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Lovers of Chinese food may have experienced a headache or feeling sick after eating a meal from a takeaway or restaurant, but might not know it's a real syndrome.

What doctors used to call 'Chinese restaurant syndrome' is actually a reaction to monosodium glutamate (MSG), a seasoning commonly used in Chinese food.

Now renamed MSG symptom complex, it happens when the flavouring causes symptoms like headache, sweating, nausea, tiredness or a rapid heart rate.

Scientists have not produced convincing evidence of the negative health effects of eating MSG, and it is considered safe to eat by the US Food and Drug Administration.

But MSG symptom complex is real, medics say, and avoiding foods which contain it is the best way to stop it happening to you. 

However, the seasoning is found in popular foods like hot dogs, canned foods and crisps as well as Chinese food, so may be hard to avoid for many. 

London-based GP and writer Dr Jane Leonard has revealed drinking ginger or peppermint tea, as well as staying hydrated and taking painkillers is the best way to help yourself if you do fall victim to MSG.

MSG is best known for being used to flavour Chinese food, but it is thought to cause unpleasant effects in some people such as tiredness and nausea

Scientific evidence for the effects of MSG is limited but doctors and patients say it is a real issue, though they are not sure why the seasoning causes these symptoms.

MSG is a form of glutamic acid which is found naturally in the human body, as well as in foods including cheese, meat, fish, mushrooms, tomatoes and walnuts. 

But despite its natural occurrence, when MSG is used as an added flavouring, it can have unpleasant effects on people who eat it.

A study by the Yeonsung and Kyung Hee universities in South Korea, published in 2014, found people complained of various problems after eating MSG.

Most common were thirstiness, feeling sleepy or weak, feeling sick or having a headache. 

Chinese restaurant syndrome, as it reportedly used to be called by doctors, is a collection of symptoms caused by a reaction to the monosodium glutamate (MSG) which is best known for being used to flavour Chinese food.

The medical name for the condition is now MSG symptom complex and, although experts are not sure why, it may cause the following symptoms:

  • Breathing difficulties
  • Chest pain
  • Tiredness
  • Nausea 
  • Facial flushing 
  • Headache
  • Numbness or burning in the mouth
  • A rapid heart rate
  • Sweating
  • Swelling of the face 

Dr Jane Leonard, a London-based GP, says if someone is experiencing mild symptoms they should try drinking water and peppermint or ginger tea, resting, and taking painkillers for a headache.

Source: Medical News Today 

And Dr Leonard, a GP and cosmetic doctor in London, says there are ways to make yourself feel better if you feel bad after eating MSG.

'Scientific research into the syndrome is limited' 

She wrote in Medical News Today: 'Some people experience symptoms, such as headaches and sweating, after eating in Chinese restaurants. 

'The medical community once called this group of symptoms Chinese restaurant syndrome. Doctors now call it MSG symptom complex. 

'While there are many anecdotal reports of MSG-induced symptoms, scientific research into the syndrome is limited.

'The treatment for MSG symptom complex varies, depending on the symptoms and their severity.'

Try drinking ginger or peppermint tea 

Dr Leonard suggests if people feel mild symptoms they should drink peppermint or ginger tea to help settle their stomach.

Ginger tea is known to help reduce nausea, and has been used by pregnant women and those who have been through chemotherapy, to make them feel less sick.

Scientists are not sure why the tea calms the stomach, but think it could be due to gingerol, the main ingredient in the root, controlling levels of brian chemical serotonin – which is linked to vomiting – or reducing inflammation in the gut.

Peppermint tea, meanwhile, is said to break down fat in the digestion system, relieving nausea.

Dr Leonard says people suffering after eating MSG should also drink water to keep hydrated, rest, and take painkillers if they have a headache.

If someone suffers more severe symptoms, like difficulty breathing, chest pain or an allergic reaction, they should visit their doctor.

Severe reactions are possible 

One man in Mahad, northern India, was reported in 2017 to have lost his voice and ability to swallow after eating MSG.

According to a report in the Indian Journal of Critical Care Medicine, the 23-year-old went to hospital with a difficulty speaking and unable to swallow his saliva.

Doctors found his mouth had swelled up and blamed it on MSG in the Chinese fried rice he had eaten for dinner the night before.

The man complained of giddiness, sweating, and itching all over his body, but recovered in a couple of days.

Staying hydrated is most important. It is recommended to see a doctor if you have a high fever (temperature over 101.5 F), blood in your stool, prolonged vomiting, or dehydration.  Signs of dehydration, including a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up, or diarrheal illness that lasts more than 3 days. Learn more.

MSG stands for monosodium glutamate. It is a flavor enhancer that is commonly added to Chinese food, canned vegetables, soups, and processed meats. It is part of a larger group of chemicals called glutamates. “MSG contains glutamic acid which is also naturally found in tomatoes, parmesan cheese, meat, walnuts, clams, sardines, mushrooms, and other foods,” says Emily Rubin, RD, the head dietitian for the celiac and fatty liver centers at Thomas Jefferson University in Philadelphia.

