# Can a restaurant use a preservative that will be a trigger?



## Guest (Aug 11, 2000)

I'm not sure if I worded the topic correctly, but I am wondering about preservatives. I eat a lot of salad, and I've had severe attacks sometimes after going to certain restaurants and eating a salad. My mom has a more mild IBS, and she had D immediately after eating a carrot salad from Chick-fil-a - 12 times (she does not have severe IBS which is why it happened 12 times before she realized what was causing it)! This does not happen with any of the separate ingredients or carrot salad from other places, just theirs. I told her maybe they are using a preservative that causes her D.I'm wondering if restaurants use some kind of preservative on their salad that is a trigger. Anyone know what it might be? I eat A LOT of salads that are fine and a few that really cause pain and D. What I'm trying to say is it is not the salad ingredients itself, unless it is something strange in the dressing. I eat ranch dressing mainly and am fine with it.


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## Guest (Aug 11, 2000)

Well, they very well might use something to keep the lettuce looking fresher, my husband told me a lot of places will put something on the green beans to keep them looking greener. Or it could also be just the lettuce, I read a lot of people saying that lettuce is a trigger for them.


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## LNAPE (Feb 9, 1999)

I do believe thisis true I think they call the sulfites. I know I do avoid salad bars in restratunt because the lettuce seems to upset me but I can make my own salad at home and do fine.Linda


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## Guest (Aug 11, 2000)

Another possibility is MSG. A lot of salad dressings have MSG in them, and the concentration would be much higher than for preservatives.I know MSG causes major stomach discomfort for me.


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## Guest (Aug 11, 2000)

I know some restaruants do this. My husbaqnd and I can't eat salads or sandwiches with a lot of lettuce at Mac Donalds. If we do, we have to drive right home and head for the bathroom. Also look out for coleslaw, and as someone said green beans.


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## Auroraheart (Aug 8, 2000)

Has she tried eating the salad last? (like a dessert) That sounds odd, but my dietician told me that lettuce is fiberous and that if you "prepare" you system for it by eating other stuff first then it is "easier" to eat, if you have to eat it at all. Is your Mom using any dressing on the salad? That could do it too...higher fat salad dressings bother me. That fruit/veg wash stuff...can't remember the name right now...bothers me too.


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## Guest (Aug 11, 2000)

I'm not sure if she eats if first or last and it has it's own dressing already, so she is not adding any. I just thought if I could pinpoint the specific additive that causes the D I could ask some restaurants if they use it and therefore avoid it but still enjoy eating out. Thanks for all of your info so far - these are all very good points to consider.


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## Mike NoLomotil (Jun 6, 2000)

Hi OTP>Ahhhh Chik-Fil-A! One of my favorite places to get a tasty GI flush.There are over 3,500 approved food additives, preservatives, emulsifiers that can be found in any combination in processed foods. we consume about 20 pounds of these a year. Our bodies can safely neutralize many of these in low concentrations, but as the number and concentration keep going up it is getting harder to cope with.Add to that the native foods that may produce pseudoallergy due to lectin, histamine and various "peptide" content...without even considering hypersensivity (of any of the 4 GEL and COOMBS classes or the other several types of hypersesnitivity reactions) and one is up against the wall when one eats out. Esp. if you have IBS.I wondered for years what the heck it was in Chik-Fil-A that was bothering me after I ate there. Later found ou the main thing was the relatively innocuous tumeric in the mustard and the dipping sauces, plus the "sorb" family of chemicals in the sauces.I have no idea what is in teh chicken when it is processed, the breading, and the exact comp. of the bread...I would love to have the resources to analyze all that for specificity!Anyway...unless one is going to go the whole route to root out reactives, (2) basic rules will cover a large percentage of adverse reactions to foods and additives.Rule Of the 3P's: Packaged, processed, PoisonRule of the Foods That Bite: check out the post I made several times on how certain foods themselves may cause pseudoallergy and check yourself for specific sensitivity to these with oral challenge. Then play keep-away. Rather than post the whole thing again, and since I have limited time today, maybe someone remembers which thread(s) that is on or you can e-mail me and I will send it to you.My e-mail server is down right now so I apologize if there is a delay.[This message has been edited by Mike NoLomotil (edited 08-11-2000).]


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## Guest (Aug 14, 2000)

Thanks everyone - this is very interesting information.


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## K9Mom (Sep 20, 1999)

Restaurant lettuce kills me too!! Salads at home are okay, although I tend to avoid them. I am manical about washing the lettuce at home! I've noticed that Romaine lettuce is the only lettuce that has never given me an attack...go figure!







