{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:18:39Z","timestamp":1768882719561,"version":"3.49.0"},"reference-count":48,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Salicylic acid and its derivatives (including acetylsalicylic acid\/aspirin) are popular in medicine. They also occur naturally in many food products. The aim of the study was to investigate the effect of the personalized low salicylate diet (PLSD) on the reduction of asthma, rhinosinusitis and urticaria symptoms in patients with hypersensitivity to aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs). To achieve the research goal, a prospective, nonrandomized, baseline-controlled intervention study was conducted. Thirty patients diagnosed with NSAIDs hypersensitivity, who despite pharmacotherapy had symptoms of hypersensitivity, were included in the study. The PLSD was recommended for all participants for a period of two to four weeks. The intensity of subjectively declared symptoms of asthma, rhinosinusitis and urticaria were measured before and after dietary intervention, using, respectively, the asthma control test (ACT), the sino-nasal outcome test (SNOT-22) and the four-item itch questionnaire (FIIQ). Diet adherence and salicylate intake were measured by a 3-day food record. The severity of symptoms improved significantly after the intervention. The median of the ACT score was 24 scores before and 25 after the dietary intervention (p &lt; 0.002), the median of the SNOT-22 score was 25 before and 13 after a dietary intervention (p &lt; 0.0002) and the median of the FIIQ score was 5 before and 0 after a dietary intervention (p &lt; 0.0002). The intake of salicylates decreased from 0.79 mg\/day (before intervention) to 0.15 mg\/day (p &lt; 0.001) (during intervention). Although the usefulness of a low salicylate diet in the treatment of salicylate hypersensitivity is controversial, the results of our study indicate that the PLSD may have a positive effect in reducing symptoms of salicylate hypersensitivity and could be an additional tool supporting the therapy of these patients.<\/jats:p>","DOI":"10.3390\/nu13030991","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T11:18:38Z","timestamp":1616152718000},"page":"991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1302-9171","authenticated-orcid":false,"given":"Paulina K.","family":"K\u0119szycka","sequence":"first","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str., 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1093-4571","authenticated-orcid":false,"given":"Ewa","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str., 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3071-7593","authenticated-orcid":false,"given":"Danuta","family":"Gajewska","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C Nowoursynowska Str., 02-776 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1016\/S0002-8223(21)03743-3","article-title":"Salicylates in foods","volume":"85","author":"Swain","year":"1985","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2891","DOI":"10.1021\/jf058158w","article-title":"Salicylic acid content of spices and its implications","volume":"54","author":"Paterson","year":"2006","journal-title":"J. Agric. Food Chem."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/mnfr.201000408","article-title":"A systematic review of salicylates in foods: Estimated daily intake of a Scottish population","volume":"55","author":"Wood","year":"2011","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jfca.2016.12.008","article-title":"Naturally occurring dietary salicylates: A closer look at common Australian foods","volume":"57","author":"Malakar","year":"2017","journal-title":"J. Food Compos. Anal."},{"key":"ref_5","unstructured":"Swain, A.R. (1988). The Role of Natural Salicylates in Food Intolerance. [Ph.D. Thesis, University of Sydney]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jpba.2015.12.016","article-title":"Simultaneous determination of salicylic, 3-methyl salicylic, 4-methyl salicylic, acetylsalicylic and benzoic acids in fruit, vegetables and derived beverages by SPME-LC-UV\/DAD","volume":"20","author":"Aresta","year":"2016","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_7","first-page":"164","article-title":"Salicylic acid and its derivatives in plants: Medicines, metabolites and messenger molecules","volume":"20","author":"Pierpoint","year":"1994","journal-title":"Adv. Bot. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"493","DOI":"10.4161\/psb.4.6.8392","article-title":"Biosynthesis of salicylic acid in plants","volume":"4","author":"Chen","year":"2009","journal-title":"Plant Signal. Behav."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1021\/jf950458y","article-title":"Determination of acetylsalicylic acid and salicylic acid in foods, using HPLC with fluorescence detection","volume":"44","author":"Venema","year":"1996","journal-title":"J. Agric. Food Chem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.foodchem.2007.03.007","article-title":"Free salicylic acid and acetyl salicylic acid content of foods using gas chromatography-mass spectrometry","volume":"105","author":"Scotter","year":"2007","journal-title":"Food Chem."