BENZOATE INTOLERANCE
Benzoic acid, sodium, potassium, and calcium benzoate, and a variety of forms of these chemicals, are used in many different manufactured food products. They have a wide range of uses, such as keeping our food free from contaminating microorganisms, preserving food color, and preventing separation of oils and water (emulsifying). In addition, benzoates occur naturally in some foods, including berries, prunes, tea, and cinnamon. For most people, benzoates pose no threat and cause no adverse symptoms when eaten even in relatively high doses. However, there is a small group of people who do react adversely to benzoates. This chapter is addressed to that small group and provides information on the what, where, and why of benzoate sensitivity, as well as instructions on avoiding all forms of benzoates in the diet, while still obtaining complete balanced nutrition.
Benzoic Acid and Sodium Benzoate
Both benzoic acid and sodium benzoate are chemicals that manufacturers use to prevent spoilage by microorganisms in a wide variety of processed foods, beverages, and pharmaceuticals, thus extending their shelf life. Benzoic acid is a common ingredient in flavorings (specifically, chocolate, lemon, orange, cherry, fruit, nut, and tobacco) that are used in carbonated and noncarbonated beverages, ice cream, ices, candies, baked goods, pie and pastry fillings, icings, and chewing gum. It may also be used in pickles and margarines. In such processed foods, benzoic acid is used up to a level of 0.1%.
Benzoic acid occurs naturally in foods at varying levels (Table Benzoates: examples of their sources and use as additives). High levels occur in
♦ Most berries, especially strawberries and raspberries
♦ Prunes
♦ Tea
♦ Spices such as cinnamon, cloves, and anise
♦ Cherry bark and cassia bark
Sodium, potassium, and calcium benzoate are used as preservatives in margarine, codfish, bottled soft drinks, maraschino cherries, mincemeat, fruit juices, pickles, fruit jelly preserves, and jams. In addition, these chemicals may be added to the ice used for cooling fish, and they may be ingredients in eye creams, certain skin creams, and toothpastes.
What Happens to Benzoates in the Body?
Benzoic acid, sodium, potassium, and clacium benzoate are rapidly absorbed into the body from the digestive tract. They are then taken up and circulated in blood. Upon reaching the liver they combine with the amino acid glycine and are excreted from the body through the kidneys in urine. As long as liver function is healthy, and adequate glycine is available, these chemicals are completely eliminated from the body.
Benzoyl Peroxide
Benzoyl peroxide is used primarily as a bleaching agent in the manufacture of
♦ White flour
♦ Some cheeses (especially blue cheeses such as Gorgonzola)
♦ Lecithin
Lecithin is an emulsifier, which allows dissimilar food ingredients such as oil and water to stay mixed and not separate on standing. It is used in manufactured foods containing fats and oils. Lecithin’s action is improved when benzoyl
peroxide, hydrogen peroxide, acetic or lactic acid, or sodium hydroxide is added to produce hydroxylated lecithin, which disperses more readily in water and acts as a better emulsifier than pure lecithin. Certain vitamins can be destroyed by the addition of benzoyl peroxide to food. Where the loss could be significant, such as in the destruction of beta carotene in milk, U.S. government regulations require that the vitamin be replaced, such as in the addition of vitamin A to cheese made from bleached milk.
Most benzoyl peroxide added to food has been converted to benzoic acid by the time the food is eaten. Only a small fraction of the bleach is ingested, most of which is converted in the intestine to benzoic acid or a similar product that is readily excreted in the urine.
Adverse Reactions to Benzoates
The mechanism of adverse reactions to foods containing benzoate is unknown, but evidence suggests that the cyclo-oxygenase pathway of arachidonic acid metabolism may be affected, in a way similar to the activity of salicylates. People who are sensitive to acetysalicylic acid (aspirin) are particularly likely to be sensitive to benzoates.
Symptoms of Benzoate Sensitivity
The following symptoms have been reported by people who are sensitive to benzoates:
♦ Asthma
♦ Urticaria (hives)
♦ Angioedema (tissue swelling)
♦ Headaches
Those who have experienced Type I hypersensitivity reactions (atopic allergy), such as respiratory-tract symptoms including asthma or skin reactions (e.g., hives and eczema), may be particularly likely to react to benzoates.
