male ratio 1.05) with NP were enrolled (mean age, 38 ± 11 years). Recurrence of nasal polyposis was 64.7%. OAC was performed in all cases; 43.79% cases had aspirin hypersensitivity. In addition, OFC tests determined that 69.9% of patients had salicylate food allergy. Salicylate food intolerance was significantly higher in NP cases with AERD than in aspirin tolerant patients (p<0.05). Yet, positive skin prick test was not associated with NP recurrence and AERD.. Atopy and NSAID exacerbated respiratory disease; therefore, they can both be considered as predictors of NP recurrence. Our study also showed that salicylate food intolerance was associated with AERD in nasal polyposis.

Topics: Adult; Allergens; Aspirin; Cross-Sectional Studies; Drug Hypersensitivity; Female; Food Hypersensitivity; Humans; Iran; Male; Middle Aged; Nasal Polyps; Prognosis; Salicylates; Skin Tests

Topics: Aspirin; Food Analysis; Food Hypersensitivity; Fruit; Humans; Salicylates; Spices; Vegetables

Whereas many people with coeliac disease (CD) are asymptomatic when consuming a gluten-free diet (GFD), a proportion continues to experience symptoms. The reasons for this are unclear.. Thirty-nine adult members of The Coeliac Society of New South Wales, all of whom had persistent gastrointestinal symptoms despite adhering to a GFD, were evaluated. Dietary analysis indicated that 22 (56%) were consuming a GFD as defined by the WHO/FAO Codex Alimentarius (Codex-GFD), in which foods containing up to 0.3% of protein from gluten-containing grains can be labelled as 'gluten free'. The remaining 17 were following a no detectable gluten diet (NDG)-GFD, as defined by Food Standards Australia. All subjects were required to follow a NDG-GFD during the study. Those in whom symptoms persisted after changing from a Codex-GFD and those who entered the study already on a NDG-GFD began an elimination diet followed by open and double-blind challenges to identify specific non-gluten food or food chemical intolerances.. Of 22 patients who switched to a NDG-GFD symptoms resolved in 5 (23%) and were reduced in 10 others (45%). Thirty-one subjects commenced the elimination diet. Symptomatic improvement was experienced in 24 (77%). Subsequent food or food chemical challenges resulted in a mean of five positive challenges per individual. Diarrhoea was the most commonly provoked symptom, followed by headache, nausea, and flatulence. Symptoms were especially provoked by amine, salicylate and soy.. The consumption of trace amounts of gluten, traditionally allowed in a Codex-GFD, may be responsible for the continuing symptoms seen in some patients with CD. Further investigation for non-gluten food intolerances should follow if symptoms persist after adherence to a NDG-GFD.

Topics: Adult; Aged; Amines; Animals; Biopsy; Celiac Disease; Diet Records; Female; Food Hypersensitivity; Food, Formulated; Glutens; Humans; Intestine, Small; Male; Middle Aged; Milk; Nutrition Assessment; Panicum; Salicylates

Topics: Food Hypersensitivity; Fruit; Humans; Infant; Salicylates; Sudden Infant Death

Food intolerant symptoms can have various causes, including enzyme deficiencies (of lactase or aldehyde dehydrogenase) and pharmacological effects (e.g., caffeine, salicylates). The irritable bowel syndrome can also be associated with intolerance to specific foods in some cases, but the mechanism is unclear. Immunological causes are less common but may explain the small bowel mucosal changes associated with gluten enteropathy, as well as the childhood enteropathy provoked by cow's milk or, rarely, by other foods. Food allergy of the more immediate and classical type is associated with reactions both within and outside the gastrointestinal tract. Where these include urticaria, asthma and eczema, immunoglobulin E antibodies are often demonstrable by skin or radioallergosorbent tests, but pseudo-allergic reactions can produce a similar clinical picture. Diagnosis of food intolerance depends on withdrawing the food concerned and assessing the response to a blind challenge. Objective ways of detecting subclinical reactions are also useful, including the detection of a mediator response involving prostaglandins, histamine or serotonin.