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11085","DOI":"10.1021\/acs.jafc.7b04313","article-title":"Overall content of salicylic acid and salicylates in food available on the European market","volume":"65","author":"Szkop","year":"2017","journal-title":"J. Agric. Food Chem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1159\/000488348","article-title":"Which Fruits and Vegetables Should Be Excluded from a Low-Salicylate Diet? An Analysis of Salicylic Acid in Foodstuffs in Taiwan","volume":"176","author":"Chiang","year":"2018","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1136\/jcp.54.7.553","article-title":"Salicylic acid in the serum of subjects not taking aspirin. Comparison of salicylic acid concentrations in the serum of vegetarians, non-vegetarians, and patients taking low dose aspirin","volume":"54","author":"Blacklock","year":"2001","journal-title":"J. Clin. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.mehy.2004.10.001","article-title":"Could vitamin S (salicylate) protect against chilhood cancer?","volume":"64","author":"Morgan","year":"2005","journal-title":"Med. Hypotheses"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00394-005-0572-9","article-title":"The effects of cranberry juice consumption on antioxidant status and biomarkers relating to heart disease and cancer in healthy human volunteers","volume":"45","author":"Duthie","year":"2006","journal-title":"Eur. J. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1017\/S0007114507744422","article-title":"Circulating salicylic acid is related to fruit and vegetable consumption in healthy subjects","volume":"98","author":"Spadafranca","year":"2007","journal-title":"Br. J. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.ijcard.2012.09.192","article-title":"Mediterranean diet: Natural salicylates and other secrets of the pyramid","volume":"166","author":"Siniorakis","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1136\/jcp.56.9.651","article-title":"Urinary excretion of salicyluric and salicylic acids by non-vegetarians, vegetarians, and patients taking low dose aspirin","volume":"56","author":"Lawrence","year":"2003","journal-title":"J. Clin. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/all.13599","article-title":"Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)-a EAACI position paper","volume":"74","author":"Kowalski","year":"2019","journal-title":"Allergy"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/j.1365-2133.1960.tb13817.x","article-title":"The effect of aspirin in chronic urticaria","volume":"72","author":"Warin","year":"1960","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1136\/bmj.2.5410.649","article-title":"Urticarial Reactions","volume":"2","author":"Calnan","year":"1964","journal-title":"Br. Med. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"975","DOI":"10.7326\/0003-4819-68-5-975","article-title":"Intolerance to aspirin. Clinical studies and consideration of its pathogenesis","volume":"68","author":"Samter","year":"1968","journal-title":"Ann. Intern. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1034\/j.1399-3003.2000.016003432.x","article-title":"Natural history of aspirin-induced asthma. AIANE Investigators. European Network on Aspirin-Induced Asthma","volume":"16","author":"Szczeklik","year":"2000","journal-title":"Eur. Respir. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1067\/mai.2003.1487","article-title":"Aspirin-induced asthma: Advances in pathogenesis, diagnosis, and management","volume":"111","author":"Szczeklik","year":"2003","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/all.12941","article-title":"Respiratory hypersensitivity reactions to NSAIDs in Europe: The global allergy and asthma network (GA2 LEN) survey","volume":"71","author":"Makowska","year":"2016","journal-title":"Allergy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.jaci.2014.08.020","article-title":"Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature","volume":"135","author":"Rajan","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1046\/j.1365-2230.2003.01228.x","article-title":"Aspirin sensitivity and urticaria","volume":"28","author":"Grattan","year":"2003","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/all.12539","article-title":"Challenge-proven aspirin hypersensitivity in children with chronic spontaneous urticaria","volume":"70","author":"Cavkaytar","year":"2015","journal-title":"Allergy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/0194599814555836","article-title":"Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: A pilot crossover study","volume":"152","author":"Sommer","year":"2015","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1002\/alr.21678","article-title":"A novel treatment adjunct for aspirin exacerbated respiratory disease: The low-salicylate diet: A multicenter randomized control crossover trial","volume":"6","author":"Sommer","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s12161-016-0621-4","article-title":"A Simple and Robust Protocol for fast RP-HPLC Determination of Salicylates in Foods","volume":"10","author":"Szkop","year":"2017","journal-title":"Food Anal. Methods"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"7037","DOI":"10.1039\/C9FO01660K","article-title":"Dietary salicylates in herbs and spices","volume":"10","author":"Gajewska","year":"2019","journal-title":"Food Funct."