Benzoic acid can act as a mild irritant to the skin, eyes, and mucous membranes. Its adverse effects often increase when the chemical is combined with other additives.
Managing Benzoate Sensitivity
People differ in their sensitivity to chemicals like benzoates. Consequently, it is impossible to define a limit of benzoate intake that applies to everyone who is
sensitive to benzoate. The general recommendation is to reduce benzoate intake by avoiding foods known to contain added benzoates. Therefore, benzoate-sensitive persons should avoid
♦ Natural sources of benzoic acid (see Table Benzoates: examples of their sources and use as additives).
♦ Any processed foods containing benzoic acid, sodium benzoate, potassium benzoate, or calcium benzoate. In the United States and Canada, these names will appear on food labels; in European countries, benzoic acid will be listed as E210, sodium benzoate as E211, potassium benzoate as E212, and calcium benzoate as E213.
♦ Bleached flour.
♦ Products containing hydrolyzed lecithin, such as margarines, salad and cooking oils, frozen desserts, chocolate, and baked goods.
Benzyl and Benzoyl Compounds
A large number of benzyl and benzoyl compounds are allowed in foods. Examples are benzyl acetate, benzyl alcohol, benzyl ether, benzyl butyrate, benzyl cinnamate, benzyl formate, benzyl propionate, and benzyl salicylate. On food labels, this ingredient will include the word “benzyl” or “benzoyl.” Most of these compounds are used as synthetic flavorings and perfumes in a wide variety of processed and manufactured foods, beverages, chewing gum, soaps, hair sprays, hair dyes, skin creams, sunscreens, perfumes, and cosmetics.
Some of these compounds are skin irritants and can cause hives and contact dermatitis. Others are digestive-tract irritants and can cause intestinal upset, vomiting, and diarrhea. In very high concentrations, they can have a narcotic effect. A few irritate the eyes and cause respiratory symptoms when inhaled.
Parabens
Parabens, a class of derivitives of benzoic acid, are sometimes used as preservatives in foods. People who are sensitive to benzoates may also react to parabens because paraben metabolism mimics that of benzoates in the later stages. There are no naturally occurring parabens. On food labels, parabens are indicated by the term “ethyl p-hydroxybenzoate,” “methyl p-hydroxybenzoate,” or “propyl p-hydroxybenzoate.” In European countries, these will appear on labels as E214, E218, and E216, respectively (see Table Benzoates: examples of their sources and use as additives).
Parabens are used in processed fruits and vegetables, baked goods, fats, oils, and seasonings. They may be present in cakes, pies, pastries, icings, fillings, fruit products (e.g., fruit sauces, fruit juices, fruit salads, syrups, preserves, jellies), syrups, olives, pickles, beers, ciders, and carbonated beverages.
Table Benzoates: examples of their sources and use as additives
| Benzoate | E Number | Found in | Added to | |
| Benzoic acid | E210 | Edible berries
Fruits Vegetables |
Jams
Beer Dessert sauces Flavored syrups Fruit pulp and puree Fruit juice Marinated fish (herring and mackerel) Pickles Salad dressings Yogurt Flavored coffees Margarine Table olives Concentrated juices Soft drinks |
|
| Sodium benzoate | E211 | No natural source | Caviar
Prawns Candies Margarine Fruit pies Soft drinks Oyster sauce Salad dressings Barbecue sauce Taco sauce Cheesecake mix Soy sauce Jams and jellies Dill pickles Table olives Concentrated pineapple juice |
|
| Potassium benzoate | E212 | No natural source | Margarines
Table olives Dill pickles Concentrated pineapple juice |
|
| Calcium benzoate | E213 | No natural source | Concentrated pineapple juice | |
| Ethylhydro -xybenzoate | E214 | No natural source | Beer
Cooked packed beetroot Coffee and chicory essence |
|
| Propyl-
hydroxybenzoate |
E216 | No natural source | • Coloring dyes in solution
• Dessert sauces • Flavored syrups |
|
| Methyl | E218 | No natural source | • Frozen drink concentrates | |
| hydro xybenzoate | • Fruit-based pie fillings | |||
| • Fruit pulp or puree | ||||
| • Glucose | ||||
| • Marinated fish (herring and mackerel) | ||||
| • Pickles | ||||