[This message has been edited by K9Mom (edited 08-14-2000).]


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## Mike NoLomotil (Jun 6, 2000)

Yeah, lettuce is something that has to be really watched out for and washed very very well esp. if up from "south of the border". besides the usual and customary chemical contaminants in the irrigating water, it is frequently contaminated with, shall we say, fecally-related bacteria due to the lack of "facilities" for the field workers down there. And contamination in lettuce can run very deep into the vegetable due to its structure (lots of surface area but easily penetrated by water.


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## Guest (Aug 14, 2000)

Dear OH THE PAIN,Can I relate.... I can not go to restraunts, unless they are safe restraunts... sound goofy? In my area I know which restraunts I can eat at and which foods I can eat. If I should eat the wrong food item, I get SEVERE CRAMPING, DISTENTION, HARDENING OF THE ABDOMIN, AND DIAHREA that all occur within 5 to 15 minutes after completing the meal. I then am entirely washed out after this episode. My mother cannot eat in restraunts either, but she almost goes into a coma from whatever it is that does not happen with home cooking.I went to an allergist and had the complete allergy testing. I was not allergic to any food products. They can not test additives. And, you may not beable to tolerate certain additives, spices, oils, etc., (I really think it may also have something to do with what they fry in?!) but not really be allergic - just can not digest or tolerate... IN OTHER WORDS - IT WAS NO HELP (EXCEPT TO KNOW I DID NOT HAVE A FOOD ALLERGY). From working in an ER, and as an EMT, I do know that food allergies are different than my symptoms, anyway... (swollen throat, comprimised airway, rash, etc...) I felt like I was dying from cramping and diahrea from Burger King's onion rings, and cannot tolerate most coated frys. I eat at a local restraunt, their breakfasts - great hashbowns - and I'm done for the day... !!! Needless to say when I leave town, I have been ordering oatmeal at breakfast, lunch and dinner, at the restraunt - or I do not eat nothing but toast.... feel cheated sometimes - but that is the way it goes if I want to avoid those HORRIFYING EPISODES !!!Now, salads bother me in restraunts, also... but here is another thing... don't buy Dole salad in the bag.. they will get you at home - they put something on those too!!I was told never to drink coffee with your breakfast (or meal) when you are out to eat.. you may want to watch out for that, too. It is supposed to trigger IBS.Good Luck finding your triggers - and sorry to hear you have to suffer, as I..... Stomach Troubles[This message has been edited by Stomach Troubles (edited 08-14-2000).]


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## JennT (Jul 17, 2000)

Oh, yeah... restaurants!I went to a wedding for a Vietnamese couple I know this weekend. The reception had all sorts of food, both familiar and not, so I popped a couple preventive Immodium and then ate sparingly. Thanks to the Immodium (and probably all the ginger in the food), I managed scallops, shrimp, crab, lobster, squid, jellyfish, fried rice with all sorts of stuff, mushroms, and squab. I did *not* get D. I *did* get a headache, bloating, and mild cramping... and for me, these are all symptoms of too many sulfites!


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## me3 (Jul 21, 2000)

I agree with K9Mom about the Romaine lettuce. I recently figured out that ICEBERG (the "head" type)lettuce, the kind almost all restaurants use, triggers bloating almost right away - and an IBS attack the next morning. However, ROMAINE (the leaf type) is perfectly fine - no reaction. It is easy to make a salad without any lettuce at all which I also do a lot.


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## eric (Jul 8, 1999)

For the most part restaurants do not use sulfites anymore or Msg, however I am sure some do either knowing it or not. MSG is a tenderizer and flavor inhancer and is found in some spices.FYI: http://pharminfo.com/pubs/msb/sulfite237.html ------------------ http://www.ibshealth.com/


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## JennT (Jul 17, 2000)

Yeah, but the key word is "knowingly". I found out the other day that most of the Asian restaurants in my area use the same supplier, and that supplier's tempura batter has sulfites in it. That's probably what it was at the Vietnamese restaurant last weekend... that lovely crab puff in all that tempura batter...


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## HateMyIBS (Aug 9, 2000)

It is so great to see that restaurant food make other IBSers sick. I thought it was just me and I cannot come up with a pattern though. Only certain restaurants, without any particular foods, just the restaurant. I have a problem with one time something will make me sick and the next time it wount. Like popcorn, I love popcorn ,but i know if I eat it I will die. But, sometimes I eat it and I'm fine? But, usually if I eat a good meal in a restaurant within 15-20 minutes afterwards, I'm dying? Why?


