Fruits with salicylates are foods with preservatives that may have salicylates, as well as a list of other individual fruity items like: berries, grapes, melons, etc that you might be more familiar with instead. The fruits which contain high amounts of salicylates include apples, apricots, grapes, strawberries, oranges, guava, pears and plums.
High Salicylate Foods
Salicylates are natural chemicals made by plants. They are found in fruits and vegetables and help protect plants against disease and insects.
Salicylate extracts have been used medicinally for thousands of years. Salicylic acid, more commonly known as aspirin, relieves pain and inflammation and lowers fevers. However, salicylates can also cause health problems for people who take them. Learn about what salicylate does in the body and when you should avoid it.
Why You Should Avoid Salicylates
For many, salicylates provide the same protective effects in your body as they do for the plants that produce them. Like the Mediterranean, vegetarian, or vegan diets, high salicylate diets have proven health benefits like lower risks of cancer, heart disease, and diabetes.
Medicinally, salicylate derivatives like white willow bark, methyl salicylate, and salicylic acid provide anti-inflammatory and pain-relieving benefits. Aspirin is often used to manage heart disease and has contributed to lowering heart disease death rates.
However, for others, salicylates in the diet can lead to health problems. Such issues include insensitivities, allergies, and swelling of different organs.
Allergies
Some people have developed an allergy to dietary salicylates. Those who are allergic to salicylates must avoid aspirin, white willow bark, methyl salicylate, and any medications that contain salicylic acid. Therefore, it’s important to read any labels for these ingredients before buying or taking medication.
Some individuals are particularly sensitive to the salicylates found naturally in fruits and vegetables. If you have any symptoms of a possible salicylate allergy, you should avoid foods such as:
- Blueberries
- Apples
- Avocados
- Mushrooms
- Cauliflower
- Coffee
- Pine nuts
It’s important to remember this is not a complete list of all of the foods containing salicylate. To know if a food contains salicylate, look up the item before you shop.
Allergy symptoms can include:
- Itching or hives
- Swelling of the hands or feet
- Nasal congestion
- Headaches
- Stomach pain
- Diarrhea
In some cases, people with severe allergies can go into anaphylactic shock (closing of the wind pipe). Get medical help right away if you experience any severe allergic reactions.
Reye’s Syndrome
When people have a headache, they often take medication like aspirin to help ease their symptoms. However, studies have shown that some people who take aspirin for these problems — particularly children or teenagers — develop swelling in the liver and brain. Called Reye’s syndrome, this is a serious, yet rare, condition that requires medical attention.
Low Salicylate Diet
What is Salicylate Intolerance?
Salicylate (suh-lih-suh-late) intolerance or salicylate sensitivity is when the body has a reaction to salicylates, but it does not involve the immune system.
In people who are sensitive to salicylate, when they eat foods that contain salicylates they may have symptoms of nasal polyps, bronchial asthma, rhinitis, gastrointestinal inflammation, diarrhea or hives.
They also need to avoid medications and skin products that contain salicylate including aspirin, bismuth subsalicylate, choline salicylate, diflunisal, magnesium salicylate, and salsalate.
What are Salicylates?
Salicylate is a natural chemical found in plants that is used to protect themselves against disease, bacteria, fungi and insects. It is in varying amounts in foods and drinks that we consume, including vegetables, fruits, nuts, spices, alcohol, coffee and tea.
The synthetic form of salicylate is acetyl salicylate (aspirin). The amount of salicylate in plant-based food is lower when compared to taking a moderate dose of aspirin.
Although salicylate may cause issues for some people there is recent research looking at the beneficial effects they may have within the body. This includes its anti-inflammatory effect and also whether the positive effect of eating fruits and vegetables could be related to the levels of salicylates consumed.
What is a Low Salicylate Diet?
A low salicylate diet means that you carefully eat foods that contain no salicylate or that are low in salicylate, and you avoid high salicylate food. This diet may reduce symptoms of salicylate intolerance.
Usually you start by eliminating foods that contain salicylates, then reintroduce foods slowly to identify whether salicylates are tolerated and what level they are able to be consumed without causing symptoms.
If you are exploring a low salicylate diet it is important to consult a registered dietician as by removing or reducing fruit and vegetables from your diet may cause deficiencies in vitamins, minerals and other nutrients.
Currently there are no peer-reviewed studies supporting the use of low salicylate diet in children, and due to the risk of negative outcomes including nutritional deficiencies, eating disorders or food aversion issues a low salicylate diet in children is not often recommended.
There are currently no standard tests to diagnose salicylate intolerance.
