Salicylates - friend or foe?

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Salicylates, are chemical compounds derived from salicylic acid, which has been used as a common painkiller and to reduce fever and inflammation for centuries, first as a herbal remedy prepared from willow bark and more recently as acetyl-salicylic acid or aspirin (Paterson et al, 2006).



While salicylates are increasingly being used in a variety of medications and some researchers have proposed that natural salicylates may be beneficial to health (Paterson et al, 2006; Wood et al, 2011), these compounds can cause many side-effects and foods containing salicylates are associated with allergic or sensitivity reactions in susceptible patients. 

Side-effects of salicylates

The commonest side-effects of medications which contain salicylates are nausea, bleeding of the stomach and gastrointestinal tract, dyspepsia, skin reactions (hives, urticaria), liver toxicity, prolonged bleeding time, impaired kidney function, dizziness, mental confusion and allergic reactions, which can range from mild to severe (i.e. anaphylactic reactions that can be life-threatening).

The Ubiquitous compound

Nowadays, salicylates are found everywhere, in prescription, over-the-counter and topical medications, as well as in foods. Typical examples are listed below:

Prescription drugs:

analgesics or painkillers, muscle relaxants and cough/flu medicines, anti-coagulation medications, anti-inflammatories

Over-the-counter drugs:

painkillers, antipyretics (medicines to lower body temperature), antacids, cold and flu medications, anti-allergy drugs, preparations to relieve menstrual pain

Topical drugs:

painkillers, corn, callus and wart applications, acne lotions and creams, medications to treat dermatitis and psoriasis, anti-dandruff and anti-seborrheic shampoos and lotions

Foods

1-10 mg Salicylate/100g of food:

Fruit: fresh apricots, melon, grapes, oranges, pineapple, raspberries, strawberries, canned guava, dried dates, raisins
Vegetables: fresh chicory, leeks, onions, green pepper, shallots, chili
Condiments: tomato sauce, dried celery
Alcohol: Drambuie, Champagne, Benedictine
Tea: Peppermint, Green tea

10-100 mg Salicylate/100g of food:

Spices: aniseed, cayenne, cinnamon, cumin, dill, garam masala, mace, mixed herbs, mustard, oregano, rosemary, sage, tarragon, turmeric
Condiments: Worcestershire sauce

More than 100 mg Salicylate/100g of food:

Spice: curry, paprika
Herbs: thyme

(Perry et al, 1996)

Research Studies

Swain and coworkers (1985) determined the salicylate content of 333 food items, and noted that most fruits, particularly berry fruits and dried fruits, contain salicylates. The salicylate content of vegetables varies between 0 and 6 mg per 100g (i.e. in gherkins), and herbs and spices tend to have the highest content. Certain drinks, such as the alcoholic beverages listed above, tea (regular and green), sweets (licorice and peppermint sweets), and some types of honey, also contain salicylates and may cause negative reactions in sensitive persons.

It has been suggested that salicylates in foods may have a beneficial effect to prevent certain diseases such as colon cancer. Plants use salicylates as a hormonal mediator to develop resistance to pathogen attack and environmental stresses. Pharmaceutical forms of salicylic acid, such as aspirin, are being prescribed to prevent cancer of the colon, and Paterson and his coworkers (2006) theorise that the finding that a diet rich in fruits and vegetables also helps to prevent colon cancer, may be due to the salicylate content of these foods.

More recently, Wood and his team (2011) have tried to assess average salicylate intakes in the Scottish population to determine their beneficial effects. These researchers found that the main dietary sources of salicylates were "alcoholic beverages (22%), herbs and spices (17%), fruits (16%), non-alcoholic beverages, including fruit juices (13%), tomato-based sauces (12%) and vegetables (9%)". According to this study, Scottish men and women, on average ingest about 4.42 and 3.16 mg salicylates/day, respectively (Wood et al, 2011).

At present research investigating these theories relating to the beneficial effects of salicylates in plant-based foods and certain beverages, are still in the early stages and we will have to wait and see what conclusions are reached.

Avoiding salicylates

If you are allergic or sensitive to salicylates, and you need to avoid foods that contain these compounds, then it is essential that you consult a registered dietician to help you with a low-salicylate diet. You won’t suffer any deficiencies if you cut out all the alcohols, herbs and spices that contain salicylates, but many of the foods, especially fruits and some vegetables, that are also sources of salicylate, are also rich in vitamin C, beta-carotene and other phytonutrients.

Total avoidance of such foods can lead to deficiencies with negative health effects, which is why it is a good idea to seek the assistance of a dietician to help you with an individual diet prescription that excludes the offending foods, but is still balanced. Visit the Association for Dietetics in SA (Adsa) website or phone them on (011) 789-6621 or 789-1383 to find a dietician in your area.

Your doctor and pharmacist will be able to advise which medications you should avoid, so always mention your salicylate allergy to your medical practitioner or pharmacist and always ask your chemist to help you check if over-the-counter medications contain salicylates.

It will be interesting to see what results the latest research into the beneficial effects of dietary salicylate intake, will produce. The fact that salicylates may be beneficial to some and highly dangerous to others, is another example of the old saying that “One man’s meat, is another man’s poison.”

 - (Dr IV van Heerden, DietDoc, October 2011)         

(Image: iStock)

References

(Paterson J et al, 2006. Is there a role for dietary salicylates in health? Proc Nutr Soc, 65(1):93-6; Perry CA et al, 1996. Health effects of salicylates in foods and drugs. Nutr Rev, 54(8):225-40; Swain AR et al, 1985. Salicylates in foods. J Am Diet Assoc,85(8):950-60; Wood A et al, 2011. A systematic review of salicylates in foods: Estimated daily intake of a Scottish population. Molecular Nutrition & Food Research, 55(Suppl 1):S7-S14)

Any questions? Ask DietDoc

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How food affects your mood
Understanding food intolerance

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