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## lindsay* (Jul 23, 2000)

my GI doc informed me that the preservatives(especially), waxes, and pesticides put on non-organic produce will cause flare-ups. wash your veggies and only buy organic.


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## sos (Jul 3, 2000)

Yes restaurants use preservatives and yes they can make you sick with D. My husband who very rarely gets D, he is so "normal" it drives me crazy gets D from salads from certain restaurants, like Olive Garden, Golden Coral and McDonald's. Beware of buffets. My cousin who was a waitress for many yes confess to me a waitress secret. If a customer is rude to her or on there last visit didn't leave a tip she and her co-workers would put a drop of eye drops in their food which gave them instant D. They would set back and laugh watching the customer run to the bathroom. I having IBS D and need no help getting D did not find this very amusing.


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## Mike NoLomotil (Jun 6, 2000)

QUICK FOOTNOTE TO ERICS POSTE;yeah, it was my undertsnding that sulfites are not allowed to be used anymore for maintaining the presentation-quality of the food in the salad...veggie...etc. All that stuff comes prepacked in nitrogen flushed and vacuum sealed plastic no? But I do not know if the reg. and/or enforcement has any teeth, nor whether it may extend into the foods that are prepared offsite and pre-treated for onsite final prep. like all the chain-restaurants do (only exception I know to that is the COOKER chain where everything is made on-site). Do you know? I am drawing a blank on this one. Wish I had time to look it up because it affects so many people.Any info out there? Anybody "in the biz"?Gotta goMNL


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## eric (Jul 8, 1999)

Mike, I was a chef for twelve years in a couple of very exclusive restaurants. We did not use any sulfites in salads or vegatables. It was only in wine, however we did cook with wine and sherry.I also worked in a four star swiss restaurant in NY where some of the swiss spices contained MSG.I am not sure however and will ask my brother who is a senior chef for a large restaurant corporation about this, if sulfites break down in cooking. There are so many issues with this it is hard to pinpoint a cause and effect relationship to what might be the real trigger. It can be a multitude of reasons.------------------ http://www.ibshealth.com/


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## linr (May 18, 2000)

SOS, I have heard of the eye drop thing before and was told that this can really make someone deathly ill. I can't believe someone would really do that. I wouldn't think getting a bad tip would warrant making someone that ill.Sad.


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## Guest (Aug 16, 2000)

I just wanted to tell you what my aunt told me about lettuce in restaurants.(my uncle is a doctor) Her son worked in a nice restaurant when he was a little younger and they put a preservative on the lettuce so it wouldn't spoil as quickly as with out it. So that makes it nice for the restaurants but bad for us IBS's that can't enjoy a salad past the time it goes in our mouths. My aunt knew all to well what I was referring to because she also has IBS D and can't eat a salad from out at all. KP


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## zigmissus (May 19, 1999)

Me too, me3! Iceberg lettuce is an instant IBS trigger. I always order a Caesar salad, because it's usually made from romaine lettuce, which is fine. Bottled salad dressings are also difficult for me. MSG gives me horrible cramps, D and headache. Although few restaurants add MSG, it's already in many, many ingredients. Fast food places are notorious for it. Their food is often prepared off-premises and trucked to the outlets, so MSG is used to maintain freshness and flavor. If you ask, MacDonalds will give you a pamphlet detailing the ingredients in their food. MSG is in a LOT of it. For IBSers, eating out can be a dangerous minefield.


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## eric (Jul 8, 1999)

zigmissus, I agree with MSG it doesn't sit well with me either. As for the salads I believe it is illegal to use sulfites on raw veggies. I will look into this some more, I don't know about all restaurants. I now in the ones I worked in we didn't if some one gets an allergic reaction to sulfite they can die.However, when I see Mcdonalds and tempura batter and no that fat stimulates the colon, I think it becomes hard to pinpoint and I personally wonder what the trigger have been.Also, I think the advise of eating the salad last if you can is good advise as well as eating romaine. I will look into this some more.I also no from many years doing this there are all sorts of reasons. Buffets you should probably stay away from as the food sits out. There is also cross contamination issues, clean utensils and cutting boards and surfaces to name a few. ------------------ http://www.ibshealth.com/


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## JennT (Jul 17, 2000)

*Is* it illegal to use sulfites on raw veggies? I was under the impresseion that it was only illegal (at least here in Washington State) to use them on veggies in the salad bar... using them on, say... the green beans they serve at your table was okay legally.So when my hubby wants to go out for "fast food", we always go to Izzy's... I can't eat the pizza, but I can eat their salad bar and most of their hot food bar. Mmmmm... Izzy's bbq chicken.-JennT