List of Foods that are High or Low in Salicylates
Many studies have be done to report the levels of salicylate in different foods, however the results remain variable due to differences in testing methods, where the products come from, type of food processing and storage. For this reason food lists should be used as a general guide.
Beverages
High salicylate beverages (Avoid)
- Beer, birch beer, and root beer
- Bubbly drinks (like soda pop)
- Regular coffee
- Tea
- Wine, port, rum and liqueurs
Low salicylate beverages (OK to drink):
- Cereal drinks
- Decaffeinated coffee
- Milk (any kind)
- Pear juice (homemade)
- Whiskey, vodka or gin
Breads and Starches
High salicylate breads and starches (Avoid):
- Sweet potato
Low salicylate breads and starches (OK to eat):
- Breads and cereals
- Noodles and pastas
- Peas
- Rice
Desserts / Sweets
High salicylate desserts and sweets (Avoid):
- Mint or wintergreen products
- Pies and cakes made with fruits
Low salicylate desserts and sweets (OK to eat):
- Homemade cakes and cookies made without high salicylate fruits and jams
Fats
High salicylate fats (Avoid):
- Almonds, peanuts and avocados
- Mayonnaise
- Olives and olive oil
- Salad dressings
Low salicylate fats (OK to eat):
- Butter and margarine
- Cashews and poppy seeds
- Vegetable oils
Fruits
High salicylate fruits and juices (Avoid):
- Apples
- Apricots
- Berries: blackberries, boysenberries, raspberries, blueberries, cranberries and strawberries
- Cherries
- Currants
- Dates
- Gooseberries and huckleberries
- Grapes and raisins
- Kiwifruit
- Lemons
- Melon (all kinds)
- Oranges and mandarins
- Nectarines and peaches
- Pineapple
- Plums and prunes
- Pomegranates
Low salicylate fruits and juices (OK):
- Apples (golden delicious variety)
- Bananas
- Nashi pears
- Papayas
- Pears (peeled)
- Rhubarb
Vegetables
High salicylate vegetables (Avoid):
- Alfalfa sprouts
- Asparagus
- Beetroot
- Broccoli
- Chilli
- Cucumber
- Endive
- Olives
- Peppers (Capsicum)
- Radishes
- Tomatoes
- Zucchini
Low salicylate vegetables (OK to eat):
- Brussels sprouts
- Cabbage
- Celery
- Green beans
- Iceberg Lettuce
- Potato (white, peeled)
NUTRITION
Evidence Based
Salicylate Sensitivity: Causes, Symptoms, and Foods to Avoid
Food sensitivities and intolerances are common problems that can be difficult to diagnose.
While salicylate sensitivity, also known as salicylate intolerance, is not as common as gluten or lactose intolerance, it’s a real issue for some people.
Salicylates are compounds found in foods, medications, and other products that can cause adverse reactions in those who cannot tolerate them ().
A sensitivity to these compounds is associated with a wide variety of symptoms and can therefore be hard to identify.
This article explains the causes and symptoms of salicylate sensitivity, including which foods to avoid.
What are salicylates?
Salicylates are a group of chemicals derived from salicylic acid.
They are found naturally in certain foods and manufactured for use in products such as aspirin, toothpaste, and food preservatives.
Both natural and synthetic forms can cause adverse reactions in some people.
Plants produce natural salicylates to defend against harmful elements like insects, fungus, and disease ().
Natural salicylates are found in a wide array of foods, including fruits, vegetables, coffee, teas, nuts, spices, and honey.
Meanwhile, the synthetic form is commonly used as a food preservative and found in medications like aspirin and Pepto-Bismol.
Compared to foods, medications such as aspirin contain larger amounts of salicylates, which is why salicylate intolerance is most commonly linked to medications.
For example, dietary intake of salicylates is usually 10–200 mg per day. Comparatively, a single dose of aspirin can contain 325–650 mg of salicylates, depending on the type ().
SUMMARY
Salicylates are chemicals found naturally in certain foods and manufactured for use in medications and other products.
What causes salicylate sensitivity?
While consuming excessive amounts of salicylates can result in adverse reactions in anyone, most people can safely consume foods rich in them on a daily basis or take a couple of aspirin now and then for a headache.
However, those with a sensitivity to salicylates may experience side effects when they consume a food or use a product that contains even small amounts of these chemicals.
These people have a decreased ability to properly metabolize and excrete salicylates.
Salicylate sensitivity is thought to be caused by an overproduction of leukotrienes — inflammatory mediators that have been linked to a variety of conditions, including asthma, allergic rhinitis, anaphylaxis, rheumatoid arthritis, and interstitial lung diseases ().
