It probably isn't sulfites

WINE TALK
1

Lettie Teague in today’s WSJ:

Wine Headache? Chances Are It’s Not the Sulfites

Key take-aways, some of which I knew, other parts of which I didn’t:
–True sulfite allergies are extremely rare, and are generally only found in extremely asthmatic people. Moreover, the symptoms are shortness of breath and wheezing, not headaches.
–White wines generally have more sulfites.
–A blind study of the affect of white, red and white-dyed-red wine found not difference in headache rates.
–Most wine headaches are probably due to alcohol, not anything else in the wine (surprise, surprise!).

2

Probably not.

Sulfites are getting a very undeserved bad rap these days.

3

I have a somewhat different take on the article.

I think is allows that as much as one percent of the population is sulfite sensitive. That’s a lot of people. As long as wine labels don’t have an ingredients list (like a bag of dried fruit), I think the sulfites need to be called out.

Although one sentence in the article allows for the possibility of other allergies due to “proteins or histamines”, this article generally dismisses the possibility of allergic reactions to red wine. My wife and another person I know will sometimes break out in hives from drinking red wine, occasionally fairly dramatically. This is unrelated to asthma. It may also be unrelated to sulfites - biogenic amines were mentioned in an earlier thread - but there is certainly some sort of allergic reaction.

4

Histamine from the oak is not good, either.

5

But, since all wines – even those with no added sulfurs – have some sulfites naturally, the warning label seems pointless.

Also, an ingredients list is what is used to make a product. It doesn’t include the chemical byproducts of fermentation, cooking, etc.

I wish the article had dealt more with histamines and other possible irritants. But I think her point was to take on the myths about sulfites, and in particular the notion that they produce headaches. Even that 1% who are actually allergic aren’t going to get headaches, the doctors said. They’ll just be gasping for breath.

6

I understand the point, which is valid. I think the article could have been more balanced, i.e. less dismissive of the small percentage of folks with real allergies.

Natural or added, the substance can be there, and unfortunately some folks who are susceptible may still need to be reminded and producers still need to CYA so they don’t get sued by the folks who ignore the labeling.

7

Producers aren’t doing it to cover their asses. The Feds require it!

8

Headaches are almost always due to the accumulation of the alcohol metabolite, acetaldehyde. There is a genetic predisposition to being an incomplete metabolizer. (Ethanol should give you the end metabolic product of acetate which is a good buffer in the blood.) The genetic problem is a lack of alcohol dehydrogenase enzyme which changes acetaldehyde to acetate. This is a potent cause of headache. Dehydration also contributes.

9

One percent of the population is sulfite sensitive, but only about half of the US population drinks wine and only about 22 percent buys wine more than four times a month. And I would imagine that if you think you’re getting headaches from sulfites in wine, you probably wouldn’t be buying wine several times a month unless you’re a real masochist, and that number is only about five to ten percent of the population.

So assuming that the population of masochists mirrors the rest of the population (and I suppose that in a literal sense they do because most people avoid pain) maybe only half the masochists repeatedly buy wine to get headaches. But for them, headaches wouldn’t be problematic would they?

So once you remove the people who don’t drink wine and the people who buy wine because it gives them headaches, the percentage of people who could possibly get headaches from sulfites in wine gets a lot smaller.

As far as people having various allergies, that’s got to be true. Until I was in my forties I thought that everyone flushed when confronted with sour fresh fruits like strawberries, oranges, pineapples, etc. I mentioned that to someone and she looked at me like I was crazy and told me I had an allergy. Who knew? Same thing happens when I have many really acidic white wines. I don’t avoid any of those things and obviously the reaction isn’t from the sulfites.

For those people who blame the sulfites in wine, they should try some dried apricots or raisins, or they should try asparagus (full of sulfur compounds that make your pee smell), smoked and dried fish, garlic, onions, chives and leeks, which are full of sulfur compounds that give those foods their pungency, or soy sauce. There are many different sulfur compounds so not everything is going to cause reactions, but I think that the word “sulfite”, which has a hard sound to it, probably has as much to do with people’s fear as anything real.

10

Maybe they should go the Parks & Recreation route and call sulfites “S-Dazzle.”

11

dennis feinstein already has that trademarked, bro.

12

I have seen this with someone I know, but it happens with white wine, not red, and I wonder why?

13

Is that 22% of winedrinkers, or 22% of the US total population?

14

I am curious about this statistic. Do you have some support for it?

I had always thought it was much lower but I don’t have a specific data set to support my current view.