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## Mike NoLomotil (Jun 6, 2000)

HI ERIC>Yeah, it was my assumption that the "better restaurants" (ie: prep and cook their own food) would not be utilizing any sulfites (as you say except that whuch is naturally in the wines they use)and minimum other additives except flavorings. I was more thinking along the lines of the chain-restaurants were I and the other Joe-LunchBuckets tend to congregate (low to mid priced places like TGIF's Houstons, etc then down to Denny's at 4 am Sunday morning after last call).My exp. and that of the pt.s we work with supports what you say. Better restaurants produce less frequency of post-social-dining episodes and more cooperative special-prep requests. I would like to really get the skinny from someone who cooks for one of the chains on exactly what is prepped offsite (you know, chicken delivered premarinated...so-called Jack Daniels Special Barbecue steaks.. 'uuuuuppppchuk'...etc.)vs. what is done on-site an how. This isa bit of a vacuum for me.And as you say it is literally impossible in any environment out of the patients span of control to match-up a reaction with anything. My interest really is in better-educating people to the facts of the reality that maybe these kinds of places need to be deleted from the dining-cycle of IBS victims (esp. D types). This is always a point of resistance esp. with South Florida IBS victims, where often the constant dining out is the center of their social lives and that issue must be dealt with. Can you say Century Village? (if not from here you might not know the significance of that...)Absent actual inside insite in the "chain cooking trade" we are often left with passing along general suppositions...specific have more impact. Ihave frined who is a sous chef at a country club in Boca and he looks at my questiosn like "paaaleeze...pollute my brain with such knowledge?". (FOOTNOTE: I do know during season he gets to go be personal chef to one of the Wall Street robber barons who winters here...and has use of his own 'Benz during that time to go do the shopping and such). Nice work if you can get it!So, anybody in the biz whose not a good quality chef like Eric? Uh, that is probably Not what I mean to say...but gotta run.Have a day!MNL


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## Guest (Aug 16, 2000)

My two worst experiences so far were1) A chef-type salad from Blackeyed Pea. It was a WONDERFUL salad and I am disappointed that I am fearful to eat there again.(2)Ravioli (in a white sauce) and ceasar salad from Macaroni Grill. We only went there becasue we had a gift certificate so it doesn't matter if I ever eat there again.I've had great ceasar chicken salads with no IBS symptoms from Fudruckers and Chicken Out and Boston Market. I also have good luck with Wendy's salads and pita salads. We eat out a lot - can you tell?


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## morning (Jun 8, 2000)

Okay, so which one of us is going to start our own restaurant chain that serves IBS friendly foods? Seems as though there would be quite a national market! I used to love to eat out, and now it is nothing but anxiety...I sit there and nibble on my meal while everyone else gobbles down huge quantities of yummy food!







It is not fair! I would rather prepare dinner for everyone at MY home than to hear those dreaded words, "Let's go out to eat!"..........Morning


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## eric (Jul 8, 1999)

