60 Food Additives That May Be Causing Your Food Symptoms

Of the 350 additives allowed to be added to foods in Australia there are 60 that are most likely to be a problem for sensitive people. These additives include artificial/natural colours, flavour enhancers, artificial antioxidants and some preservatives.

Around 5% of the general population are sensitive to food additives. If you find you are sensitive to one food additive, for example MSG, then chances are that you will be sensitive to more. In fact, it is not uncommon for the extra sensitive individuals to be sensitive to 6 different food chemicals and additives.

If you are sensitive to at least one food additive, then you may also be sensitive to naturally occurring salicylates, amines and glutamates in some foods. Depending on how mild or severe your symptoms are, it may be worth investigating through the low chemical (salicylate | amines | glutamate | food additives) elimination diet to identify which you are reacting to, and how to manage them in your diet.

FOOD ADDITIVES

The use of food additives has allowed us to have an ongoing food supply, prevent food spoilage and give us real time protection against bacterial poisoning.

There are about 350 food additives that are allowable in Australia- used to stop food spoiling, help maintain food appeal, keep the food stable, help maintain a good mouthfeel, and can provide extra nutrition through added vitamins and minerals. Each type of food additive serves a function that allows us to have ready access to foods all year around.

Yet food additives - with particular emphasis on preservatives and MSG - get a lot of bad press. For those with food additive sensitivity, some food additives can cause issues. According to Dr Rob Loblay, head of the allergy unit at Sydney's Royal Prince Alfred Hospital, around 5 per cent of the general population are sensitive to one or more food additives. These sensitivities are actually food intolerances rather than allergic reactions, as the immune system is not involved.

The Food Standards Australia New Zealand (FSANZ) only allows food additives to be used after assessing their safety. So for the majority, food additives appear to be safe for most of us. Problems can occur if excessive amounts are consumed, or if there is a pre-existing sensitivity.

FOOD ADDITIVES MOST LIKELY TO PROVOKE SYMPTOMS

Of the 350 food additives- there are 60 additives that have been flagged as most likely to cause food reactions in sensitive people.

These 60 food additives are divided into 4 main groups:

1. Natural & artificial colours (some)

2. Flavour enhancers

3. Artificial antioxidants

4. Preservatives- some (Sorbates, Benzoates, Sulphites, Nitrates & Nitrites and Propionates)

Let's look at these.

1. COLOURS: natural & artificial:

Colour additives are used to add colour or restore lost colour in foods and drinks.

Like all food additives, if artificial colours have been added to a food or drink then this needs to be declared on the ingredient list by either the name or number or both. In the case of colours, numbers tend to be used.

The following artificial colours are eliminated in the Diagnostic Elimination Diet along with other food additives, as they can trigger symptoms in sensitive people:

• YELLOW: Tartrazine (102), Quinoline yellow (104), Sunset yellow FCF (110)

• RED: Azorubine/Carmoisine (122), Amaranth (123), Panceau 4R (124), Erythrosine (127), Allura red AC (129)

• BLUE: Indigotine (132), Brilliant Blue FCF (133)

• GREEN: Green S or Acid brilliant green (142), Fast green FCF (143)

• BLACK: Brilliant black BN or PN (151)

• BROWN: Brown HT or Chocolate brown (155)

• ANNATTO: 160b

Since 2010, across the European Union, if a food product contains any of the following 6 colours (102, 104, 110, 122, 124, 129) a warning label has to state that they may have an adverse effect on activity and attention in children. This was based on a single study.

FSANZ (Food Standards Australia New Zealand) looked at this study and did not find evidence to support lowering the safety limits for these particular colours.

A committee of the US Food and Drug Administration in 2011 reviewed whether available scientific data supported a causal link between eating food colours and hyperactivity. The committee found that current data did not support a link.

However, if you feel you or your child may be sensitive to food colour additives, then there are many case studies of people whose food symptoms are minimised when they avoid problematic food colour additives.

