Nickel is a common metal found everywhere in our environment. For some people, exposure to nickel can lead to an allergic reaction known as nickel allergy, the most common cause of metal allergy. This article explores the connection between nickel in your diet and nickel sensitivity, providing guidance on how a low-nickel diet can help manage symptoms.
Understanding Nickel Allergy
Nickel allergy is a chronic and recurring problem, affecting females more often than males. Once someone develops a nickel allergy, it often persists throughout their life. Nickel is present in soil, water, air, and the biosphere. It's also found in many foods, making diet a significant source of nickel exposure for the general population. For individuals with nickel sensitivity, consuming nickel in their diet can trigger dermatitis.
Prevalence and Sources of Nickel Exposure
The prevalence of nickel sensitivity varies across countries, ranging from 4% to 13.1%. Certain occupational groups, such as hairdressers, may experience higher rates, reaching 27-38%. Women are often sensitized through non-occupational contacts like ear piercing and fashion jewelry, while men are more commonly sensitized through occupational exposure.
Nickel is a ubiquitous trace element that occurs in soil, water, air and of the biosphere. It constitutes approximately 0.008% of the Earth's crust. The plant acquires its total quota of Nickel from the soils. Animal acquires nickel mostly from plants and from other animals. Human acquires nickel both from Plants and Animals.
Symptoms and Manifestations of Nickel Allergy
The degree and pattern of nickel allergy can vary. Some individuals may develop skin allergy from even brief contact with nickel-containing items, while others may only develop allergy after years of exposure.
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Common manifestations include:
- Skin allergy from brief contact with nickel-containing items
- Hand eczema due to chronic contact with nickel-containing articles
- Vesicular hand eczema following nickel ingestion
- Baboon syndrome, a generalized rash affecting the buttocks, anogenital area, flexures, and eyelids
The Role of Diet in Nickel Allergy
Food is considered a major source of nickel exposure for the general population. The nickel content of food is strongly influenced by the concentration of nickel in the soil. An average diet supplies 300-600 μg of nickel to the human body per day.
How Nickel in Food Triggers Dermatitis
The presence of sufficient amounts of nickel in the diet of a nickel-sensitive person can provoke dermatitis. Oral administration of nickel sulfate in the range of 600-5,600 mg has been shown to provoke hand eczema. Hands are the most commonly affected site for systemic nickel dermatitis, but other body areas may also be affected.
Nickel Content in Various Foods
Plant tissues generally contain more nickel than animal tissues. The amount of nickel in foods can vary considerably from place to place due to variations in the nickel content of the soil.
Foods with relatively high nickel content include:
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- Beer, red wine, mackerel, tuna, herring and shellfish
- Sunflower seeds, linseeds, hazelnuts, marzipan, walnuts
- Tomatoes, onion, raw carrots
- Cereals, pulses and vegetables
Average Dietary Intake of Nickel
The mean total dietary intake of nickel has been reported to be between 0.12-0.21 mg in UK, 0.13 mg in Finland, 0.17 mg in US, and between 0.207-0.406 mg in Canada. The dietary intake of nickel in Denmark is comparatively higher and could reach over 900 μg/day, due to the high intake of oatmeal and legumes, including soybean, nuts, cocoa and chocolate.
Factors Influencing Nickel Absorption
Gastrointestinal absorption of nickel is variable and depends on the composition of the diet. Nickel absorption may be suppressed by binding or chelating substances, competitive inhibitors, or redox reagents. Conversely, absorption is often enhanced by substances that increase pH, solubility, or oxidation, or by chelating agents that are actively absorbed. Iron deficiency can also enhance nickel absorption.
The Low-Nickel Diet: A Management Strategy
Careful selection of food with relatively low nickel concentration can bring a reduction in the total dietary intake of nickel per day and thereby can minimize the risk for endogenous activation of immunocompetent cells in nickel sensitive individuals. This can influence the outcome of nickel dermatitis.
Principles of a Low-Nickel Diet
A low-nickel diet aims to reduce the total amount of nickel consumed daily, helping to control nickel dermatitis. While it may not completely clear dermatitis, it's likely to lead to fewer and milder flare-ups.
- Choose Low-Nickel Foods: Prioritize foods with naturally low nickel content.
- Avoid Canned Foods: Opt for fresh or plastic-packaged alternatives.
- Limit High-Nickel Items: Reduce consumption of nuts, seeds, soy products, and chocolate.
- Consider Vitamin C: Some recommend taking 500-1000mg of vitamin C with meals to prevent nickel absorption.
Foods to Favor on a Low-Nickel Diet
- Animal tissues generally contain less nickel in comparison to plant tissues. Meat, poultry and eggs are suitable for low nickel diet.
- The nickel content of cereals is low.
- Vegetables such as potatoes, cabbage and cucumber can be used.