MSG is added to foods to enhance their savory or umami quality. Umami is a fifth flavor category, joining sweet, sour, salty, and bitter, according to the Academy of Nutrition and Dietetics. Always check out the ingredient list on the labels of prepared foods for MSG.

What does MSG taste like?

MSG has no texture or smell. It simply enhances a food’s natural flavor as opposed to adding a new one and tends to be most flavor intensifying when used in poultry, seafood, meats, and some vegetables.

What is MSG made of?

In a nutshell, MSG is produced by fermenting starch, sugar beets, sugar cane, or molasses. Fermentation is the process by which yeast or bacteria convert carbs into alcohol. This is the same process used to make yogurt and other healthful fermented foods.

Where did MSG come from?

A Japanese scientist first isolated MSG from seaweed soup in 1908 and noted its flavor-enhancing properties. He then filed a patent to produce MSG, which led to commercial production of the flavor enhancer; and decades later, the controversy started, the US Food and Drug Administration notes. In 1968 a brouhaha ignited when a biomedical researcher wrote to the editors of the New England Journal of Medicine citing a strange illness he developed after eating at Chinese restaurants—specifically those that cooked with MSG. His symptoms included numbness, weakness, and heart palpitations and became known as “Chinese Food syndrome.” Despite the lack of social media at the time, the letter went viral. Soon after its publication, everyone turned on MSG and a flurry of research on its health effects began.

There has been controversy as to whether some people develop symptoms such as headaches, muscle aches, and tingling after consumption of MSG, according to Rubin. “There has been no definitive evidence of a link between MSG and these symptoms,” she says. Despite this, some 50 years after the syndrome was first named, U.S. consumers still say they avoid MSG, according to the International Food Information Council, an industry-funded group.

The U.S. Food and Drug Administration says that MSG is “generally recognized as safe” (GRAS). The watchdog group requires that foods containing added MSG list it on the ingredient panel as monosodium glutamate. If MSG is found naturally in some of the ingredients (hydrolyzed vegetable protein, autolyzed yeast, hydrolyzed yeast, yeast extract, soy extracts, and protein isolate), the manufacturer does not have to list MSG on the label. That said, these foods can’t say “No MSG” or “No added MSG” on their packaging. MSG also cannot be listed as generic spices and flavoring. Here’s a guide to decoding food labels.

Why do people think MSG is bad?

Some people may be sensitive to the additive and experience swelling in the throat and other symptoms when they consume a lot. Experts such as Michael Galitzer, MD, an integrative medicine specialist in Los Angeles and author of Outstanding Health: A Longevity Guide for Staying Young, Healthy, and Sexy for the Rest of Your Life believe the flavor enhancer is dangerous: “Its ingestion can cause inflammation of the small intestine, referred to as leaky gut, which will result in symptoms such as bloating, gas, diarrhea, and abdominal pain,” he says. These 7 signs suggest you may have a leaky gut.

How much MSG is safe?

Most research suggests you’d have to eat more than 3 grams of added MSG in a sitting to experience adverse effects—that’s according to a 2019 review of studies published in the journal Comprehensive Reviews in Food Science and Food Safety. The FDA explains that a typical serving of a food with added MSG contains less than 0.5 grams of MSG and that Americans consume about that much daily, on average. “MSG is generally found in processed foods. If your diet is filled with fresh, whole foods, your MSG intake is low,” says Rubin.

Is MSG gluten-free?

Yes, according to the National Celiac Foundation. There may be starches or sugars used in fermenting MSG, but wheat starch—which contains gluten—is not one of them. Even if wheat starch were used to make MSG, it is highly unlikely that the end-product would contain traces of gluten. They further clarify by stating that a person with celiac disease may react to the wheat in soy sauce, but not the MSG, for example.

Does MSG cause headaches?

MSG has been linked to headaches—including a debilitating migraine headache—but this link is far from conclusive. In fact, some research suggests MSG does not increase the risk of migraines. These findings were presented by the headache information site Curelator at the 2018 Annual Scientific Meeting of the American Headache Society. In January 2018, the International Headache Society struck MSG from a list of causative factors for headaches. Here are 13 foods that do make headaches worse.

The FDA states that drowsiness that may occur in some people who are sensitive to MSG and consume 3 grams or more of the flavor enhancer. “MSG is controversial and the research has been inconsistent, but there are MSG-sensitive people and for them, it can trigger headaches, migraine, numbness, and extreme fatigue,” says Robin Foroutan, RDN, an integrative medicine dietitian at the Morrison Center in New York City and a spokesperson for the Academy of Nutrition and Dietetics. “I generally recommend that people with tendencies for headaches, migraine, and fatigue avoid it.”

mark schlicht/ShutterstockWhat types of food tend to have added MSG?

