Salicylate elimination diets in children: is food restriction supported by the evidence?

Richard F Heller, C Ann Heller and Jane Heller
Med J Aust 2013; 199 (7): . || doi: 10.5694/mja13.10829
Published online: 7 October 2013

To the Editor: The two contributions by Gray and colleagues1 and Loblay and colleagues2 on the topic of salicylate intolerance illustrate that absence of evidence does not equate to evidence of absence.3 Neither paper quotes the admittedly sparse European peer-reviewed literature on the topic, including an understanding of the basic biochemistry,4,5 a diagnostic test, and clinical prevalence studies of intolerance to dietary salicylate.5-7 A wealth of anecdotal evidence also exists about the benefits of a low salicylate diet on gastrointestinal symptoms in the community, with support groups such as the Food Intolerance Network reporting many “success stories” resulting from dietary interventions ( It is unfortunate that there is a lack of high-quality clinical and epidemiological research into what appears to be a common problem. However, even in the absence of a greater understanding of the underlying causes, selective and appropriately implemented dietary manipulation may be really helpful.

  • 1 Faculty of Health and Medicine, University of Newcastle, Sydney, NSW.
  • 2 Sydney, NSW.
  • 3 School of Animal and Veterinary Science, Charles Sturt University, Wagga Wagga, NSW.


Competing interests:

No relevant disclosures.

  • 1. Gray PEA, Mehr S, Katelaris CH, et al. Salicylate elimination diets in children: is food restriction supported by the evidence? Med J Aust 2013; 198: 600-602. <MJA full text>
  • 2. Loblay RH, Soutter VL, Swain AR. Salicylate elimination diets in children. Med J Aust 2013; 198: 603. <MJA full text>
  • 3. Altman DG, Bland JM. Statistics notes: absence of evidence is not evidence of absence. BMJ 1995; 311: 485.
  • 4. Paterson J, Baxter G, Lawrence J, Duthie G. Is there a role for dietary salicylates in health? Proc Nutr Soc 2006; 65: 93-96.
  • 5. Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int 2008; 105: 137-142.
  • 6. Zopf Y, Baenkler HW, Silbermann A, et al. The differential diagnosis of food intolerance. Dtsch Arztebl Int 2009; 106: 359-369.
  • 7. Raithel M, Baenkler HW, Naegel A, et al. Significance of salicylate intolerance in diseases of the lower gastrointestinal tract. J Physiol Pharmacol 2005; 56 Suppl 5: 89-102.


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