This overproduction is caused by the inhibition of cyclooxygenase, an enzyme that regulates the production of leukotrienes ().
The buildup of leukotrienes in the body leads to symptoms related to salicylate intolerance.
In fact, it’s estimated that 2–22% of adults with asthma are sensitive to these compounds ().
Research also suggests that people with food allergies and inflammatory bowel disease are more likely to have this intolerance ().
SUMMARY
People with salicylate intolerance cannot consume even small amounts of these chemicals without experiencing negative side effects.
Symptoms of salicylate sensitivity
Salicylate sensitivity can cause varied symptoms that mimic those of allergies and other illnesses.
What’s more, some people experience symptoms only in the presence of unrelated allergies, making salicylate sensitivity a difficult condition to diagnose.
The most common symptoms involve the respiratory tract. However, the skin and intestinal tract may also be affected.
Symptoms include ():
- stuffy nose
- sinus infection and inflammation
- nasal and sinus polyps
- asthma
- diarrhea
- gas
- abdominal pain
- gut inflammation (colitis)
- hives
- tissue swelling
However, keep in mind that symptoms can vary from person to person.
The amount of salicylates that triggers a reaction can differ depending on the individual’s ability to break them down.
Therefore, some people experience symptoms after being exposed to a small amount of these chemicals, while others can tolerate larger amounts before they have a reaction.
SUMMARY
Salicylate sensitivity is linked to a variety of symptoms, including stuffy nose, asthma, diarrhea, and hives. It can be difficult to diagnose because its symptoms can vary from person to person.
Which foods contain salicylates?
A number of foods contain salicylates.
Fruits, vegetables, and spices tend to contain the largest amounts, though salicylates are found in other foods as well.
The salicylate level of a food can vary based on a number of factors, including growing conditions, preparation, and level of ripeness.
For example, dried fruits contain larger amounts than raw fruits as a result of the removal of water during processing.
Foods highest in salicylates include ():
- Fruits: raisins, prunes, apricots, blackberries, blueberries, cherries, cranberries, grapes, pineapples, plums, oranges, tangerines, strawberries, and guava
- Vegetables: broccoli, cucumbers, okra, chicory, endive, radishes, zucchini, watercress, alfalfa sprouts, eggplant, squash, sweet potato, spinach, artichokes, and broad beans
- Spices: curry, aniseed, cayenne, dill, ginger, allspice, cinnamon, clove, mustard, cumin, oregano, pimiento, tarragon, turmeric, paprika, thyme, and rosemary
- Other sources: tea, rum, wine, cordials, vinegar, gravies, mints, almonds, water chestnuts, honey, licorice, jam, chewing gum, pickles, olives, food colorings, aloe vera, savory-flavored chips and crackers, and fruit flavorings
This list is not exhaustive, as there are many other food sources of these compounds.
Salicylates are also found in a number of non-food products, including:
- mint-flavored toothpaste
- perfumes
- shampoos and conditioners
- mouthwash
- lotions
- medications
Furthermore, salicylates can be absorbed through the skin, so those with an intolerance should be aware of the ingredients in lotions, cleansers, and perfumes .
The most potent sources are aspirin and other nonsteroidal anti-inflammatory drugs, including ibuprofen ().
SUMMARY
Salicylates are found in a number of foods, as well as in non-food products like toothpaste and medications.
Diagnosis and management
While salicylate intolerance to medications like aspirin has been established, there is a lack of research exploring salicylate intolerance to foods. Currently, there are no laboratory tests to diagnose it. However, certain tests may be used to rule out an allergy.
The standard test for salicylate intolerance to medications is exposure or provocation, which involves administering a small amount of salicylic acid and monitoring for symptoms.
Only healthcare professionals should administer this test, as serious reactions can occur.
People who have a known intolerance to aspirin and other medications that contain salicylates should avoid these medications.
However, having a diagnosed sensitivity to aspirin and other medications high in salicylates doesn’t necessarily mean you need to avoid salicylate-rich foods.
This is because medications such as aspirin contain much larger amounts of salicylates than foods do, and an intolerance is usually dose-dependent.
Still, people who are extremely sensitive to salicylates may benefit from restricting their intake of foods that contain these compounds.
A detailed medical history, including a food and symptom diary, is the best indicator a healthcare professional can use to diagnose a salicylate intolerance.
If a healthcare professional suspects an intolerance, an elimination diet that excludes foods rich in salicylates is usually the treatment option of choice.
