Food, Wine (Sulfites)
Some people with severe asthma have a sulfite sensitivity like in wine. Wine reactions are linked to sulfites, which are chemicals used in wine production. Sulfites are used to sterilize wine barrels and tanks. They are added at various stages of production to control the growth of yeast and bacteria, and at the end to preserve the taste, smell, and look of the product.1
Sulfites are also used as a preservative and antioxidant in other foods and drinks.2 Sulfites are commonly found in potatoes, shrimp, and dried fruit, as well as beer.2 They prevent foods from turning brown.
Symptoms of sulfite sensitivity
Symptoms of a sulfite sensitivity usually begin within an hour of having a drink.1 In surveys, asthma symptoms are most commonly reported. Hay fever, cough, swelling of the face, itching, eczema, and headache are also common. The symptoms usually improve after 15 to 60 minutes without treatment.1
Sulfite sensitivity is not an “allergy” in the classic sense, because sulfites do not set off the immune system.1 Therefore, a skin prick allergy test cannot be done to diagnose the sensitivity.3 An oral challenge is necessary for diagnosis. However, far fewer people react to sulfites in the laboratory than they do in a real-world setting.
How common is wine-induced asthma and sulfite sensitivity?
In laboratory tests, about 5% to 10% of people with asthma seem to be sensitive to sulfites.1 The reactions can be life-threatening. People with severe, persistent, and steroid-dependent asthma are most at risk.1,2,3
Outside of the laboratory, the number of people who say that they have alcohol-triggered asthma symptoms is much higher than 10%. In one survey of people with asthma, 32% of respondents reported wheezing after drinking alcohol of any type.1 Wine appears to be the drink that triggers asthma most frequently: 30% of wine drinkers and 22% of beer drinkers reported wine-induced asthma symptoms.
Why do so many people report a reaction, but so few people have a reaction in the laboratory? This gap has not been fully explained. People may experience more sulfite sensitivity when their asthma is not well controlled. Cigarette smoke, pollen, and other irritants might make a person more sensitive to alcohol. People doing a laboratory experiment would not be exposed to these other triggers.1 Finally, alcoholic drinks have several chemicals besides sulfites that could trigger a response.
What can I do to reduce my exposure to sulfites?
Unless you have a history of reacting to foods with sulfites, there is no recommendation to avoid them.3
If you must avoid sulfites due to sulfite sensitivity, it is important to read the Nutrition Facts label. Sulfites must be included on the label for any foods that have more than ten parts per million of sulfites, which is basically any added sulfites.4 Sulfites may appear on the ingredients label as:
- Sulfur dioxide
- Sodium sulfite
- Sodium bisulfite
- Potassium bisulfite
- Sodium metabisulfite
- Potassium metabisulfite
Use of sulfites on fresh vegetables and fruit was banned in 1986, after 13 people died and several more became sick.5 The FDA ban and labeling rules seems to have made a difference. Reports of sulfite sensitivity reactions dropped from 111 per year before the new rules to 10 per year.6