Sulfite information. This is 1996 so I will look for futher info if I can find anything. Sulfites: Safe for Most, Dangerous for Some by Ruth PapazianIt wasn't a special occasion--or even a fancy restaurant--but Karen, 37,will never forget that meal:My boyfriend and I were at a hamburger joint, and I had a burger andfries. About 10 minutes after we finished eating, my throat began toitch. I grabbed my [asthma] inhaler but I could feel my throatconstricting. I couldn't breathe and started to panic. When I passedout, my boyfriend flagged down a passing police car. The officer radioedfor an ambulance, and I was rushed to the hospital. I was revived with amassive dose of epinephrine to counteract the reaction caused by thesulfite solution the potatoes had been soaked in before frying.I know enough to stay away from wine, shrimp and other foods thatcontain sulfites, and take note whenever I don't feel right after eatingsomething. But I never expected french fries to be sulfited. I've hadallergic reactions to sulfites before, but this time I came close todying.I was angry that this happened to me. I felt powerless--I was carefuland knowledgeable, and yet I couldn't protect myself. Who ever heard ofa lethal french fry? Afterward, I refused to eat out in restaurants foralmost two years, and I still can't visit people or go on vacationwithout knowing there is a hospital nearby.The Food and Drug Administration estimates that one out of a hundredpeople is sulfite-sensitive, and that 5 percent of those who haveasthma, like Karen (who asked that her last name not be used), are alsoat risk of suffering an adverse reaction to the substance. "By law,adverse reactions to drugs must be reported to FDA by doctors orpharmaceutical companies. But with sulfites and other food ingredients,reporting is voluntary so it's difficult to say just how many people maybe at risk," cautions FDA consumer safety officer JoAnn Ziyad, Ph.D.Complicating matters, scientists have not pinpointed the smallestconcentration of sulfites needed to provoke a reaction in a sensitive orallergic person. FDA requires food manufacturers and processors todisclose the presence of sulfiting agents in concentrations of at least10 parts per million, but the threshold may be even lower. The assayused to detect the level of sulfites in food is not sensitive enough todetect amounts less than 10 ppm in all foods (that's 1 part sulfite to100,000 parts of food--the equivalent of a drop of water in a bathtub)so that's what the regulation has to be based on, explains Ziyad."The most rapid reactions occur when sulfites are sprayed onto foods orare present in a beverage, but the most severe reactions occur whensulfites are constituents of the food itself," says Ron Simon, M.D.,head of Allergy, Asthma and Immunology at Scripps Clinic and ResearchFoundation in La Jolla, Calif.A person can develop sulfite sensitivity at any point in life, and noone knows what triggers onset or the mechanism by which reactions occur."Doctors believe that asthmatics develop difficulty breathing byinhaling sulfite fumes from treated foods," notes Dan Atkins, M.D., apediatrician at the National Jewish Center for Immunology andRespiratory Medicine in Denver, Colo. He says that in a severe reactionan overwhelming degree of bronchial constriction occurs, causingbreathing to stop. This can lead to lack of oxygen reaching the brain,heart, and other organs and tissues and, possibly, a fatal heart rhythmirregularity."We now know that asthmatics who have more severe symptoms and aredependent on corticosteroids, such as prednisone or methylprednisolone,are especially prone to sulfite sensitivity and are most at risk ofhaving a severe reaction," notes Atkins. But it's a chicken-and-eggsituation, notes Simon: "We don't know which comes first, the asthma orthe sulfite sensitivity, because some people's first experience withasthma is a sulfite reaction, and as their asthma becomes more severethey eventually become steroid-dependent."Sulfite sensitivity can be tricky to diagnose. Karen went to aninternist and two pulmonary specialists without getting to the bottom ofher problem."People who do experience adverse reactions to sulfites know that it'ssomething they ate, but might not know what that something is," saysAtkins. "I'll ask a patient complaining of an adverse reaction what heor she ate and drank when it occurred. If beer or wine doesn't seem tobe the problem, I tend to dismiss sulfite sensitivity. But if I thinksulfites may be the culprit, I'll do a challenge [a type of allergy testin which a small amount of the suspect substance is administered in acapsule or in a drink and the patient is monitored to see whether thereis a reaction]."If a person develops hives after ingesting sulfites, the doctor will doa prick test (a small concentration of sulfite is placed on the skin,which is then pricked; the test is positive if a welt develops on thespot). "People who have positive skin tests to sulfites are likely to beallergic to the additive, rather than have a sensitivity. These people,who are usually not asthmatic, are most at risk of anaphylactic shock,[a life-threatening reaction]," says Simon.Regulatory Status in FluxSulfur-based preservatives, or sulfites, have been used around the worldfor centuries to: inhibit oxidation ("browning") of light-colored fruits and vegetables, such as dried apples and dehydrated potatoes prevent melanosis ("black spot") on shrimp and lobster discourage bacterial growth as wine ferments "condition" dough bleach food starches maintain the stability and potency of some medications.When the Federal Food, Drug, and Cosmetic Act was amended in 1958 toregulate preservatives and other food additives, FDA considered sulfitesto be generally recognized as safe (GRAS). But when FDA reevaluatedtheir safety and proposed to affirm the GRAS status of sulfiting agentsin 1982, the agency received numerous reports from consumers and themedical community regarding adverse health reactions. In response, FDAcontracted