Topics: Aldehyde Dehydrogenase; Animals; Asthma; beta-Galactosidase; Cattle; Food Hypersensitivity; Humans; Migraine Disorders; Milk; Salicylates

Topics: Food Hypersensitivity; Humans; Salicylates; Urticaria

Topics: Attention Deficit Disorder with Hyperactivity; Child; Food Hypersensitivity; Food Preservatives; Humans; Salicylates; Sucrose

Topics: Drug Hypersensitivity; Female; Food Additives; Food Coloring Agents; Food Hypersensitivity; Food Preservatives; Humans; Middle Aged; Salicylates; Urticaria

As the problem of chronic urticaria is frustrating both to the physician and patient, an attempt to study its aetiology was made. 100 cases of chronic urticaria was studied in 1979. Patients having daily urticaria for more than 6 weeks, were included. There were 52 males and 48 females. A detailed history of the pattern of urticaria, drugs, physical causes, diet and illnesses were asked for, followed by physical examination. Each were then screened through a Diagnostic Tray including basic haematological tests, urinalysis, stools analysis, physical allergy tests, food provocation battery and further special tests. 17 patients had physical urticaria, cold (6), pressure (5), delayed dermographism (1), cholinergic (4), solar (1). 4 patients had severe reactions with aspirin, one with tetracycline; one had undiagnosed thyrotoxicosis. 36 of all the patients had a positive test on provocation with the food battery: aspirin (13), preservatives (3), colour dyes (6), yeast (1) and others (15). It has been suggested that these are not the immediate cause but are aggravating factors. 48% of patients showed dermographism. The number of idiopathic cases about 77% is consistent with the findings of others. We feel that an attempt to exclude treatable causes has brought reassurance to many of the patients. Long term antihistamine therapy was given in these cases.

Topics: Adolescent; Adult; Candidiasis; Child, Preschool; Chronic Disease; Coloring Agents; Drug Hypersensitivity; Female; Food Additives; Food Hypersensitivity; Humans; Infections; Male; Physical Stimulation; Salicylates; Time Factors; Urticaria

Topics: Bacterial Infections; Cold Temperature; Dermatitis, Atopic; Drug Eruptions; Drug Hypersensitivity; Food Hypersensitivity; Histamine Release; Hot Temperature; Humans; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Insect Bites and Stings; Light; Respiratory Hypersensitivity; Salicylates; Urticaria; Virus Diseases

Topics: Diet; Drug Hypersensitivity; Food Hypersensitivity; Humans; Salicylates

Topics: Allergens; Azo Compounds; Benzoates; Food Additives; Food Hypersensitivity; Humans; Salicylates; Urticaria; Yeasts

Thirty-one children with behavioural problems and learning difficulties were allergy tested for sensitivity to salicylates, artificial colours and flavours, eighteen children had a positive response, and 15 of these were given the Australian Version of the Feingold K.P. diet. Ninety-three per cent responded with improved behaviour in the areas of overactivity, distractability, impulsiveness and excitability. Sleep and enuresis problems were resolved partially or completely. This study demonstrates that the aforementioned elimination diet significantly affects behaviour.

Topics: Child; Child Behavior; Flavoring Agents; Food Coloring Agents; Food Hypersensitivity; Humans; Hyperkinesis; Salicylates; Sleep

Topics: Diet; Drug Hypersensitivity; Flavoring Agents; Food Additives; Food Hypersensitivity; Food Labeling; Gastrointestinal Diseases; Humans; Joint Diseases; Nervous System Diseases; Respiratory Hypersensitivity; Salicylates; Skin Diseases

Topics: Diagnosis; Drug Hypersensitivity; Eosinophils; Food Hypersensitivity; Leukocyte Count; Meprobamate; Milk; Plants, Edible; Salicylates; Toxicology; Urethritis