Salicylates.
They are the compounds in many plant foods that keep them from spoiling. Most fruits, and some vegetables, are salicylate-rich, as are virtually all spices, with turmeric/curry being among the worst offenders. Animal products (meat, eggs, dairy) are low-salicylate unless they’re spiced or cured. According to my research so far, just about anything fermented is high-salicylate.
According to “drugs.com,” salicylates (in their synthetic form?) do more than delay food rot:
Salicylates are nonsteroidal anti-inflammatory drugs. They inhibit the synthesis of prostaglandin and other mediators in the process of inflammation and have anti-inflammatory, antipyretic and analgesic properties. Salicylates can be used to reduce fever, pain and inflammation such as in arthritis.
In any event, salicylates can cause food sensitivities. The Feingold Diet, an elimination diet popular among parents of children with behavioral challenges, recommends cutting salicylates (along with additives, colorings, and other irritants) then trying higher-salicylate foods one-by-one to test tolerance levels. I’ve found a handful of websites dedicated to low-sal diets—that’s the lingo, apparently, to avoid pronouncing “salicylate” constantly—including this one and this one. Some people try, miraculously, to manage a low-sal SCD regimen.
The last week of 2016, we were skiing again, in Park City, Utah. Christmas day we flew from New York City to Salt Lake City and spent the night in a downtown hotel. The next morning we drove to Park City and picked up our rental skis. That afternoon, as Martin took a lesson at the National Ability Center and Adrian skied a few initial runs, I went to the Whole Foods Market and stocked up to cook for seven days. We reconvened at our rented condominium, had dinner, and hit the sack.
Martin had been having a troublesome few months, as you may know. When Martin is having a tough time, even if he’s sleeping well (which, these days, he almost invariably is), I often find myself awake during the night, fretting. Such was the case that first night in Park City. I woke around 3:30 am (which is 5:30 am in New York, just about when I usually get up) and couldn’t go back to sleep, so I moved to the sofa with my iPad and started reading.
I’m not sure why I felt compelled to navigate directly to salicylates. I’d thought about salicylates once or twice in the distant past and, for whatever reason, not pursued the topic, probably because I was onto some other next big thing. But this occasion, in the wee hours on a Park City sofa, I read a page about salicylate sensitivity, then another. And another. And another. I read about hyperactivity. Anxiety. Sensitivity. Uncontrollable laughter.
I thought, “This sounds like Martin. This sounds a lot like Martin.”
Martin’s diet has been clean for years. We’ve done GAPS, modified GAPS, SCD, and custom variations to account for mitochondrial dysfunction. We’ve made much progress toward heal Martin’s gut; he no longer “postures,” his belly is flat, his bowel movements are works of art. Still, he exhibits physical manifestations that may be food-related, like occasional shiners and visible inflammation. I’ve taken him recently for allergy testing, both traditional and naturopathic. I’ve discovered the beef allergy and a few others, including horses (riding them, not eating them, though there was once an unfortunate incident in South America when Martin ate some jerky after I failed to recognize the local word for “horse”). I avoid what I’m told to avoid.
But I’ve never put Martin on a low-sal diet.
By this time it was 4:30 am. I texted my friend Stacey, “I think Martin might be salicylate-intolerant. I really think I might be onto something.”
Her reply came hours later, when we were already skiing: “I don’t even know what that means, but hey glad you’re getting somewhere.” To the extent one can hear frustration in a text message, I heard some frustration in hers. I know she’s been having an even tougher time with her son, and feeling like they aren’t making much progress toward recovery.
That evening, I texted back, truthfully: “At the moment, I’m getting nowhere. He’s a complete disaster today.” I mean, why did you think I was texting you about salicylates at 4:30 am? “But I’m going to try removing salicylates from his diet and see what happens.”
I couldn’t put my low-sal plan into effect immediately. I’d already spent hundreds of dollars at the Whole Foods Market, stocking us up for the week. I had freeze-dried pineapple (high-sal!), fresh sweet potatoes (high-sal!), Lärabars (dates and almonds, high-sal!), coconut oil (extra high-sal!). Plus, I couldn’t find just one website that compiled all the salicylate contents that I needed to know about. Nori seaweed? Ground flax meal? Kohlrabi? Who could give me these important facts? I spent my evenings, after skiing and cooking, surfing around to put together the most comprehensive list I could. Different sources even disagreed on the salicylate content in some foods, like cauliflower and parsley.
I searched for a low-sal cookbook and finally located one, which needed to be sent from New Zealand. I ordered it immediately.
I returned to the Whole Foods Market and picked up lower-sal safflower oil—the store didn’t have the sunflower oil I was looking for—and white potatoes for breakfast. For the ski week, I managed what I would call “reduced-salicylate” but not “low-salicylate.” Martin had turkey bacon (unacceptable for celery salt and spices) and bison hot dogs (same), plus carrots and other medium-sal veggies. His mountainside snacks were still the nut- and seed-based products I’d brought to Utah or purchased on-site, though I did make an effort to send the cashew (low-sal) versions instead of the almond (high-sal) versions.
Our second-to-last morning in Utah, when I was almost out of food, I made Martin a “breakfast tortilla,” which was peanut butter spread between two almond tortillas and fried. Peanut butter is medium-salicylate, and almonds are high-salicylate, making this breakfast the largest serving of salicylates he’d had all week. Midway through breakfast, Martin started laughing. Laughing so hard he could barely get food into his mouth. Laughing so hard he needed to leave the table to jump. Martin laughs inappropriately, often. But this was of a new magnitude.
I asked him what was going on. He replied, “I don’t know! I can’t stop laughing!”
Uncontrollable laughter. Was this salicylate-related? When Adrian emerged, from the shower, I relayed what had happened. He could also see for himself, as Martin was still laughing. We decided immediately to explore a low-sal diet to the fullest. Adrian said, “I support this. Let me know what you need from me.”
We arrived home late Monday night, January 2. Tuesday morning, I went shopping. This first shopping venture in the low-sal world felt strange. Martin will be eating starchy foods he loves that previously I kept in strict moderation, like potatoes and rice. For cooking, the only plant-based oils I use at home have been raw coconut and extra-virgin oil, both of which are extremely high-sal; now, along with rendered animal fat, I am urged to use sunflower or rice-bran oil, and even (gasp!) the refined forms. Honey, with all its beneficial properties, is out now, even manuka honey. Lower-sal sweeteners are the more refined forms, like sugar cane. (No way. I’ll be sticking to maple syrup and maple sugar, which are allowed.) No more fruit, except papayas, bananas, peeled pears, and peeled golden delicious apples.
Of course, I wonder why Martin is salicylate-sensitive now (if in fact I’m correct). Has he always been this way? Is it new? Will I ever know? Martin is a never-ending series of “why now?”
The cookbook from New Zealand arrived quite promptly, considering the distance it had to travel. I opened it with alacrity, ready to get to work.
. . . And found that virtually every recipe contains (gluten) flour or dairy. Most recipes contain both.
Looks like I’m back to improvising.
Finding My Kid 