Low sulfur diet: Difference between revisions

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==Sulphite sensitivity ==
==Sulphite sensitivity ==
People with sulfite sensitivity do not need to avoid sulfates or sulfur.<ref name="allergy-au">{{Cite web|url=https://www.allergy.org.au/patients/other-allergy/sulfite-sensitivity-faq | title = Sulfite Sensitivity Frequently Asked Questions (FAQ)|last = |first = | authorlink = | date = | website = Australasian Society of Clinical Immunology and Allergy (ASCIA)|language=en-gb|archive-url=|archive-date=|url-status=|access-date=2021-10-21}}</ref> Sulphite sensitivity does not normally cause an allergic reaction, asthma symptoms are the most common response in people with sulfite sensitivity.<ref name="diet" />
People with sulfite sensitivity do not need to avoid sulfates or sulfur.<ref name="allergy-au">{{Cite web|url=https://www.allergy.org.au/patients/other-allergy/sulfite-sensitivity-faq | title = Sulfite Sensitivity Frequently Asked Questions (FAQ)|last = | first = | authorlink = | date = | website = Australasian Society of Clinical Immunology and Allergy (ASCIA)|language=en-gb|archive-url=|archive-date=|url-status=|access-date=2021-10-21}}</ref> Sulphite sensitivity does not normally cause an allergic reaction, asthma symptoms are the most common response in people with sulfite sensitivity.<ref name="diet" />


Medications containing ''sulfates'' e.g., morphine sulfate, and soaps or shampoos containing sodium lauryl sulfate (SLS) do not need to be avoided.
Medications containing ''sulfates'' e.g., morphine sulfate, and soaps or shampoos containing sodium lauryl sulfate (SLS) do not need to be avoided.
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*Wine, cider, beer, apple juice, cordials, instant teas, drinks with added sulphites or sulphates
*Wine, cider, beer, apple juice, cordials, instant teas, drinks with added sulphites or sulphates
*Foods labeled as containing sodium sulphite or sulphate, sodium thiosulphate, sulphurous acid, sulphur dioxide, sodium or potassium metabisulphite, sodium or potassium bisulphite, or sodium dithionate
*Foods labeled as containing sodium sulphite or sulphate, sodium thiosulphate, sulphurous acid, sulphur dioxide, sodium or potassium metabisulphite, sodium or potassium bisulphite, or sodium dithionate
*European additives including E220, and E221 to E228<ref name="nhs">{{Cite web|url=https://www.nhs.uk/conditions/food-allergy/causes/ | title = Food allergy - Causes|last = National Health Service | first = |authorlink=National Health Service | date = 2018-10-03 | website = |language=en|archive-url=|archive-date=|url-status=|access-date=2020-10-13}}</ref>
*European additives including E220, and E221 to E228<ref name="nhs">{{Cite web|url=https://www.nhs.uk/conditions/food-allergy/causes/ | title = Food allergy - Causes|last = National Health Service | first = | authorlink = National Health Service | date = 2018-10-03 | website = |language=en|archive-url=|archive-date=|url-status=|access-date=2020-10-13}}</ref>
*Supplements or medications may contain sulfur, including [[Methylsulfonylmethane|MSM]] or those containing gelatine.<ref name="badgut" /><ref name="webmd" /><ref name="allergy-au" /><ref name="diet">{{Cite web|last = Nutrition Department {{!}} Department of Health|first =  | title = Low sulphite diet – Fact sheet | date = 2017 | url=https://cdn.wchn.sa.gov.au/downloads/WCH/hospital-services/nutrition/children/conditions/low-sulphite-diet-fact-sheet.pdf?mtime=20210325120731&focal=none|pages=|publisher=Women's and Children's Health Network {{!}} Government of South Australia|access-date=2021-10-20}}
*Supplements or medications may contain sulfur, including [[Methylsulfonylmethane|MSM]] or those containing gelatine.<ref name="badgut" /><ref name="webmd" /><ref name="allergy-au" /><ref name="diet">{{Cite web|last = Nutrition Department {{!}} Department of Health|first =  | title = Low sulphite diet – Fact sheet | date = 2017 | url=https://cdn.wchn.sa.gov.au/downloads/WCH/hospital-services/nutrition/children/conditions/low-sulphite-diet-fact-sheet.pdf?mtime=20210325120731&focal=none|pages=|publisher=Women's and Children's Health Network {{!}} Government of South Australia|access-date=2021-10-20}}</ref>
</ref>