Soy sauce is a common one, says Foroutan. “It’s best to read the ingredient list if you want to avoid it.” Here are some more types:

  • Chips and other snack foods
  • Seasoning blends
  • Canned soups
  • Frozen foods
  • Processed meats (jerky, deli meats, hot dogs, sausages)

Fast food and MSG:

At one time, it was easy to find MSG in fast-food restaurants, but more and more chains are eliminating the flavoring. Here’s the lowdown on some popular fast-food chains and whether they use MSG.

Does McDonald’s use MSG?

None of the items on McDonald’s core U.S. menu contain added MSG, but a handful of test and regional items in the United States do contain added MSG, a McDonald’s spokesperson confirmed.

Does Panda Express use MSG?

This popular Chinese restaurant does not add MSG to any of their dishes, but some ingredients may contain natural MSG, according to the corporate website.

MSG is present in some of Chick-fil-A’s menu choices, but they also offer a variety of options that do not contain added MSG, states Chick-fil-A, Inc.

Does Burger King use MSG?

The chain has dropped the flavoring from all its foods.

Does Subway use MSG?

The popular sandwich shop doesn’t add MSG to any of the items on the chain’s standard menu.

Does Domino’s use MSG?

The pizza delivery chain does not add MSG to any of its food.

homelesscuisine/Shutterstock

Could MSG be good for you?

Consuming umami-rich broth may promote healthy eating behaviors and food choices, especially in women at risk of obesity, according to a study in Neuropsychopharmacology. Researchers evaluated changes in the brains of women after they consumed chicken broth with or without MSG. The broth with added MSG lit up areas of the brain connected to satisfaction and better eating control, the researchers discovered. What’s more, women who had the broth made better choices during their meal, favoring foods with less saturated fat.

“Our study suggests the possibility that people at high risk of obesity could benefit from an umami-rich broth before a meal to facilitate healthy eating and healthy food choice,” says Miguel Alonso-Alonso, MD, PhD, an Assistant Professor at the Center for the Study of Nutrition Medicine in Beth Israel Deaconess Medical Center in a news release.

“In Western and European cuisine, flavor is built by adding fat,” says Carlene Thomas, RDN, a dietitian in the Washington DC- area and author of The Wedding Wellness Workbook: Your Nutrition How-To Before “I Do.” This includes butter, heavy cream, and cheese. “For those struggling with calorie consumption, using umami to season rather than fat could help with healthy weight management,” she says. (Here are 9 signs your overeating is actually an addiction.)

MSG can also be a major tool in helping to reduce your salt intake, Thomas adds. “The use of umami allows for less salt, specifically for MSG. That means, sodium levels can be reduced while maintaining or improving the taste of a product,” she explains. That can make a big difference in sodium intake, she says. (Check out these 7 signs you are eating too much salt.)

Sources

  • Emily Rubin, RD, LDN, the head dietitian for the celiac and fatty liver centers at Thomas Jefferson University in Philadelphia.
  • The International Food Information Council Foundation, "Let's Bust 3 Common Myths About MSG"
  • Academy of Nutrition and Dietetics, "Umami: The Science and Lore of Healthy Eating"
  • Comprehensive Reviews in Food Science and Food Safety: "A Review of the Alleged Health Hazards of Monosodium Glutamate"
  • New England Journal of Medicine, "Chinese-Restaurant Syndrome"
  • The International Food Information Council Foundation, "Newsbite: Why Are Americans Still Avoiding MSG?"
  • European Food and Safety Authority (EFSA), "EFSA reviews safety of glutamates added to food"
  • Michael Galitzer, MD, an integrative medicine specialist in Los Angeles, Calif. and author of Outstanding Health: A Longevity Guide for Staying Young, Healthy, and Sexy for the Rest of Your Life.
  • National Celiac Foundation, "Confusing Ingredients in the Gluten-Free Diet"
  • Panda Express, "The Original Orange Chicken"
  • Mcdonalds, statement from corporate communications
  • Chick-fil-A, statement from corporate communications
  • Robin Foroutan, RDN, an integrative medicine dietitian at the Morrison Center in New York City and a spokesperson for the Academy of Nutrition and Dietetics."It's best to read the ingredient list if you want to avoid it."
  • American Headache Society, "New Curelator Data Questions Popular Belief That Many Common Foods Act As Migraine Triggers"
  • Neuropsychopharmacology, "Neurocognitive effects of umami: association with eating behavior and food choice"
  • Miguel Alonso-Alonso, MD, PhD, an Assistant Professor at the Center for the Study of Nutrition Medicine in Beth Israel Deaconess Medical Center
  • Carlene Thomas RDN, LD, a dietitian in the Washington DC- area and author of The Wedding Wellness Workbook: Your Nutrition How-To Before "I Do"