- Most fruits, including pears, strawberries, apples, grapes, and most berries, are safe to eat on a low-nickel diet.
- Corn alternatives have only slight traces of nickel. Foods like cornmeal, corn tortillas, cornflakes, or cornstarch can safely replace wheat or grains.
- For rice and rice-based products, look for polished rice instead of unpolished. White rice is typically polished and safe to eat.
- Root vegetables-like potatoes, carrots, beets, sweet potatoes, and onions-contain only trace amounts of nickel and are safe to eat for those with sensitivities.
Foods to Avoid or Limit on a Low-Nickel Diet
- Plant tissues generally contain more nickel than animal tissues.
- Avoid all drinks and vitamin supplements with nickel and canned food.
- stay away from shellfish and any canned products. Of note, supplements are noted to be avoided in some resources due to the lack of regulation and ability to know nickel content.
- The main foods to stay away from are nuts, seeds, and soy products.
- High-Nickel Foods to Avoid. Flour and Grains, Seeds, Seafood, Legumes, Vegetables, Fruits, Chocolate
- Chocolate and cocoa powder (especially dark chocolate)
- All nuts (walnuts, peanuts, almonds, hazelnuts, soy nuts)
- All seeds (sunflower seeds, linseed)
- Licorice Baking powder, Gelatin, Marzipan, Margarine, Commercial salad dressings, Vitamins containing nickel, Canned foods in general
Practical Tips for Following a Low-Nickel Diet
- Read Labels Carefully: Check for hidden sources of nickel in processed foods.
- Cookware Choices: While cooking, nickel-plated utensils should not be used and should be replaced. Acidic food should not be cooked in stainless steel utensils as the acids may lead to the dissociation nickel from the utensils and it may increase the nickel content of the food. However, it should be understood that the dermatitis will not clear completely during the diet period; however, it is likely to lead to fewer and milder flare-ups. Types of cookware that are safe: non-stick coated of any type, aluminum, copper, cast iron.
- Hydration: Severely allergic individuals may choose to avoid foods which are rich in nickel. The first quart of tap water drawn from any faucet in the morning.
- Consider Vitamin C and Iron: Eat foods high in vitamin C and iron. Consider vitamin C and/or iron supplementation with meals. Studies have found that eating foods high in vitamin C and iron can reduce the absorption of ingested nickel.
Sample Meal Ideas
- Breakfast: Low-Nickel Corn Pancakes topped with fresh strawberries and honey.
- Morning Snack: Apple chips or oven dried strawberries.
- Lunch: Roasted Red Pepper Soup
- Dinner: One-Pot Chicken and Rice
- Afternoon Snack: Air-popped popcorn drizzled with olive oil and salt (or cinnamon).
Factors Affecting Nickel Levels in Food
- Even seasons can influence the concentration of nickel in human food derived from plants. There are differences in the concentration of nickel in different parts of same plant. Therefore the benefit received by a patient from a particular Low ND may not be uniform in all the seasons and in every patient.
- The amount of nickel in the soil and water used to grow the food.
- Processed and canned foods can add nickel via equipment used and leaching from the metallic can.
- Tap water may contain nickel. Hot water can leach nickel from faucets into the water sitting overnight in the fixtures.
Additional Considerations
Iron Deficiency and Nickel Absorption
It is seen that absorption of nickel in the human body can be enhanced by iron deficiency and thus, an individual with iron deficiency anemia (IDA) tends to retain more nickel from the diet. In other words, individuals with IDA are at a higher risk to accumulate nickel in their body.
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Factors Influencing the Success of a Low-Nickel Diet
In practice, the benefit of Low nickel diet is not uniformly seen in all patients receiving it for nickel dermatitis. This is due to the fact that there are factors which can interfare with Nickel absorption from the diet in human body. In addition, there are some factors which can influence the level of nickel concentration in the food.
Other Sources of Nickel Exposure
Limiting nickel in your diet might not be enough to avoid rashes, so it is best to limit external sources of nickel such as cookware and jewelry as well.
- Jewelry: Make sure any jewelry or watches you wear are nickel-free, hypoallergenic, or made from surgical-grade stainless steel, yellow gold, pure sterling silver, or platinum.
- Clothing: Common sources include bra hooks, belts, buttons, and zippers.
- Electronics: These include cell phones, laptops, and tablets.
- Household objects: These can include your house keys, razors, and eyeglass frames.
Conclusion
Nickel allergy can be a challenging condition to manage, but a low-nickel diet can be an effective tool for reducing symptoms and improving quality of life. By carefully selecting foods, avoiding high-nickel items, and considering other sources of nickel exposure, individuals with nickel sensitivity can minimize flare-ups and live more comfortably.
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tags: #nickel #sensitivity #diet #plan