with the Federation of American Societies for ExperimentalBiology (FASEB) to examine the link between sulfites and reported healthproblems that ranged from chest tightness or difficulty breathing tohives to fatal anaphylactic shock.In 1985, FASEB concluded that sulfites are safe for most people, butpose a hazard of unpredictable severity to asthmatics and others who aresensitive to these preservatives. Based on this report, FDA took thefollowing regulatory actions in 1986: Prohibited the use of sulfites to maintain color and crispness on fruits and vegetables meant to be eaten raw (for instance, restaurant salad bars or fresh produce in the supermarket). Required companies to list on product labels sulfiting agents that occur at concentrations of 10 ppm or higher, and any sulfiting agents that had a technical or functional effect in the food (for instance, as a preservative) regardless of the amount present. (This labeling requirement was extended to standardized foods, such as pickles and bottled lemon juice, in 1993.)FDA requires that the presence of sulfites be disclosed on labels ofpackaged food (although manufacturers need not specify the particularagent used). This information will be included in the ingredient portionof the label, along with the function of the sulfiting agent in the food(for instance, a preservative).When food is sold unpackaged in bulk form (as with a barrel of driedfruit or loose, raw shrimp at the fresh fish counter), store managersmust post a sign or some other type of labeling that lists the food'singredients on the container or at the counter so that consumers candetermine whether the product was treated with a sulfiting agent.In 1987, FDA proposed to revoke the GRAS status of sulfiting agents on"fresh" (not canned, dehydrated or frozen) potatoes intended to becooked and served unpackaged and unlabeled to consumers (french fries,for example), and issued a final ruling to this effect in 1990. However,the rule was held null and void in 1990 after a protracted court battlein which the "fresh" potato industry prevailed on procedural grounds.This legal setback notwithstanding, "the agency continues to haveconcerns about the safety of sulfiting agents, and plans further actionto protect the consumer," notes Ziyad. Steps the agency is consideringinclude establishing maximum residual levels for specific foods andadditional labeling rules."The ultimate goal of sulfite regulation is to make sure that there isno higher level of sulfite residues in food than is absolutely necessaryand to encourage the use of substitutes for sulfites in foodprocessing," says Ziyad.Sniffing Out SulfitesSince 1985, FDA's Adverse Reaction Monitoring System has been trackingreactions to sulfites. Over a 10-year period, 1,097 such cases have beenreported. However, thanks to regulatory action taken by FDA over theyears, coupled with increased consumer savvy, the number of reportedsulfite-related health incidents has been dropping steadily. In 1995,just six cases were reported.Ten years ago, FDA banned the use of sulfites on fruits and vegetablesthat are to be eaten raw (as with a salad bar)--and the vast majority ofthose in the food service industry honor the prohibition--but consumerswho are sulfite-sensitive "shouldn't take anything for granted," saysZiyad.Current FDA regulations do not require managers of food serviceestablishments to disclose whether sulfites were used in foodpreparation. "Consumers continually request FDA to extend the regulationto include food service establishments because either waiters and otherstaff members didn't know whether the food was treated with sulfites, orgave erroneous information," notes Ziyad. "FDA's position on the issuehas been that consumers who see sulfites listed on the label of apackaged food should be able to deduce that the same food sold in a foodservice establishment would also contain sulfites," she explains.In addition, sulfites are still found in a variety of cooked andprocessed foods (including baked goods, condiments, dried and glacï¿½edfruit, jam, gravy, dehydrated or pre-cut or peeled "fresh" potatoes,molasses, shrimp, and soup mixes) and beverages (such as beer, wine,hard cider, fruit and vegetable juices, and tea).Since sulfites are added to so many foods, someone who is sensitive tothe additive must not assume that a food is safe to eat, says Atkins. Herecommends these measures to avoid sulfites when buying unlabeled foodsat the deli or supermarket and ordering at a restaurant:If the food is packaged, read the label. If it is being sold loose or bythe portion, ask the store manager or waiter to check the ingredientlist on the product's original bulk-size packaging.Avoid processed foods that contain sulfites, such as dried fruits,canned vegetables, maraschino cherries, and guacamole. If you want toeat a potato, order a baked potato rather than hash browns, fries, orany dish that involves peeling the potato first.If you have asthma, have your inhaler with you when you go out to eat.Similarly, if you've experienced a severe reaction to sulfites in thepast (such as breaking out in hives), carry an antihistamine and makesure you have handy a self-administering injectable epinephrine, such asEpiPen, so that if you have a reaction you can stabilize your conditionuntil you get to an emergency room."It takes some doing, but you can take steps to minimize your contactwith sulfites if you are diagnosed with asthma or sulfite sensitivity,"says Ziyad. "But you may not even know you have a problem with sulfitesuntil a reaction occurs. Undiagnosed people are at risk because even ifthey know that sulfites can cause adverse reactions, they often don'tassociate sulfites with their own health problems," says Ziyad."Regulations can go a long way towards protecting people, but there's nosubstitute for knowledge."For more information on sulfites, call (1-800) FDA-4010.Ruth Papazian is a writer in Bronx, N.Y.FDA Consumer magazine (December 1996)------------------ http://www.ibshealth.com/