SUMMARY
To diagnose an intolerance to salicylates, a healthcare professional will usually take a detailed history of diet and related symptoms. People who are very sensitive to dietary salicylates may require a salicylate-restricted diet under the direction of a doctor or registered dietitian.
Salicylates in foods
Anne R. Swain, Stephen P. Dutton, and A. Stewart Truswell’ Human Nutrition Unit. University of Sydney, New South Wales, Australia To determine salicylate content, 333 food items were anaivzed. Foods were homogenized with 25% sodium hydroxide, allowed to stand overnight, acidified with concentrated hydrochloric acid, and then extracted with warm diethyl ether over 5 hours. The extract was dried a�d taken up in dilute sodium bicarbonate solution tor analysis. Salicylic acid was separated by high performance liquid chromatography and quantified by reading at 235 nm. Salicylic acid standards were used throughout to standardize extractions and analyses. This is the most comprehensive set of data on food salicylates yet pU.blished; extraction appears to have been more complete tor some foods, giving higher values than those previously published. ,’vlost fruits, eS;Jecially berry fruits and dried fruits, contain salicylate. Vegetables show a wide range from 0 to 6 mg salicylate per 100 gm food (for gherkins). Some herbs and spices were found to contain very high amounts per 100 gm, e.g., curry powder, paprika, thyme, garam masala, and rosemary. Among beverages, tea provides substantial amounts of salicylate. Licorice and peppermint candies and some honeys contain sal icylates. Cereals, meat, fish, and dairy products contain none or negligible amounts. The Feingold diet for treatment of hyperactivity in children was devised to exclude foods that contain artificial colorings, artificial flavorings, and natural salicylates. Exclusion of fruits and vegetables was based on German analyses of sal icylate content done at the turn of the century. Information on the exact quantities of salicylate in foods has not been generally available, nor has it been ‘The .uthor<; t�ank Mr<;. S. Vindedz,s and Or. F B. Wh,tehead ;or copies of unpublished references ’24 and 51) Th�v are .ery grateful to Professor A. Basten, Josephme Rogers, MaXlne Hosk,ng, Dr. Roberc Lobl.y, Dr. Shervl Van Nunen and Professor R. CI.ncy for support and encouragement and 10 Ceo” Hutct’ison ror adVice on high performance liqUid chromatography IHPLC’ methodology. The authors also thank Dr. I. R. Brown and M. P. Smyth !Mass Specuometry Un,t, School oi Chemistry, Linlyef>ity or Sydney) ior the CC-.MS co�f”mation of salicylate peaks irom the HPLC. certain whether permitted foods are completely free of salicylate. There have been claims from fruit canners that some of the fruits excluded by Feingord did not contain appreciable salicylate. Emphasis on salicylates in hyperactivity has decreased; there has been more interest lately in artificial colors . Meanwhile, interest has been growing in the role of salicylates in some cases of urticaria and of asthma. It has long been known that urticaria may follow the ingestion of acetyl salicylic acid medication, but it is now realized that salicylates in foods also can precipitate acute urticaria or exacerbate chronic urticaria. Salicylate-sensitive urticaria was first nored by Calnan . Warin in 1960 reported that 22 of 70 patients with chronic urticaria developed exacerbations after administration of aspirin. Moore-Robinson and Warin reported an incidence of 22% of 228 patients, and Champion et al. in 1969 found that 21 % of 268 patients with chronic urticaria reacted to aspirin. lames and Warin in 1970 reported further investigations in a series of 100 patients with chronic urticaria. Ninety-six patients had been given test doses of aspirin in a “patient blind” manner; 37 of the 96 patients gave a positive reaction to the test dose. Several authors reported that diets constructed to exclude salicylate mav induce prolonged remission of urticaria in those patients who have shown a positive response to oral aspirin challenge . In 1972, Lackey discussed the part played by salicylates in various foods. Seventy-five percent of the patients of Warin and Smith either cleared or considerably improved after being on the appropriate diet for a 2-month period. This improvement was in line with the results obtained by others, including Michaelsson and Juhlin in 1973 and Doeglas ) in 1975. More recently, Ros et al. () reported their results with exclusion diets. Fifty-nine patients who reacted to salicylates, preservatives, and azo dyes were given a diet designed to reduce consumption of those items. This produced remission in 24% and improvement in 57%. Similarly, Juhlin () in 1981 reported that most patients improve when given a diet free from the chemicals to which they reacted. It is well known that aspirin may exacerbate asthma. McDonald et al. reported that 8 of 42 patients with severe asthma and no history of aspirin exacerbations reacted to an aspirin challenge ci 540 m