Allergies & Intolerance

Substances in wine may produce allergies or intolerance. The two are similar, except that allergies usually come on suddenly, can be triggered by a small amount of wine and are potentially life-threatening. Wine intolerance usually comes on gradually, may happen only when you drink generous amounts of wine or if you drink wine often, and is not life-threatening. Allergies express themselves most often by urticaria, wheezing, and asthma, while intolerance is often expressed through headaches and migraine although symptoms may overlap.

Sulftes

UK Mail Online June 5, 2012 (www.dailymail.co.uk). Up to 10% of people are sulfite sensitive, according to Professor Hassan Vally in Melbourne, Australia, and asthmatics may be more prone. Reactions vary from flushed skin and urticaria, to elevated blood pressure, nausea, wheezing, asthma, and even fatal anaphylactic shock. Headaches, often attributed to sulfites, do not occur from sulfites. The highest levels of sulfites are in wine, beer, dried fruit, pizza, potato chips, jam, and processed meats. It is theorized that sulfites might interact with saliva to form a gas in the mouth which tightens airways or the inability to convert sulfites in the liver due to a lack of sulfite oxidase enzyme in sensitive individuals may elevate levels of sulfites in the body. A blood test, known as a CAST test is about 50% reliable in diagnosing the condition. A definitive diagnosis requires a challenge test in a hospital setting where the patient is sprayed with sulfur dioxide or given a solution of sulfite to drink. Individuals can test themselves with dried apricots. If they react after ingestion, they probably have a sensitivity, but this self-test should be avoided outside of a hospital setting if someone is highly sensitive. Mass produced wines tend to have higher sulfite concentrations since the wineries use generous sulfur dioxide on large production lines. Organic wines have the lowest sulfite levels. Those who are possibly sensitive to sulfites should check all labels for sulfite content.

Gluten

Wine is considered a gluten-free product and there are no laws requiring labels indicate if a wine contacts gluten. The TTB does allow wineries to put “gluten free” stamp on their labels if they qualify. The Celiac Disease Foundation and Celiac Sprue Association lists wine as a gluten-free food, but some products with gluten are used to produce wine (fining agents such as hydrolyzed wheat gluten, milk protein, gelatin, egg whites are used to soften tannins and reduce oak flavors), but there is no trace of these agents left in wine. Some people, however, with allergies have reported reactions to wine that they attribute to fining agents. However, allergies to milk or egg products are common in children, but very rare in adults who are the target wine drinkers.

Since 2002, wineries in New Zealand and Australia have been required to put an allergen warning on wines fined with egg or milk products whether there is residual or not. The European Commission introduced the system last year, yet many wines are fined with egg or milk products but do not have any residue in the finished wine. Many wineries have turned to using other fining agents as a result.

When barrels are manufactured, some coopers coat the recessed part of the barrel that the top and bottom heads are secured to with a paste made from wheat or rye flour to create a seal. When the barrel reaches the winery it is washed out with water so it is unlikely for the flour to contact the wine. In spite of this, some people with gluten allergies report reactions to wines that they think is due to barrel aging. If in doubt, one with gluten allergies should drink wines that are unfined and aged in stainless steel.

Substances Used in Wine Clarification as Potential Allergens Dtsch Arztebl Int 110 (3) 2013 Potential allergens include fish gelatin or isinglass, protein from chicken eggs, milk products, rubber arabicum, lysozyme, pectinasse, cellulose, glucosidase, urease and aroma enzymes. Moulds as well as insect proteins can contaminate the must and play a role. Phenolic flavonoids in the skin of grapes (anthocyanins and catechins) can also trigger allergic intolerance reactions leading to headaches or migraine. Other non-organic ingredients, such as ethanol metabolites acetaldehyde and acetic acid, also play a role in wine intolerance, often expressed as urticaria. Declaring allergens in wine has become mandatory in Europe since 2012 (sulfites or sulfur dioxide more than 10 mg per kg and lysozyme or ovalbumin or casein from cow’s milk).

Prevalence of Wine Intolerance: Results of a Survey from Mainz, Germany Dtsch Arztebl Int 109 (25) 2012 This is the first study of its kind to provide data on frequency of wine intolerance in a general population. Researchers found that about 7 percent of adults suffer from an intolerance to wine (similar to another study of adults in Copenhagen which showed a prevalence of hypersenstivity reactions after alcohol consumption, especially red wine, to be 8%). 4,000 people ages 20-70 filled out a questionnaire about alcohol intake and reported intolerance or allergy symptoms. 9 percent of women self reported wine intolerance compared to 5.2 percent of men. Allergy-like symptoms were more common after consumption of red wine (skin flushing and itching, nasal congestion, intestinal cramps, diarrhea, and rapid heart rate). About a fourth of people in the study with wine intolerance also reported a general intolerance to alcohol. Those with allergy to red wine but not white wine may have an allergy to the lipid transfer protein present in the skins of grapes, but further research is needed to find the multiple reasons for wine intolerance. The results suggest wine intolerance is fairly common in a general population comparable to intolerance to other foods. This was a self reported study that may not be valid and the study also had other limitations. It was suggested in correspondence that reactions can be avoided by not drinking wine and alcohol or changing to a wine that is more easily tolerated. 54th Annual Meeting of American Headache Society in Los Angeles. A presentation from Brazil was reported to WebMD June 20, 2012. This small study suggests that some types of red wine are more likely to trigger headaches than others. The researchers said that the more tannin a wine has, the more likely it can trigger migraine headaches. Tannins may boost the production of brain serotonin which can trigger migraines in susceptible people.

Biogenic Amines

Biogenic amines are ingested in foods such as wine, beer, cheese and sauerkraut. Histamine is the best known member of this group of substances. The concentration of biogenic amines in wine is relatively low compared to other foods such as cheese, but the effect on sensitive people can be intensified when wine is ingested with other foods that contain biogenic amines. The biogenic amines can cause intolerance manifested by nausea, cold sweats, hot flushes, palpitations, rash, headache, gastrointestinal upset, shortness of breath, reduced blood pressure, cardiac arrhythmia, and even unconsciousness in severe cases. Alcohol can increase the sensitivity to biogenic amines. There is ongoing research in Germany and elsewhere to find measures to identify and reduce biogenic amines in wine. Some preventive measures include tested starter yeast cultures, early detection of bio amine-forming bacteria, and procedures to prevent their growth (flash pasteurization or bentonite). Some countries are reviewing whether to establish upper limits for histamine in wine. See www.laboratoryequipment.com/news/2012/11/measures-make-safer-wine.

Biogenic Amines in Wine - What are They, What is Their Impact and How Do We Control Their Formation? Washington State University Viticulture & Enology June 30, 2011. Pascal Herr, a French researcher, did a 3-year-long study on biogenic amines. He found that biogenic amines are formed by a wide range of yeasts and lactic acid bacteria. The most important biogenic amines in wine are histamine and tyramine. Various approaches to reducing biogenic amine content of wine have been taken: thermovinification combined with flash pasteurization for Pinot Noir, lysozyme and MLF strategies for white wines, and absorption of amines by bentonite and cell hull preparations. The management of pH is important since a pH of above 3.5 promotes growth of lactobacilli and pediococci. Spontaneous MLF may have higher levels of biogenic amines than inoculated MLF starter.