Phenols, Salicylates & Additives
Phenols, salicylates, food dyes, and additives are problems that can be addressed after the Gluten-Free/Casein-Free (GFCF) diet has been started. Generally, it is recommended for parents to address foods high in phenols, salicylates, and additives about 2-6 months after starting the GFCF or other similar diet.
Phenols are unique properties that can found in high or low amounts in different foods. High levels of phenols in certain foods seem to affect children with autism and individuals with sensitive digestive and/or immune systems. In addition, salicylates and additives can also have a negative affect the aforementioned individuals and in many cases, need to be avoided altogether.
It is important to note that almost all foods have phenols, but in different amounts. A child with low PST (phenol sulfur transferase) will have trouble processing foods high in phenols, so you will want to reduce or avoid eating foods high in phenols so the child’s body does not overload when trying to process the phenols it will ingest anyway.
People who eat large quantities of foods high in phenol or foods containing salicylates and/or additives may experience some of these negative side affects:
- laughing at inappropriate times (at night or when something is not funny)
- strange rashes that appear on the body
- erratic behaviors and moods
- self-stimulatory behaviors
- waking up in the middle of the night
- having a difficult time with their stools (constipation, diarrhea, and/or undigested foods)
It is important to note these symptoms can also be due to autism, or other medical issues. It is also common for some to experience some of the issues above and not all. For many families with children on the spectrum, eliminating or greatly reducing ingestion of phenols, salicylates, and additives resulted in much happier child with less issues.
In my son’s case, I also found he craved foods high in phenols, salicylates, or those that contained additives. For example, he would crave and eat as many bananas as I would let him eat (up to six a day) or seek foods that caused him to feel poorly and experience many of the negative symptoms above.
The only way to know if phenols, salicylates, or additives affected him was to remove them as much as possible from the diet. Within two weeks of eliminating foods high in phenols and removing foods that contained salicylates and/or additives, my son’s symptoms, for the most part, his negative symptoms, went away only to return when there was a forbidden food infraction.
There are hundreds of products that contain high levels of phenols and salicylates, and countless food sources with dyes and additives. The chart is the food list I use to know which foods to keep out of my son’s diet as much as possible.
It is important to note that my son was a very limited eater and EVERYTHING he eats now is LOW in sugar (or has no sugar) and is completely gluten-free, casein-free, and soy-, egg-, and yeast-free as well.
Items Eliminated TRY THESE IN THEIR PLACE!
Food dyes................. Avoid, period!
Tomatoes................. Just avoid for a period of 3-6 months!
Apples..................... Pears are a good replacement
Peanuts................... Almonds & cashews instead!
Bananas................... Fresh pineapple, mangos & papaya are good!
Oranges................... *See other fruits!
Cocoa..................... Try GFCF carob
Red grapes............... Try GREEN grapes (eat sparingly)
Vanilla w/ alcohol....... Frontier vanilla without alcohol
Preservatives............ Common preservatives are TBHQ, Nitrates and Nitrites (aka pink salt) BHA and BHT–AVOID!
Natural flavors.......... AVOID! Or verify what those flavors are!
Artificial Flavors ...........AVOID.
*Some other good fruit choices include FRESH: lemons,kiwis, avocados, all melons, mango and cranberries. Canned pineapple (not fresh) is good, but get it "canned" in glass, not metals. Nuts include coconuts.
It Is Important To Note
- Some phenols are concentrated in the skin and the seeds of some foods.
- Roasted nuts, juices, and dehydrated foods can cause a phenolic response. It is best to go for raw alternatives.
- Yeast-based foods such as bananas can cause a negative, but different reaction. It is worthwhile to test yeast levels as well. (For some families, it is not clear if their child has a yeast OR phenol/additive issue. Sometimes they have both issues. Both yeast and phenol/additive issues need to be addressed and monitored in many children.)
- Avoid naturally flavored and processed foods (my rule: anything with more than 10 ingredients DOESN’T make it into my son’s stomach!)
- Keep a food and behaviors journal. Track what your child eats and watch for any negative behaviors/reactions (extra hyperactivity, stimmy outbreaks, rashes on face/bottom, violent outbreaks, or night wakenings.) My son used to laugh at night for an hour (scary!), but after I removed bananas from his diet, those episodes disappeared! He now replaces them with PEARS and MANGOS, and doesn’t have a problem.
There is some great information on phenols from the Feingold Association of the United States’ website, that also includes a description of the Feingold Diet, which advocates awareness and the subsequent avoidance of all additives and chemicals in foods that may affect people’s behaviors, including special needs individuals. Please note that this article is not a primer for the Feingold diet but rather basic information about salicylates and phenols in use with people with ASD.
Phenolic & Sulphur Transferase Abnormalities Technical Description
Sulphur Transferase Abnormalities
Waring (1993), encouraged and supported by O'Reilly (1993) and other parents, has published data which convincingly demonstrates deficiencies in the sulphur- transferase capabilities of people with autism. They have demonstrated also that this inadequacy is the consequence not of an absence of the responsible enzyme (sulphur transferase) but of the sulphate ions which are needed if the sulphation is to be accomplished.
If this sulphation process is not functioning satisfactorily there are many possible consequences which may be of relevance in the autistic syndrome. These have been described elsewhere (Waring 1993). It is worth recording that similar deficiencies have been reported in people with migraine, rheumatoid arthritis, jaundice and other allergic conditions all of which are frequently reported as being common in the families of people with autism. I am unaware of any survey which actually demonstrates this and nothing better than anecdotal evidence exists.