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1093\/ajcn\/51.2.241","article-title":"A new predictive equation for resting energy expenditure in healthy individuals","volume":"51","author":"Mifflin","year":"1990","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jaci.2003.09.008","article-title":"Development of the Asthma Control Test: A survey for assessing asthma control","volume":"113","author":"Nathan","year":"2004","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1749-4486.2009.01995.x","article-title":"Psychometric validity of the 22-item Sinonasal Outcome Test","volume":"34","author":"Hopkins","year":"2009","journal-title":"Clin. Otolaryngol."},{"key":"ref_36","first-page":"600","article-title":"Czteropunktowy kwestionariusz oceny \u015bwi\u0105du\u2014Walidacja kwestionariusza","volume":"99","author":"Reich","year":"2012","journal-title":"Dermatol. Rev. Prz. Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1111\/all.12260","article-title":"Classification and practical approach to the diagnosis and management of hypersensitivity to nonsteroidal anti-inflammatory drugs","volume":"68","author":"Kowalski","year":"2013","journal-title":"Allergy"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/j.1398-9995.1980.tb01730.x","article-title":"Aspirin intolerance and recurrent urticaria in normal adults and children. Epidemiology and review","volume":"35","author":"Settipane","year":"1980","journal-title":"Allergy"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1159\/000342424","article-title":"Clinical management of patients with a history of urticaria\/angioedema induced by multiple NSAIDs: An expert panel review","volume":"160","author":"Asero","year":"2013","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/0091-6749(90)90222-P","article-title":"Long-term effects of aspirin desensitization--treatment for aspirin-sensitive rhinosinusitis-asthma","volume":"85","author":"Sweet","year":"1990","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_41","first-page":"303","article-title":"Exploring the association between ingestion of foods with higher potential salicylate content and symptom exacerbation in chronic rhinosinusitis. Data from the National Chronic Rhinosinusitis Epidemiology Study","volume":"57","author":"Philpott","year":"2019","journal-title":"Rhinology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1002\/alr.21826","article-title":"Contemporary management of chronic rhinosinusitis with nasal polyposis in aspirin-exacerbated respiratory disease: An evidence-based review with recommendations","volume":"6","author":"Levy","year":"2016","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s40629-020-00125-7","article-title":"Dietary implications in acetylsalicylic acid intolerance","volume":"29","author":"Ahrens","year":"2020","journal-title":"Allergo J. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1111\/j.1753-4887.1996.tb03803.x","article-title":"Salicylates in Foods","volume":"54","author":"Janssen","year":"1996","journal-title":"Nutr. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13601-015-0078-3","article-title":"Sensitivity to food additives, vaso-active amines and salicylates: A review of the evidence","volume":"5","author":"Skypala","year":"2015","journal-title":"Clin. Transl. Allergy"},{"key":"ref_46","first-page":"81","article-title":"Salicylate Food Intolerance and Aspirin Hypersensitivity in Nasal Polyposis","volume":"14","author":"Esmaeilzedeh","year":"2017","journal-title":"Iran. J. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s394-001-8358-x","article-title":"Salicylic acid in soups prepared from organically and non-organically grown vegetables","volume":"40","author":"Baxter","year":"2001","journal-title":"Eur. J. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"11648","DOI":"10.1021\/jf800974z","article-title":"Salicylic acid sans aspirin in animals and man: Persistence in fasting and biosynthesis from benzoic acid","volume":"56","author":"Paterson","year":"2008","journal-title":"J. Agric. Food Chem."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/3\/991\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:38:01Z","timestamp":1760161081000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/3\/991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,19]]},"references-count":48,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["nu13030991"],"URL":"https:\/\/doi.org\/10.3390\/nu13030991","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,19]]}}}