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## eric (Jul 8, 1999)

FYI: On other food related illnesses.What Makes People Sick From Food? Food Borne Illness People can get sick when the food they eat has germs. Germs cause food borne illness or food poisoning. Germs grow easily in foods like meat, fish, poultry, milk, re-fried beans, cooked rice, and baked potatoes. These are called potentially hazardous foods. These are all foods that are moist or damp, and they have protein that the germs need to grow. Germs grow well on these and other foods kept warm in the "Danger Zone". Part of your job is to protect the food and to stop germs from growing, so that no one will get sick. First, wash your hands well. Second, be sure that the food is wholesome and protect it from germs. Third, if you keep food very hot or cold, out of the "Danger Zone", germs will not grow. There are different kinds of germs: Bacteria are the most common. They are everywhere, they grow fast, and they may spoil food or cause food borne illness. Some bacteria make poisons. Some poisons are not destroyed by normal cooking. Almost always the food looks and smells good, but it may have enough bacteria or poison to make someone sick. Two examples of this are roast beef that has not been kept cold enough, and chicken soup that has not been kept hot enough. A virus is another kind of germ that causes illness. A virus can be in liquids and foods that a sick person touches. A virus can also be in raw or uncooked foods. Parasites are tiny worms that live in fish and meat. They die if they are frozen long enough or cooked long enough. Chemicals, such as rat bait or cleaners, can also cause food poisoning. You must be sure to keep all chemicals away from food. Examples of Food Borne Illness Salmonella Salmonella bacteria are often found in eggs and on poultry and meats, but can come from other sources. People handling raw poultry and meats can easily contaminate their hands, cutting boards and utensils with salmonella. Wash and sanitize all items that have been used with raw poultry and meats before using them for other foods. Foods that are not cooked such as salads and cold sandwiches can easily make people ill with salmonella food poisoning. Symptoms of salmonella food poisoning: Stomach pain, diarrhea, chills, nausea, vomiting, and a fever of 101-104 degrees. Illness usually occurs within 6-72 hours (average 12-36 hours) after eating contaminated food. Usually lasts from 2-7 days. Prevention of salmonella food poisoning: Cook poultry and meat to internal temperatures of 165 F or more. Keep hot foods hot at 140 F or more. Keep cold foods cold at 45 F or less. Use good hand washing. Salmonella germs come from human feces or from poultry contaminated foods. Use wiping cloths wet with bleach water. The bleach water will kill the germs on surfaces and equipment. Staphylococcus Staph is a bacteria carried on the hands and face and in the nose of most healthy people. It produces a poison that is not destroyed by cooking or freezing. The poison is very strong and it only takes a little bit to make a person sick. Symptoms of staph food poisoning: Nausea Explosive vomiting usually 2-4 hours after eating contaminated food. Diarrhea follows the vomiting Sometimes sweats and cold, clammy skin Weakness, dehydration Usually there is no fever Prevention of staph food poisoning: Wash hands properly, especially after touching your nose or pimples. Use good temperature control to keep hot foods hot (140 F or above) and cold foods cold (45 F or less). This will keep the germs from making the poison. Don't nibble while preparing food. Your saliva will get from your hands to the customers' food. Don't smoke or use any kind of tobacco while preparing food. Your saliva will get into the food. Do not work if you have boils, abscesses or infected cuts. Mix food with sanitized spoons or spatulas, not your hands. E.coli E.coli germs are found in ground beef or on the surfaces of other beef products and in the feces of infected persons. People handling raw beef products can easily contaminate their hands and utensils with E.coli germs. It takes very few of these germs to make people sick. Hepatitis A Hepatitis A is an infection of the liver caused by a virus. It can be spread through food contaminated by feces after poor hand washing. A person may spread hepatitis from two weeks before they have symptoms to two weeks after. Some cases are mild and there may not be symptoms. Because people may not be aware they have hepatitis, they must always use good hand washing habits. Symptoms of hepatitis A: Begin to appear 2-6 weeks after exposure to hepatitis. Fever, chills, loss of appetite, nausea, vomiting, fatigue, pain in upper right abdomen, dark urine, light colored stools, and jaundice (yellowing of the skin and whites of the eyes). Even if there are no symptoms, hepatitis can be identified with a blood test. Prevention of hepatitis A: People with hepatitis A should not handle or prepare food for others. Good hand washing must be practiced after using the toilet, diapering children, cleaning toilets, and preparing food. Many other germs can cause illness. Most of these illnesses can be prevented by proper hand washing and by keeping hot food hot and cold food cold. Following these guidelines is your responsibility to your customers. Chemical Poisoning Chemical poisoning occurs when a chemical, such as a cleaning compound or a pesticide (such as rat poison or insect spray) gets into the food. Chemical poisoning can lead to death. Symptoms of chemical poisoning: Vary with the chemical. Usually acts very quickly. Usually there is an 'off taste'. Prevention of chemical poisoning: Store chemicals properly, below and away from food and food equipment. Label chemical containers clearly, including spray bottles. Use chemicals correctly.------------------ http://www.ibshealth.com/