If you feel you are sensitive to added food colours then avoid the following colours: 102, 104, 110, 122 - 124, 127, 129, 132, 133, 142, 143, 151, 155, 160b A special note on the natural colour (annatto or 160b):

There are many natural colours that are used to colour foods and drinks such as caramel, turmeric, vegetable carbon and lutein and these are generally tolerated.

The exception is Annatto (160b) which is commonly liked to food reactions in sensitive people. Just goes to show that the word natural does not guard against food reactions!

Annatto (160b) is commonly found in margarine, custard, vanilla ice cream (see above), ice cream cones, cheeses, cakes and puddings, and noodles, just to mention a few foods.

Some companies will use 160(a) instead which is carotene or beta-carotene which is much better for the sensitive community as this additive has not been linked with food reactions.

In summary: 160(b) should be avoided but 160(a) is fine.

2. FLAVOUR ENHANCERS

We have all heard of MSG- but there are food additives that may give the same reaction as MSG.

Most savoury snacks like flavoured chips/Pringles, flavoured rice crackers/biscuits owe their taste to flavour enhancer

Lets have a look at the flavour enhancers that may cause food reactions:

• GLUTAMATES: glutamic acid (620), Monosodium glutamate = MSG (621), Monopotassium glutamate (622), Calcium glutamate (623), Monoammonium glutamate (624), Magnesium glutamate (625)

• OTHER FLAVOUR ENHANCERS: Disodium-5'guanylate (627), Disodium-5'-inosinate (631), Disodium-5'ribonucleotides (635), Maltol (636), Ethyl maltol (637)

• FLAVOUR MODIFIERS: Glycine (640), Leucine (641)

In summary: 620 - 625, 627, 631, 635 - 637, 640, 641

3. ARTIFICIAL ANTIOXIDANTS

We have all heard of antioxidants as being a good thing- but for some people, artificial antioxidants added to foods can cause distressing symptoms.

Antioxidants have an important function- without them, fat in food would go rancid. Artificially antioxidants commonly found in foods which contain fat are widespread: crackers, cake mixes, pastry, fast food- just to name a few. These antioxidants are listed in the ingredients list as their name or number or both.

Some foods that have fat as less than 5% of the ingredients do not have to list the artificial antioxidants associated with that fat due to the 5% labelling rule. This is a bit of a loop hole as people who are sensitive to artificial antioxidants may react to these unlisted antioxidants. If you are one of these, be wary of any fats or oils in a product that has less than 5g fat per 100g serving size.= (check the nutritional panel).

Natural antioxidants such as ascorbic acid (= vitamin C) or tocopherols (= vitamin E) are also food additives and these tend not to cause food reactions (300 - 309, 315, 322), although some may react.

Artificial Antioxidants known to cause symptoms in some people:

• GALLATES: Propyl gallate (310), Octyl gallate (311), Dodecyl gallate (312)

• tert-Butlhydroquinone or TBHQ (319), Butylated hydroxyanisole or BHA (320), Butylated hydroxytoluene or BHT (321)

In summary: 310 - 312, 319 - 321

4. PRESERVATIVES

There are 5 groups of preservatives that may cause food reactions in some people: Sorbates, Benzoates, Sulphites, Nitrates & Nitrites and Propionates. Sulphite sensitivity mainly impacts people with asthma, however it can also cause urticaria (hives)- a recent review suggested that up to 10% of people with asthma are sensitive to sulphites.

Benzoates have been linked to a range of symptoms such as asthma, asthma, atopic dermatitis (inflammation of the skin), rhinitis (similar to hay fever) and anaphylaxis (life threatening narrowing of the trachea making it hard to draw breath) but the scientific backing for this is lacking.

You will find preservatives in many breads, wraps, pizza bases, pastry, bread crumbs, cheese, yoghurt, soft drinks, margarine/soft spread, noodles, dried fruit, wine... the list goes on. Sulphites in cosmetics can also be an issue.

