Salicylates
Salicylates are naturally occurring chemicals found in fruits and vegetables. People can have a sensitivity to salicylates and this sensitivity can manifest through skin, gastrointestinal, respiratory, and nervous system issues. People with autism often have low sulfate levels which leads to impaired sulfation and sensitivities to salicylates and phenols in general.
Quick Facts
Salicylates are naturally-occurring chemicals found in fruits and vegetables. People can have a sensitivity to salicylates and this sensitivity can manifest through skin, gastrointestinal, respiratory, and nervous system issues.
Phenols are a group of chemical compounds that include salicylates, amines and glutamates. All may be potentially problematic for different people, though this note will specifically focus on salicylates. In short, salicylates are phenols (technically a particular category of phenol).
Phenols or polyphenols have been associated in animal research with protective effects against cancer, cardiovascular disease, diabetes, and Alzheimer’s disease, and anti-aging properties. This drives home the point of bio-individuality in that even food compounds that may be beneficial for some people can be detrimental to others.
Sulfation is the process by which our bodies break down phenols.
Sulfate is critical to the function of this enzyme and insufficient sulfate can lead to poor sulfation and reactions to phenols. This is where salicylates intersect with autism. People with autism often have low sulfate levels which lead to impaired sulfation and sensitivities to salicylates and phenols in general.
Salicylate sensitivity manifests most often with:
Rhinitis or inflammation of the nasal membranes
Asthma
Nasal polyps
Urticaria
Gut inflammation as evidenced by gastrointestinal pain or upset
Foods Containing Salicylates
Fruits:
Most fruits especially berries, granny smith apples, grapes, pineapple, kiwi, peaches, nectarines, apricots, cherries, cantaloupe, and watermelon
Dried fruits like raisins, currants, and dates
Vegetables:
Cucumbers, asparagus, sweet corn, tomatoes, black and green olives, sweet potatoes, spinach
Tomato sauce and tomato paste
Almonds, brazil nuts, coconut, macadamia nuts, pine nuts, pistachios, walnuts, water chestnuts, and lentils
Other:
Honey and flavored syrups
Licorice and peppermint candies, fruit snacks, candied fruit and commercial candy, flavored gelatin
Certain types of tea including peppermint, lemon, black tea, coffee
Drink mixes, fruit-flavored powders, concentrates, pineapple juice, cider, orange juice, tomato juice, cranberry juice, and wine
Carbonated drinks and soft drinks
Ice cream, yogurt, or frozen desserts with high salicylate fruits
Herbs and spices, especially curry, paprika, thyme, garam masala, anise, rosemary, basil, cumin, cinnamon, mint, mustard, oregano, turmeric, flavoring extracts, and flavoring packets
Condiments like mustard, pickles and relish, ketchup, Worcestershire sauce, commercial salad dressings, and commercial gravies
Low salicylate foods
Plain fresh, frozen, or canned meat, poultry, and fish
Eggs
Fruits:
Vegetables:
Grains & Legumes:
Nuts, Seeds & Their Oils:
Fresh cashews, hazelnuts, and pecans
Plain, natural peanut butter
Dry sesame seeds and sunflower seeds
Butter, cream, milk, sour cream, and plain yogurt without additives
Other:
Homemade condiments without any ingredients to avoid
Margarine and vegetable oils, lard
Baking chocolate, confectioner’s sugar, maple syrup, corn syrup, molasses, sugar and pure cocoa
Certain herbs and spices like pepper, parsley, nutmeg, horseradish, fresh ginger, fresh garlic, fresh coriander, dried allspice
Plain coffee, plain carbonated, and mineral water
Baking powder and baking soda, distilled white vinegar, malt vinegar, plain gelatin, pure vanilla extract, pure soy sauce
NON-FOOD ITEMS CONTAINING SALICYLATES
Some medications (like aspirin) and beauty products also contain salicylates. Aspirin contains a much higher dose of salicylate than any food so those with a sensitivity should avoid it.