===Low sulfur diet===
===Low sulfur diet===
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Jason et al. (2016) reported on a single patient with ME/CFS involving significant [[post-exertional malaise]] who reported significant improvement in overall health and reduction in [[brain fog]] after switching to a low-sulfur diet at the advice of her doctor.<ref name="JasonKidd2016" /> The patient followed a [[vegan diet]] both before and after the change in diet, and self-reported her symptoms using an online tool for 70 days before and 70 days after switching from a high sulfur to a low-sulfur diet.<ref name="JasonKidd2016" />
Jason et al. (2016) reported on a single patient with ME/CFS involving significant [[post-exertional malaise]] who reported significant improvement in overall health and reduction in [[brain fog]] after switching to a low-sulfur diet at the advice of her doctor.<ref name="JasonKidd2016" /> The patient followed a [[vegan diet]] both before and after the change in diet, and self-reported her symptoms using an online tool for 70 days before and 70 days after switching from a high sulfur to a low-sulfur diet.<ref name="JasonKidd2016" />


No particular diet is recommended or shown to be effective in [[ME/CFS]].<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10= Rosamund Vallings | last11 = Bateman | first11 =  L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 =  N | authorlink13= Nicoletta Carlo-Stella | last14 = Chia | first14 =  J | authorlink14= John Chia | last15 = Darragh | first15 =  A | authorlink15= Austin Darragh | last16 = Gerken | first16 = A | authorlink16= Anne Gerken | last17 = Jo | first17 =  D | authorlink17= Daehyun Jo | last18 = Lewis | first18 =  DP | authorlink18= Donald Lewis | last19 = Light | first19 = AR | authorlink19= Alan Light | last20 = Light | first20 =  KC | authorlink20= Kathleen Light | last21 = Marshall-Gradisnik | first21 =  S | authorlink21= Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 =  J | authorlink22= John McLaren-Howard | last23 = Mena | first23 =  I | authorlink23= Ismael Mena | last24 = Miwa | first24 =  K | authorlink24= Kunihisa Miwa | last25 = Murovska | first25 =  M | authorlink25= Modra Murovska | last26 = Stevens | first26 =  SR | authorlink26= Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref> The [[International Consensus Criteria]] Primer states that most patients do best on a diet that containing sources of low-fat protein, and a range of fruit and vegetables.<ref name="ICC2011primer" />
No particular diet is recommended or shown to be effective in [[ME/CFS]].<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 =  L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 =  N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 =  J | authorlink14 = John Chia | last15 = Darragh | first15 =  A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 =  D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 =  DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 =  KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 =  S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 =  J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 =  I | authorlink23 = Ismael Mena | last24 = Miwa | first24 =  K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 =  M | authorlink25= Modra Murovska | last26 = Stevens | first26 =  SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref> The [[International Consensus Criteria]] Primer states that most patients do best on a diet that containing sources of low-fat protein, and a range of fruit and vegetables.<ref name="ICC2011primer" />


==Risks and safety==
==Risks and safety==
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== Notable studies ==
== Notable studies ==
*2016, The Use of Operant Methods to Evaluate Interventions for Patients With [[Myalgic Encephalomyelitis]] <ref name="JasonKidd2016">{{Cite journal | last = Jason | first = Leonard A |author-link=Leonard Jason | last2 = Kidd | first2=Elizabeth K|authorlink2 = Elizabeth Kidd | last3 = Brown | first3 = Abigail A  | authorlink3 = Abigail Brown | last4 = McManimen | first4 = Stephanie | authorlink4 = Stephanie McManimen | last5 = Korinek | first5 = Rachael | authorlink5 = | last6 = Tuan | first6 = Joey  | authorlink6 =  | date = 2016-04-27 | title = The Use of Operant Methods to Evaluate Interventions for Patients With Myalgic Encephalomyelitis|url=http://dx.org/10.17795/mejrh-37972|journal=Middle East Journal of Rehabilitation and Health|volume=3|issue=2| pages = e37972|doi=10.17795/mejrh-37972|issn=2423-4451|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.researchgate.net/publication/301343263_The_Use_of_Operant_Methods_to_Evaluate_Interventions_for_Patients_With_Myalgic_Encephalomyelitis (Full Text)]
*2016, The Use of Operant Methods to Evaluate Interventions for Patients With [[Myalgic Encephalomyelitis]] <ref name="JasonKidd2016">{{Cite journal | last = Jason | first = Leonard A | authorlink = Leonard Jason | last2 = Kidd | first2 = Elizabeth K | authorlink2 = Elizabeth Kidd | last3 = Brown | first3 = Abigail A  | authorlink3 = Abigail Brown | last4 = McManimen | first4 = Stephanie | authorlink4 = Stephanie McManimen | last5 = Korinek | first5 = Rachael | authorlink5 = | last6 = Tuan | first6 = Joey  | authorlink6 =  | date = 2016-04-27 | title = The Use of Operant Methods to Evaluate Interventions for Patients With Myalgic Encephalomyelitis|url=http://dx.org/10.17795/mejrh-37972|journal=Middle East Journal of Rehabilitation and Health|volume=3|issue=2| pages = e37972|doi=10.17795/mejrh-37972|issn=2423-4451|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.researchgate.net/publication/301343263_The_Use_of_Operant_Methods_to_Evaluate_Interventions_for_Patients_With_Myalgic_Encephalomyelitis (Full Text)]


