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Supplement

Review of Alleged Reaction to Monosodium Glutamate and Outcome of a Multicenter Double-Blind Placebo-Controlled Study^{1 ,2}

Raif S. Geha³, Alexa Beiser^*, Clement Ren, Roy Patterson, Paul A. Greenberger, Leslie C. Grammer, Anne M. Ditto, Kathleen E. Harris, Martha A. Shaughnessy, Paul R. Yarnold^*, John Corren and Andrew Saxon

Division of Immunology, Children’s Hospital and Department of Pediatrics, Harvard University, Boston, MA; ^* Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA; Divisions of Allergy-Immunology and ^** General Internal Medicine, Northwestern University, Chicago, IL; and Division of Clinical Immunology and Allergy, University of California, Los Angeles, CA

³To whom correspondence should be addressed.

Monosodium glutamate (MSG) has a long history of use in foods as a flavor enhancer. In the United States, the Food and Drug Administration has classified MSG as generally recognized as safe (GRAS). Nevertheless, there is an ongoing debate exists concerning whether MSG causes any of the alleged reactions. A complex of symptoms after ingestion of a Chinese meal was first described in 1968. MSG was suggested to trigger these symptoms, which were referred to collectively as Chinese Restaurant Syndrome. Numerous reports, most of them anecdotal, were published after the original observation. Since then, clinical studies have been performed by many groups, with varying degrees of rigor in experimental design ranging from uncontrolled open challenges to double-blind, placebo controlled (DBPC) studies. Challenges in subjects who reported adverse reactions to MSG have included relatively few subjects and have failed to show significant reactions to MSG. Results of surveys and of clinical challenges with MSG in the general population reveal no evidence of untoward effects. We recently conducted a multicenter DBPC challenge study in 130 subjects (the largest to date) to analyze the response of subjects who report symptoms from ingesting MSG. The results suggest that large doses of MSG given without food may elicit more symptoms than a placebo in individuals who believe that they react adversely to MSG. However, the frequency of the responses was low and the responses reported were inconsistent and were not reproducible. The responses were not observed when MSG was given with food.

KEY WORDS: • monosodium glutamate • Chinese Restaurant Syndrome • double-blind, placebo-controlled