| • Salad dressings | ||||
Table THE BENZOATE-RESTRICTED DIET
| Type of Food | Foods Allowed | Foods Restricted |
| Milk and Milk Products | • Plain milk, buttermilk, cream, sour cream, and yogurt
• All plain cheese, cottage cheese, ricotta, Quark, feta • Ice cream made with allowed ingredients |
• All prepared milk products made with restricted ingredients
• Blue cheese • Gorgonzola cheese |
| Breads and Cereals | • Any pure unbleached flour or grain
• Any plain fresh bread, buns, biscuits, pizza dough, with allowed ingredients • Homemade or purchased baked cookies, pies, etc., made with allowed ingredients • Baking chocolate and pure cocoa |
• Products made with bleached flour
• Restricted fruit • Cinnamon • Cloves • Anise • Artificial flavors • Margarine • Maraschino cherries • Some fruit juices • Some jam and jellies • Some cheeses • Chocolate that is not baking chocolate or pure cocoa • Oils with hydrolyzed lecithin • Some commercial pie and pastry fillings |
| • Breakfast cereals with allowed foods, including
- All plain grains - Corn flakes - Oats and oatmeal - Plain Cream of Wheat® - Shreddies® • Plain crackers without benzoates |
• All others
• Read all labels carefully. |
|
| • Plain pasta
• All homemade crackers, cereals, and pasta dishes with allowed ingredients |
• Read labels carefully on all packaged pasta meals. | |
| Vegetables | • All pure fresh and frozen vegetables, except those listed at right | Avocado Pumpkin Red beans Soybeans Spinach
• All prepared vegetables with restricted ingredients • Most commercial salad dressings |
| Fruit | • All pure fresh or frozen fruits except those listed at right
• Pure frozen and canned allowed fruit juices • Fruit dishes made with allowed ingredients |
• Berries, especially strawberries and raspberries
• Prunes • Peaches • Papaya (pawpaw) • Nectarines • Fruit dishes, jams, and juices with benzoates or “flavoring” |
| Meat, Poultry, and Fish | • All pure fresh, frozen, or canned meat, poultry, or fish
• Processed meat made with allowed ingredients |
• Meat, poultry, or fish processed with restricted ingredients
• Cod • Pickled products |
| Eggs | • All | • All dishes prepared with restricted foods |
| Legumes | • All plain legumes except those on restricted list
• Pure peanut butter |
• Red beans
• Soybeans |
| Nuts and Seeds | • All plain nuts and seeds | • All with restricted ingredients |
| Fats and Oils | • Pure butter and cream
• Shortening • Pure vegetable oils • Homemade salad dressings with allowed ingredients • Lard and meat drippings • Homemade gravy |
• All fats and oils with hydrolyzed lecithin
• Margarine • Prepared salad dressings with restricted ingredients |
| Spices and Herbs | • All fresh, frozen or dried herbs and spices except those listed at right | • Anise
• Cinnamon • Cloves • Seasoning packets with restricted foods • Foods labeled with “spices” |
| Sweets and Sweeteners | • Sugar, honey, molasses
• Maple syrup, corn syrup • Icing sugar • Pure jams, jellies, marmalade, and conserves made with allowed ingredients and without added benzoates • Plain artificial sweeteners • Homemade sweets with allowed ingredients |
• Flavored syrups
• Prepared dessert fillings • Prepared icings and frostings • Spreads with restricted ingredients • Prepared icings and frostings • Prepared candies • Cake decorations and other confectionery • Commercial candies |
| Other | • Baking powder
• Baking soda • Cream of Tartar • Distilled white, cider, or wine vinegars • Baking chocolate • Pure cocoa • Plain gelatin • Homemade pickles and relishes with allowed ingredients • Homemade ketchup with allowed ingredients |
• All other vinegars with flavorings”
• Chocolate candy, sprinkles, and syrup • Flavored gelatin • Mincemeat • Prepared pickles, relishes, and olives • Soy sauce • Commercial ketchup • Chewing gum |
| Beverages | • Plain milk, and buttermilk
• Pure juices of allowed fruits and vegetables • Plain and carbonated mineral water • Coffee |
• Flavored milks
• Fruit drinks and cocktails with restricted ingredients • All other carbonated drinks • Flavored coffee • All tea • All drinks with “flavor” or “spices” • Some ciders and beers |
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