==News articles ==
==News articles ==

Latest revision as of 13:52, July 25, 2023

A low sulfur diet or sulphite-restricted diet or sulphite elimination diet involves reducing or eliminating foods and drinks containing either sulfites or all causes of sulfur. A sulphite elimination diet has been suggested for people with sulphite sensitivity, which is relatively rare; a general low sulfur diet has been proposed to reduce some gastrointestinal problems in people without sulphite sensitivity.[1][2]

Sulphite sensitivity[edit | edit source]

People with sulfite sensitivity do not need to avoid sulfates or sulfur.[3] Sulphite sensitivity does not normally cause an allergic reaction, asthma symptoms are the most common response in people with sulfite sensitivity.[4]

Medications containing sulfates e.g., morphine sulfate, and soaps or shampoos containing sodium lauryl sulfate (SLS) do not need to be avoided.

Some people experience allergic reactions to sulfonamide medications, but this is a separate allergy and not caused by sulfite sensitivity.[3]

High sulfur foods and drinks[edit | edit source]

  • Processed meats, mince, although other meats may have sulfite used as a preservative
  • Crustaceans, e.g. crab or shrimp
  • As an additive or preservative, e.g., in soup mixes, pickles, commercially prepared baked goods including bread and biscuits, dried fruits, canned vegetables, gravy, condiments e.g. ketchup, relishes, or tomato puree, bottled lemon or lime juice, grapes, pizza dough, pies
  • Foods containing gelatine or pectin, e.g., jams or marmalade and jellies
  • Coconut
  • Wine, cider, beer, apple juice, cordials, instant teas, drinks with added sulphites or sulphates
  • Foods labeled as containing sodium sulphite or sulphate, sodium thiosulphate, sulphurous acid, sulphur dioxide, sodium or potassium metabisulphite, sodium or potassium bisulphite, or sodium dithionate
  • European additives including E220, and E221 to E228[5]
  • Supplements or medications may contain sulfur, including MSM or those containing gelatine.[1][2][3][4]

Low sulfur diet[edit | edit source]

Theory[edit | edit source]

Sulfite elimination diets aim to reduce symptoms caused by sulphite sensitivity.[1]

A general low sulfur diet is not linked to a particular medical hypothesis for ME/CFS.

Evidence[edit | edit source]

Jason et al. (2016) reported on a single patient with ME/CFS involving significant post-exertional malaise who reported significant improvement in overall health and reduction in brain fog after switching to a low-sulfur diet at the advice of her doctor.[6] The patient followed a vegan diet both before and after the change in diet, and self-reported her symptoms using an online tool for 70 days before and 70 days after switching from a high sulfur to a low-sulfur diet.[6]

No particular diet is recommended or shown to be effective in ME/CFS.[7] The International Consensus Criteria Primer states that most patients do best on a diet that containing sources of low-fat protein, and a range of fruit and vegetables.[7]

Risks and safety[edit | edit source]

Costs and availability[edit | edit source]

Suitable foods are widely available and inexpensive. No medication or supplements are required.

Notable studies[edit | edit source]

News articles[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 GI Society. "Sulphite-Restricted Diet". Gastrointestinal Society. Retrieved October 13, 2020.
  2. 2.0 2.1 "What Is Sulfite Sensitivity?". WebMD. Retrieved October 13, 2020.
  3. 3.0 3.1 3.2 "Sulfite Sensitivity Frequently Asked Questions (FAQ)". Australasian Society of Clinical Immunology and Allergy (ASCIA). Retrieved October 21, 2021.
  4. 4.0 4.1 Nutrition Department | Department of Health (2017). "Low sulphite diet – Fact sheet" (PDF). Women's and Children's Health Network | Government of South Australia. Retrieved October 20, 2021.
  5. 5.0 5.1 National Health Service (October 3, 2018). "Food allergy - Causes". Retrieved October 13, 2020.
  6. 6.0 6.1 6.2 Jason, Leonard A; Kidd, Elizabeth K; Brown, Abigail A; McManimen, Stephanie; Korinek, Rachael; Tuan, Joey (April 27, 2016). "The Use of Operant Methods to Evaluate Interventions for Patients With Myalgic Encephalomyelitis". Middle East Journal of Rehabilitation and Health. 3 (2): e37972. doi:10.17795/mejrh-37972. ISSN 2423-4451.
  7. 7.0 7.1 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6