August 16, 2017

Allergic Reactions to Food Additives and Preservatives

Nowadays, food is becoming less and less healthy. Various food additives, both natural and artificial, are introduced into food products to change their qualities. Many of them are not as harmless as it seems at first glance. On some of them, the body reacts in the form of urticaria, allergic dermatitis or Quincke’s edema.

Food additives are substances that are not nutritious and added to food to improve taste, appearance, extend expiry date and facilitate processing.

Food additives are classified according to the purposes of their use:

  • food dyes (tartrazine, carmine, and annatto): added to make food look more attractive;
  • preservatives (nitrates, benzoates, and sulfites): added to prevent bacterial growth and increase expiry date of the food;
  • antioxidants (BHA and BHT): added to prevent oxidation under the influence of oxygen;
  • emulsifiers and stabilizers (lecithin and gums): added to improve the texture of food;
  • odor enhancers: added to enhance the smell of food.
  • food flavors (spices, MSG, and sweeteners) are not indicated by the letters E and do not have separate names. The package indicates that the product contains flavors.

Thousands of substances are added to various foods for the purposes of flavoring, coloring, and preserving. There is a list of all of the food additives currently used in the USA confirmed by the Food and Drug Administration (FDA). Being usually only a very small component of foods, additives can cause various reactions.

It is worth remembering that only some of these substances can cause an allergy to food additives or food intolerance. Often, allergies are caused dyes and preservatives. Among the dyes, the most interesting are: tartrazine and amaranth, which can cause asthma attacks and provoke hyperactivity in children.

What Symptoms Can Food Additives Cause?

Food additives can trigger many types of reactions and cause various symptoms. Some of these reactions have an allergic nature, but many others are not allergic and an intolerance. Reactions to food additives include the following:

  • Gastrointestinal disorders (nausea/vomiting, abdominal pain, diarrhea)
  • Respiratory diseases (asthma symptoms, rhinitis, cough)
  • Skin (angioedema/urticaria, atopic dermatitis, sweating, itching, flushing)
  • Musculoskeletal disorders (joint aches, muscle aches, weakness, fatigue)
  • Neurologic disorders (attention deficit, hyperactivity disorder, mood and behavior changes, numbness, migraine headaches)
  • Cardiac diseases (arrhythmias, palpitations)

The mechanism of action of food additives can be different:

  • Allergy to Tartrazine. The dye Tartrazine is widely used in the food and pharmaceutical industries. Tartrazine causes urticaria (hives), asthma and other illness. The estimated frequency of urticarial rashes due to tartrazine is about 5-10% of the total number of patients with urticaria. The presence of cross-reactions to sulfites and tartrazine has been established.
  • Allergy to Carmine. Carmine is a rich red dye obtained from a dried insect called Dactylopius coccus. Carmine as a cause of allergic reactions appears in numerous medical histories. Reactions to Carmine are probably caused due to allergic antibodies. Based on the results of repeated studies of the effect of food dye Carmine on the human body, it has been revealed that it causes skin allergic reactions. Also, some people are allergic to Carmines, which can cause anaphylactic shock. Despite some cases of adverse effects of Carmine on the human body, it is recognized as a safe food additive and it is allowed for use in the food industry. Carmine can be also found in various drinks, red popsicles and yogurt, and cosmetics.
  • Allergy to Anatto. Anatto is a dye used to give some cheeses a yellow color. There are only some reliable reports on the IgE-mediated allergic reaction to annatto, causing anaphylaxis and urticaria/angioedema.
  • Allergy to Saffron. Saffron is a yellow food dye, made from the flower of the Crocus Sativa plant. Consuming saffron in large amounts can lead to the appearance of side effects. There can be poisoning, yellowing of the skin, eyes and mucous membranes, vomiting, dizziness, diarrhea with blood, nose bleeding, blood from the lips and eyes, and numbness. In rare cases, an allergic reaction may occur. In the United States, there were 15 cases of allergy to saffron, and 1 case of anaphylaxis.

Many other food dyes are less common, but also are able to cause adverse reactions. These include amaranth (red #2), erythrosine (red #3), sunset yellow (yellow #6), and quinoline yellow.

  • Allergy to Antioxidants. Clinically important is hypersensitivity to butylated hydroxyanisole and butylated hydroxytoluene, which are antioxidants and added to products containing oil or fats. Hypersensitivity to these compounds is detected in 6-10% of patients with chronic urticaria.
  • Allergy to Sulfites. Humans consume sulfites as food additives, using their antioxidant, bactericidal and antifungal properties for more than 2,500 years. Sulfites are preservatives used in various foods and medications. They added them to wine to prevent fermentation, in canned and frozen fruits, sea and meat products. It is known that sulfites can cause skin manifestations, bronchospasm and anaphylaxis. To prevent reactions to sulfites, it is recommended not to exceed the daily intake of 0.7 mg (in terms of sulfur dioxide) per kilogram of body weight. Meanwhile, when just having supper in a restaurant, a person can consume up to 200 mg of sulfur dioxide, so in literature, the sulfite intolerance can be referred to as a “restaurant food syndrome”.
  • Allergy to Emulsifiers and Stabilizers:Allergy to Gums. Many gums used as food additives act as emulsifiers and stabilizers. Gums include tragacanth, xanthan, guar, carrageenan, and locust bean. Some of these gums can worsen asthma. Others can cause allergic reactions.

    Allergy to Lecithin. Lecithin is used in the production of mayonnaise, chocolate, ice cream and a number of other food products. It is made from soybeans and eggs and may contain soybean proteins. Side reactions to soy lecithin are rare, even in soy-allergic people.

  • Allergy to benzoates and potassium nitrate. Antimicrobial preservatives benzoates can induce bronchial asthma, allergic rhinitis, and urticaria; and potassium nitrate causes hyperactivity and skin damage.
  • Allergy To Spices. Spices are able to cause allergic reactions, just like fruits, vegetables, and pollens. The most common allergic spices are chili peppers, cinnamon, celery, caraway, coriander, mace, garlic, onion, parsley, paprika, and pepper.

Treatment Methods

  • Avoidance of the trigger food additive is the main method of therapy for people with adverse reactions to food additives.
  • The most effective method to prevent allergic reactions to food additives is to keep the elimination diet.
  • Other possible methods of treatment and prevention of allergic reactions to food additives and preservatives include the use of drugs that influence the pathophysiological phase of the reaction – the release of mediators of allergy.
  • Therapy of allergic reactions to food additives is carried out in accordance with the clinical manifestations of the disease (urticaria, Quincke’s edema, atopic dermatitis, bronchial asthma, and anaphylaxis). The common method is to use antihistamines, corticosteroids, b2-agonists, etc.
  • In recent years, drugs that have a selective antileukotriene effect have been widely used in the therapy of aspirin asthma. In addition, comparative studies have demonstrated the high efficacy of montelukast in the treatment of patients with chronic urticaria induced by dietary supplements and/or aspirin.
  • If reactions are severe, a person needs to carry injectable epinephrine and wear a medical alert bracelet.

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