Clearly, if there is a deficit of available sulphate in the body attempts can be made to replace it. Unfortunately, sulphate ions are not absorbed from the gut so this route is not a possibility. The main source of free sulphate in the body is the amino acid "cysteine" which is obtained from the breakdown of appropriate protein material and it is this stage which may be faulty in people with autism. Some parents have attempted to combat this by feeding their children with abnormally large doses of cysteine in tablet or powder form but, as far as I am aware, the only result is a high concentration of urinary cysteine. Other parents have introduced other sulphur containing amino-acids to the diet and claim these to be beneficial.
Unfortunately the claims are difficult if not impossible to assess since those parents experimenting with this intervention are likely to be experimenting simultaneously with many others. Interestingly, the sulphur containing amino-acid "Taurine" which may be given to patients for this purpose, is reported as having an anti-opioid effect (Braverman 1987).
Since free sulphate is not absorbed orally, parents have been experimenting with alternative routes. One route which is increasing in popularity, is the percutaneous one. Magnesium Sulphate (Epsom Salts) are placed in the bath water in the hope that the sulphate will enter the body, if not via the back door, via an alternative route. Many parents have claimed benefits from this therapy and some high functioning adults have tried it for themselves. The majority claim positive changes in behaviour but some of the high functioning people have reported increased irritability (and so stopped using this therapy). Any perceived benefits may, of course, be totally unrelated to the sulphate element of the salts. It could be that the Magnesium (which is often supplied as a supplement to people with autism,) is the significant component.
The question arises as to whether sulphate ions could enter the body in this way but, if so, it could provide an intellectually satisfying explanation for the long history of the use of spas in the treatment of rheumatic conditions.
Sulphur transferase activity is important for many biological reaction in the body and some of these may be of relevance in the aetiology of autism. For example, the system is involved in the breakdown of bilirubin and biliverdin, the breakdown products of haemoglobin which are seen where bruising has occurred. It may be pushing speculation a long way but it is possible that the dark rings so often seen around the eyes of people with autism may be evidence of a lack of activity within this system. This system is also required for the breakdown and removal of phenolic compounds, indeed the tests used for estimation of its activity relies upon the conversion of paracetamol to its sulphate.
An inadequately functioning system will also result in abnormal metabolism of some neurotransmitters. In particular, serotonin, (5-HT) metabolism will be affected and the appearance of unusual metabolites (such as the hallucinogen bufotenin) could be predicted. Such an observation has been reported (Himwich 1972) but its significance is uncertain.
Other Interfering Foodstuffs
As indicated above, an adequately functional sulphur transferase system is a prerequisite for the removal of phenolic compounds from the body. Since the availability of available sulphate ions is finite, the same will apply to the ability of the body to deal with such compounds. Thus when certain foodstuffs with high phenolic content are eaten they will utilise the available sulphur transferase resources of the body and thus exacerbate the problems referred to above.
Many parents have observed that apples, oranges and other citrus fruits, chocolate (possibly on account of the phenol flavouring vanillin) and certain other foods will induce severe deterioration in the behaviour of their children with autism. Interestingly, two parents (who must remain anonymous) have contacted me independently and stated that when this situation arises, they have observed that "Cranberry Juice" will markedly reduce or even eliminate these effects. Whether this due to the sulphur content of the juice or some other mechanism or whether the effects are imaginary remains to be determined.
Some parents have found that there ate other foodstuffs which can cause problems; in particular they have removed all traces of pigment form the diet of the child (Johnson 1995). Since all of these dietary exclusions tend to be in addition to gluten and casein removal, it is difficult to ascertain precisely which elements of the exclusion are of relevance to any reported improvements.
There has been considerable discussion in the media for many years about the involvement of synthetic pigments, in particular tartrazine, in worsening the symptoms of autism. Considerable anecdotal evidence exists for their role in increasing hyperactivity (where autism is not involved). Parental reports suggest that removal of synthetic pigments from the diet have, in the vast majority of cases, made no difference whatsoever.
Salicylates Technical Summary
Eliminate salicylates, artificial colors, flavors, and preservatives.
Salicylates are naturally occurring chemical compounds thought to interfere with the production of several brain chemicals, including norepinephrine, acetylcholine, and dopamine. Foods containing salicylates include: apples, apricots, berries, oranges, nectarines, grapes, peaches, plums, cucumbers, tea, and tomatoes.
Also, eliminate aspirin-containing compounds and perfumes.
Food Dyes and Other Additives: Studies (conducted by Dr. Ben Feingold, Dr. Stephen Lockey, and others) found that food dyes and food additives were responsible for the hyperactivity in many of the hyperactive children the doctors had seen in their practices. In particular, red, orange, and green dyes were the worst offenders. Also, preservatives should be eliminated, especially BHA (butylated hydroxyanisole) and BHT (butylated hydroxytoluene).
Monosodium Glutamate(MSG): This is a food additive used to enhance the flavor of food and is commonly found in many popular foods, at the grocery store or in restaurants and fast food chains. However, it is highly suspected of causing behavioral problems among people sensitive to chemicals and additives in their diets and endangering people’s health. Symptoms of a bad reaction to MSG may include headaches/painful migraines, nausea, depression, chronic fatigue, sleep disorders, etc.