Sulfites: Friend or Foe?

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allergic to sulfites in wine
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For more than 2000 years, sulfites have been used to prevent food spoilage and discoloration. Perhaps for nearly as long, they’ve played a more sinister role – causing allergic-type reactions in some of the people who consume them. Ellen Wiest is one such individual. She often suffered from headaches, severe nasal congestion, abdominal cramps and diarrhea after eating. But she didn’t connect her symptoms to sulfites, until one June evening in 1995.

That night, Wiest was enjoying dinner with her husband at a favorite restaurant. Halfway through the meal, she developed symptoms typical of a food sensitivity. Only this time, they were accompanied by an increased heart rate, profuse vomiting and difficulty breathing. The restaurant called 911, and paramedics rushed her to the local emergency room.

Wiest learned that her meal contained a splash of wine, and sulfites in the wine sparked the anaphylactic reaction. Similar reactions to hidden sulfites have landed her in the ER twice since then. “When we eat out, I make it clear to the waiter that I will have a life-threatening reaction if I eat anything that contains sulfites,” she notes. “Most of the time, I need to explain what sulfites are and what foods usually contain them.”

While the severity of Wiest’s reaction may be uncommon, sulfite sensitivity is not. The U.S. Food and Drug Administration estimates that up to one in 100 people may be sensitive to the chemicals. Among asthmatics, the ratio shoots to one in 10 and even higher among those who depend on corticosteroids.

Sulfites Are Everywhere

In addition to their role as preservatives, sulfites are used to bleach food starches, such as corn, potato and sugar beet. Sulfites are also put to work as preventives against rust and scale in boiler water used in making steam that may come into contact with food.

Because sulfites inhibit fungal and bacterial growth, they are sprayed on both fresh grapes and those used in winemaking. Sulfites are a normal by-product of winemaking. Sulfites lurk in many popular foods and beverages, under the names of sulfur dioxide, sodium sulfite, sodium bisulfite, potassium bisulfite, sodium metabisulfite and potassium metabisulfite. Wine, bottled lemon and lime juices, and sulfur-dried fruits have the highest levels of sulfites.

The Sulfite Labeling Nightmare

Avoiding sulfites can be difficult. “I’ve learned to carefully read labels,” Wiest says. “But it’s surprising how poorly many foods are labeled with regard to sulfites.”

Current labeling laws were enacted in 1985, after sulfites were linked to 15 deaths. The Food and Drug Administration now say manufacturers must identify the presence of sulfites on food labels, but only if concentrations exceed 10 parts per million. Test strips are available to test liquid foods. However, they detect sulfites only in levels greater than 10 parts per million – and many sulfite-sensitive individuals react to much lower levels.

Seek Expert Advice

Other foods, chemicals, additives, colors and substances can create the same symptoms caused by a sulfite sensitivity, which is why it is important to consult with a doctor who is familiar with the affliction. After reviewing a patient’s records, the physician may perform oral provocative testing to confirm suspicions.

Observations as simple as “wine gives me gas” make elimination of the offending item fairly easy. However, eliminating large groups of foods may compromise the nutritional adequacy of an individual’s diet. If the diagnosis is confirmed, the patient should work with a dietician experienced in allergies and sulfite sensitivities to help plan a diet that is adequate, while avoiding foods that increase symptoms. Dietary changes are the best way to treat a sulfite sensitivity. However, there is some scientific evidence that vitamins can help treat or prevent the sensitivity, as well.

Very high amounts of vitamin B-12 supplements – 1,500 to 5,000 micrograms or 1 to 5 millegrams per day – reduce the tendency of asthmatics to react to sulfites if taken before ingesting the sulfites. Vitamin B-12 is very safe, with no upper limits established. Due to the low level of risk involved, it may be worth trying prior to restaurant meals – but only with a doctor’s approval. Asthma sufferers should always carry an inhaler when dining out. If a reaction to sulfites has occurred before, always carry an antihistamine and self-administering injectable epinephrine.

Foods That May Contain Sulfites

People who are sensitive to sulfites should be cautious about consuming the following foods and beverages. Although many items listed will rarely contain sulfites (depending on the grower, supplier and food manufacturer), others may contain sulfites at various levels. Imported foods often contain more sulfites than locally grown and processed foods. Remember, labeling of sulfites is required only if the concentration is 10 parts per million or greater.

Bakery & Grain Products

Breads containing dough conditioners
Breading batters
Cookies
Cheese-filled crackers
Cornmeal
Cornstarch
Crackers
Frozen dough
Gravy mixes
Hominy
Modified food starch
Noodle and rice mixes
Pie and pizza crusts
Potato chips
Tortillas
Tortilla chips
Waffles

Beverages

Beverages containing sugar or corn syrup
Beer
Cider
Cordials
Dried citrus fruit beverages
Fruit juices (canned, bottled or frozen)
Instant tea
Wine
Wine coolers

Fruits & Vegetables

Coconut
Coleslaw and sauerkraut
Fruit (bottled, canned, dried, frozen or glazed)
Grapes (fresh)
Guacomole
Lettuce
Maraschino cherries
Mushrooms (canned or dried)
Peppers (bottled, pickled or canned)
Potato chips
Potatoes (“fresh cut”, frozen, fries, deli potato salad or mashed)
Tomatoes
Vegetables (dehydrated, pickled or canned)
Vegetable juices

Fish & Shellfish

Clams
Crabs
Dried fish
Lobsters
Oysters
Scallops
Shrimp

Prepared Foods

Frosting (canned and mixes)
Horseradish
Olives
Processed cheese
Relishes
Salad dressings
Vinegar

Protein Products

Infant formula
Imported sausages
Soy products
Textured vegetable protein
Tofu

Sweets & Sugars

Beet sugar or corn sweetener (in low concentrations)
Gelatin, flavored and unflavored
Hard candies
Jams and jellies
Pectin
Sugar (brown, white, powdered and raw)

Miscellaneous Foods and Ingredients

Caramel color
Dried herbs and spices
Grape juice concentrate
High-fructose corn syrup/sweeteners
Maltodextrin
Polydextrose
Trail mixes