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## zigmissus (May 19, 1999)

I'm quite familiar with the the dangers of MSG, but believe it or not, this sulfite stuff is news to me. Strangely enough, many of the foods Eric listed (dried fruits, dehydrated mashed potatoes, soup mixes, some breads, most salads) always give me an IBS attack. But the reactions listed are asthma-type symptoms. Could cramps and diarrhea be related to sulfites?


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## eric (Jul 8, 1999)

Zig, I think it is a different issue personally, although perhaps you are sensitive to it, but if thats what it was, it would not just be cramps and d, it would seem other symptoms would follow. ------------------ http://www.ibshealth.com/


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## Lakegirl (May 28, 2000)

Don't forget the other restaurant hazard. I read recently of tests they did in bathrooms in restaurants, where they took swabs off of toilet handles, stall doors and exit doors and found hideously high levels of various viruses and bacteria which can induce vile GI symptoms. They even claimed that hand dryers blow salmonella, etc. around the washroom which you can become infected with. Ugh. Just take that hand sterilizer stuff and avoid the washrooms at all costs. One day we watched a waitress wipe off the chair seats (!!!) and then wipe off the table top with the same cloth and then set cutlery out on it. Just watching that nauseated me. A friend who worked in a highly reputed restaurant said a waitress once dropped a steak on the floor and the chef told her to put it on the plate and take it out. He felt it was still hot so bacteria would be killed! Would that be the same floor on which staff shoes have tracked bacteria from the bathroom floor? Gag! And many years ago I worked in a very highly priced, highly respected restaurant (I'm talking 5 stars, international reputation, Gourmet mag write-ups) at which the servers had to clean the bathrooms (yeah, toilets too) between the two evening seating times. I complained to the health dept. and they said there was nothing wrong with it. Just think, that waitress's uniform hovering over your food was just hanging around a toilet. Yummy. I hate eating out because of what I've seen go on. I've seen resorts so overwhelmed with customers that they make chefs/cooks work even if they're throwing up into garbage cans in the kitchen. (Seriously, high end establishments.) Just say no to eating out!


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## Guest (Aug 16, 2000)

Lakegirl - I know everything you say is true, but please! I try to be as clean as possible and not think about that stuff. I have also worked in restaurants and seen many meals served very "clean." I have also been in very clean bathrooms at some restaurants. You can't live your life avoiding everything that may cause you to be sick - grocery stores also have problems with uncleanliness.Everyone should do the best they can - if you see things going on at a restaurant or grocery store you don't like, then go somewhere else. Life will never be perfectly sanitary.


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## JeanG (Oct 20, 1999)

HI Eric:Thanks for the highly informative articles! Since you have so much experience within the food industry, and you have many contacts within the industry, I think you have firsthand knowledge of what goes on there, much more than those of us who have never worked in these places.







JeanG


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## Lakegirl (May 28, 2000)

Sorry, just trying to raise awareness that it might not be the food in all cases that's the issue. You just take your chances when you can't control the variables. I do actually eat in restaurants, I'm just very, very picky and scan the joint for cleanliness before I'll eat there. Not in an obsessive way, just a self-preservation sort of way. I've actually never gotten sick from eating restaurant food. Knock on wood.


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## eric (Jul 8, 1999)

What lakegirl said is true and even the stories happen. Because it is a fine dinning establishment doesn't mean it is any safer then a dive really, unless the chef and the management enforces as much caution as possible. The fact here is zillions of people eat out everyday no problem.One of the points here is tracing a trigger, which as you can see would be hard to pinpoint. I also think it can go overboard.I also have to add one of the most unsanitary area we are exposed to are our own kitchens which in a recent study which I remember seeing on tv was worse then the peoples bathrooms.A microscopic picture of a handiwipe from a kitchen.







------------------ http://www.ibshealth.com/ [This message has been edited by eric (edited 08-16-2000).]


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