15

The article says less than 1%:

More important, only a tiny percentage of the U.S. population—less than 1%—actually suffers from true sensitivity to sulfites, and these people are invariably chronic asthmatics, according to David Lang, M.D., chairman of the Department of Allergy and Clinical Immunology of the Cleveland Clinic in Cleveland, Ohio.

Dr. Lang told me that in his 28 years of practice, he’s seen only one person who had “true allergic reactions” to sulfites. Such reactions, he added, typically involve shortness of breath and wheezing, not headaches. “Sulfites have been around for centuries and have been very well-tolerated,” Dr. Lang pointed out.

16

I had heard, without supporting reference, that it was more like 1 in 10,000 that had a actual metabolic deficiency which renders them unable to process sulfites. These people can’t eat eggs or garlic along with sulfited wines, without reactions. Perhaps there are other categories of people who react as well?

17

If this thread hasn’t given you a headache yet, perhaps this post will.

The main points that sulfites are not typically the cause of headaches, and that true life-threatening sulfite allergies are very rare, have been known for many years but bear repeating periodically because the public misperception is tough to shake. Here’s an abstract from a 20-year-old review article which nicely summarizes the salient points.

J Am Coll Nutr. 1995 Jun;14(3):229-32.
Sulfite sensitivity: significance in human health.
Lester MR.
Abstract
Endogenous sulfite is generated as a consequence of the body’s normal processing of sulfur-containing amino acids. Sulfites occur as a consequence of fermentation and also occur naturally in a number of foods and beverages. As food additives, sulfiting agents were first used in 1664 and approved in the United States as long ago as the 1800s. With such long experience with their use, it is easy to understand why these substances have been regarded as safe. They are currently used for a variety of preservative properties, including controlling microbial growth, preventing browning and spoilage, and bleaching some foods. It is estimated that up to 500,000 (< .05% of the population) sulfite-sensitive individuals live in the United States. Sulfite sensitivity occurs most often in asthmatic adults–predominantly women; it is uncommonly reported in preschool children. Adverse reactions to sulfites in nonasthmatics are extremely rare. Asthmatics who are steroid-dependent or who have a higher degree of airway hyperreactivity may be at greater risk of experiencing a reaction to sulfite-containing foods. Even within this limited population, sulfite sensitivity reactions vary widely, ranging from no reaction to severe. The majority of reactions are mild. These manifestations may include dermatologic, respiratory, or gastrointestinal signs and symptoms. Severe nonspecific signs and symptoms occur less commonly. Broncho-constriction is the most common sensitivity response in asthmatics. The precise mechanisms of the sensitivity responses have not been completely elucidated. Inhalation of sulfur dioxide (SO2) generated in the stomach following ingestion of sulfite-containing foods or beverages, a deficiency in a mitochondrial enzyme, and an IgE-mediated immune response have all been implicated.(ABSTRACT TRUNCATED AT 250 WORDS)

As for the bare bone basics of ethanol metabolism…

Alcohol dehydrogenase (ADH) comes in various forms (isozymes), but it’s main job is to convert alcohol into acetaldehyde, not acetaldehyde into acetate. Aldehyde dehydrogenase converts acetaldehyde into acetate.

Alcohol makes you drunk. It also causes diuresis by inhibiting antidiuretic hormone, leading to dehydration which is one of the causes of hangover symptoms. Acetaldehyde is a toxin that also gives rise to a number of hangover symptoms. Acetate is non-toxic.

Problems can arise from under- or over-activity of alcohol dehydrogenase.

People with low alcohol dehydrogenase activity don’t break down alcohol in the stomach as rapidly as normals and therefore absorb more alcohol, making them more easily inebriated after ingesting relatively low doses of alcohol. This is common in women, especially young women. There are also racial variances in alcohol dehydrogenase activity.

Some people carry a mutated version of alcohol dehydrogenase in which the enzyme is more efficient at converting ethanol to acetaldehye. Since their acetaldehyde dehydrogenase works at normal efficiency breaking down the acetaldehyde, they develop higher levels of that metabolite and are more prone to suffering its toxic effects.

18

Thanks for this David and for correcting my error. Nice post!

19

With this being very common in Asians (Asian Flush Syndrome).

20

Wine is also believed to be moderately high in Salicylates:

http://salicylatesensitivity.com/about/food-guide/alcohol/

So if you have Salicylate Sensitivity - aspirin allergy, sinus polyps, and asthma - also known as “Samter’s Triad”, then you probably shouldn’t be drinking wine.

On the other hand, I don’t know whether there are any prominent salicylate molecules which have sulphur atoms formally attached to them.

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