The health risk of bacon is largely to do with two food additives: potassium nitrate (also known as saltpetre) and sodium nitrite.

It is these that give salamis, bacons and cooked hams their alluring pink colour.

Preservatives that may cause food reactions:

• SORBATES: Sorbic acid (200), Sodium sorbate (201), Potassium sorbate (202), Calcium sorbate (203)

• BENZOATES, PABA: Benzoic acid (210), Sodium benzoate (211), Potassium benzoate (212), Calcium benzoate (203), Propylparaben or Propyl-p-hydroxy-benzoate (216), Methylparaben or methyl-p-hydroxy-benzoate (218), PABA (para-aminobenzoic acid)

• SULPHITES: Sulphur dioxide (220), Sodium sulphite (221), Sodium bisulphite (222), Sodium metabisulphite (223), Potassium metabisulphite (224), Potassium sulphite (225), Potassium bisulphite (228)

• NITRATES & NITRITES: Potassium nitrite (249), Sodium nitrite (250), Sodium nitrate (251), Potassium nitrate (252)

• PROPIONATES: Propionic acid (280), Sodium propionate (281), Calcium propionate (282), Potassium propionate (283)

In summary: 200 - 203, 210 - 213, 216, 218, PABA, 220 - 225, 228, 249 - 252, 280 - 283

MANAGING FOOD SYMPTOMS

Most sensitive people react to more than one food chemical or additive, and it is not uncommon for the extra sensitive individuals to be reactive to 6 different food chemicals and additives.

That is why the RPAH Elimination Diagnostic Diet or FAILSAFE elimination diet (strict level of the RPAH diet) focuses on food chemicals (salicylates, amines and glutamates) as well as the problem food additives when testing for food chemical intolerance.

For those who do not want to do the full Diagnostic Diet, there is the option of cutting out the food additives and seeing if you can get an improvement in your symptoms.

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REFERENCES

1. ABC Health & Wellbeing. The hard facts on food additives. 2013-02-14. Retrieved from: http://www.abc.net.au/health/features/stories/2013/02/14/3684208.htm. Retrieved on: 2017-22-04.2.

2. Swain AR, Soutter VL, Loblay RH. RPAH Elimination Diet Handbook with food & shopping guide. Camperdown, N.S.W. Allergy Unit, Royal Prince Alfred Hospital, 2011.3. Swain AR, Soutter VL, Loblay RH. RPAH Food Intolerance Handbook Volume II: Challenges, liberalising & management. Allergy Unit, Royal Prince Alfred Hospital, 2016.4.

3. Food Intolerance Network. Complete lists of additives. 2016-March. Retrieved from: https://fedup.com.au/information/information/complete-lists-of-additives. Retrieved on: 2017-03-22.5. Food Standards Australia New Zealand. Food Colours. 2012-June. Retrieved from: http://www.foodstandards.gov.au/consumer/additives/foodcolour/pages/default.aspx. Retrieved on: 2017-06-04.6.

4. Food Standards Australia New Zealand. Food Colours. 2015-Dec. Retrieved from: http://www.foodstandards.gov.au/consumer/labelling/ingredients/Pages/default.aspx. Retrieved on: 2017-06-04.7.

5. Skypala IJ, Williams M, Reeves L, Meyer R, Venter C. Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence. Clinical and Translational Allergy. 2015;5:34. DOI:10.1186/s13601-015-0078-3. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604636/. Retrieved on: 2017-06-04.8.

6. Loblay RH, Swain AR. Food Intolerance. In: Recent Advances in Clinical Nutrition. Vol 2, 1986. Libbey, London. Eds: Wahlqvist ML and Truswell AS, 169-177. retrieved from: http://www.slhd.nsw.gov.au/rpa/allergy/research/pubs.html. Retrieved on: 2017-03-22.