Beauty products that may contain salicylates include sunscreen, perfume, shampoo and conditioner, cosmetics, lotions, cleansers, mouthwash, toothpaste, shaving cream and muscle pain creams/balms. Those with a sensitivity to salicylates should determine if topical salicylates like those in these personal care products cause a reaction.
Chemical reactions
The body can respond to foods and/or chemicals in many different ways including allergies and sensitivities. If you suspect a chemical reaction, you can either choose to avoid the chemical or additional testing.
Salicylates & Autism in the Research
Salicylate intolerance
Asthma, rhinitis and nasal polyps, as well as chronic gastrointestinal irritation and urticaria following acetylic salicylic acid ingestion may suggest intolerance. [1]
Autism risks
Recent epidemiological studies have shown a strong statistical correlation between risk for ASD and either maternal or infantile atopic diseases, such as asthma, eczema, food allergies and food intolerance, all of which involve activation of mast cells. [2]
This study provides evidence that pregnancy environmental phenol exposures may increase the risk for non-typical development in a high-risk population. [3]
Sulfation and autism
Severe autism was associated with low sulfate levels while mild symptoms were associated with higher levels of sulfate, which suggests that sulfate may be helpful in reducing both the incidence and severity of autism. [4]
Three toxins most implicated in the U.S. autism epidemic are acetaminophen (Tylenol), oral antibiotic amoxicillin/clavulanate (Augmentin), and most recently herbicide glyphosate (Round-up). Acetaminophen depletes sulfate and glutathione required to detoxify it. Oral antibiotics kill and glyphosate inhibits intestinal bacteria that synthesize methionine (precursor of sulfate and glutathione, and required to methylate DNA). [5]
Researchers have noted that patients with ASD have various metabolic and nutritional abnormalities including issues with sulfation, methylation, glutathione redox imbalances, oxidative stress, and mitochondrial dysfunction. [6]
Children may respond to sulfate supplements in the form of magnesium sulfate via epsom salts in bathwater or as trace minerals. They may also benefit from removing chocolate, bananas, citrus and artificial food colorants from their diet because a combination of low sulfotransferase activity and low sulfate levels greatly reduces the capacity for detoxification of amines and phenols, both endogenous and exogenous. [7]
Children with autism had high urinary sulfate levels. Reduction of urinary sulfate levels was associated with improvement in clinical symptoms as reported by caregivers. [7]
References
[1] Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int. 2008;105(8):137-42.
[2] Theoharides TC, Tsilioni I, Patel AB, Doyle R. Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders. Transl Psychiatry. 2016;6(6):e844.
[3] Barkoski JM, Busgang SA, Bixby M, et al. Prenatal phenol and paraben exposures in relation to child neurodevelopment including autism spectrum disorders in the MARBLES study. Environ Res. 2019;179(Pt A):108719.
[4] Williams RJ. Sulfate Deficiency as a Risk Factor for Autism. J Autism Dev Disord. 2020;50(1):153-61.
[5] Good P. Evidence the U.S. autism epidemic initiated by acetaminophen (Tylenol) is aggravated by oral antibiotic amoxicillin/clavulanate (Augmentin) and now exponentially by herbicide glyphosate (Roundup). Clin Nutr ESPEN. 2018;23:171-83.
[6] Bjørklund G, Waly MI, Al-Farsi Y, et al. The Role of Vitamins in Autism Spectrum Disorder: What Do We Know. J Mol Neurosci. 2019;67(3):373-87.
[7] Waring, R., 2009. Sulphur Metabolism In Autism. [online] researchgate.net. Available at: <https://www.researchgate.net/publication/232032839_Sulphur_Metabolism_in_Autism> [Accessed 12 November 2020].
AuthorS
Elisa Rocks, RDN
Sinead Adedipe, MS
Brittyn Coleman, MS, RDN/LD, CLT
