Salicylates and the Feingold Program
At the beginning of the Program we recommend temporarily removing foods with “salicylates.” most of them are common fruits like apples and grapes, but other fruits can be substituted, such as bananas and watermelon, which are generally well tolerated.
Willow bark, which has long been used to ease pain and fever, contains salicylate which is the basis for aspirin. Some plants make salicylates to protect themselves from insects and disease.
While salicylate-containing medicines such as aspirin can offer benefits, and plants that contain salicylates can be very nourishing, they are not well tolerated by everyone. They can trigger the same behavior, learning or health problems as additives.
Fortunately, many Feingold members do not have a problem with salicylates, and those people who are sensitive usually only need to avoid a few of them.
By temporarily removing salicylates, and later reintroducing them, you should be able to determine if any of them are a problem. Many people – even children who seem very sensitive to many of the salicylates – are able to add them back after they have avoided them for an extended time.
Many people believe ...
Many people believe that by measuring the salicylate content of various foods, we can assume that those with the highest levels are the ones that will cause problems. Unfortunately, it is just not that simple. Read on below …
- There are various kinds of salicylates (see list at bottom of this column). We don’t know which ones are most likely to cause adverse reactions – and even if we did, we don’t know which ones are in which fruits and vegetables.
- The amount of salicylate can vary from one variety of a fruit to another, and even the levels in a particular plant can change. For example, organic fruits in an orchard that has been attacked by pests will make more salicylate than other fruits.
- Different parts of a plant might have different levels of salicylate. The amounts can vary between the pulp, seeds, and peel of a fruit or vegetable.
- Sensitivity can vary depending on whether the fruit or vegetable is raw or cooked. For example, fresh pineapple may cause a problem for the same person who tolerates canned pineapple or pineapple juice. (Canned pineapple is acceptable on Stage One of the Feingold Diet, but fresh pineapple should not be used at the very beginning.)
- Foods grown in one region might not be the same as foods grown in another.
- We don’t even know that it is only the salicylate in a food that is to blame; there could be other naturally-occurring chemicals that play a part.
- Typically, a salicylate-sensitive person has problems with only some – not all – salicylates.
- Salicylate sensitivity can change; frequently a person who avoids them for a year or so can later tolerate moderate amounts of them.
In the beginning ...
In his allergy clinic at the Kaiser Permanente Medical Center in San Francisco, Dr. Feingold searched for help to identify which salicylates were likely to bother the patients. The only list of foods with suspected salicylates was decades old, but he decided to use this list as a starting point, with plans to refine it as he gained more experience with patients. Actually, the list of salicylate-containing foods turned out to be useful and he did not have to make many changes.
Over the years ...
Over the years, the Feingold Association has gathered information from our members and made small modifications to the original list. However, we find that Dr. Feingold’s techniques still work well. We ask the new member to remove all of the medical salicylates and all the “natural salicylates” that appear to be most likely to trigger problems. Once they are seeing a successful response they may begin to gradually add back the salicylates, one at a time, and test them out. While most people are able to add back those foods, there is an advantage to continuing on the Stage One (salicylate-free) part of the program for a longer time. If salicylates are avoided for a longer period, they will be more likely to be tolerated later.
Like any elimination diet ...
Like any elimination diet, the Stage One period of the Feingold Program works best if all the potential offenders are removed at the beginning, if a diet diary is kept, and if salicylates are reintroduced cautiously.
Reactions to salicylates
Reactions to salicylates can vary drastically. Here are some reactions that have been reported to us.
- Apples caused Kathy to have seizures.
- Bradley was doing very well in speech therapy. The therapist was helping him at his home when they took a 15-minute break, during which time his mom forgot and gave him an orange. When the therapist tried to work with Bradley again, he had regressed dramatically.
- Jerry had major behavior and learning problems from raisins and grapes.
- Gloria had night terrors from various salicylates.
People who are interested in eating healthy food generally consume many of the salicylate-containing fruits and vegetables, and those who give nutrition advice typically encourage the consumption of these foods. For most people, this is good advice, but for someone who is salicylate-sensitive, it can make things worse.