Revisiting the ‘Chinese Restaurant Syndrome’

A few years ago I published an article in the journal Social History of Medicine entitled “‘That Won Ton Soup Headache’: The Chinese Restaurant Syndrome, MSG and the Making of American Food, 1968-1980.” It looks at the ‘discovery’ of this unique medical condition in the late 1960s and explores what it tells us about the social construction of illness and the role of ethnic and racial food fears in colouring popular perceptions of risk.

Last year, I was asked by the Culinary Historians of Canada to write a piece for a more popular audience about the effect of this particular health scare in the Canadian context for their newsletter, Culinary Chronicles. With the CHC’s permission, I’ve decided to post it below for those of you who aren’t CHC members. If you’re interested in the scientific and technical element of the Chinese restaurant syndrome and MSG story, I would recommend sticking with my original article (which includes an extended quotation from famous Canadian Bonanza and Battlestar Galactica star, Lorne Greene). But if you’re interested in something like a short cultural history of MSG and ethnic food fears in Canada, the Culinary Chronicles piece below might be worth a read.

Ethnic Food Fears and the Spread of the Chinese Restaurant Syndrome in Canada, 1968-80

[Originally published in Culinary Chronicles, Vol. 62 (Spring 2012), 5-7.]

The ‘Chinese restaurant syndrome’ is now a largely forgotten public health panic but, for two decades following its 1968 ‘discovery,’ it was the bane of Chinese restaurateurs throughout the Western world. Largely unknown in Asia, the Chinese restaurant syndrome saw Chinese food become the primary focus of public fears over the common food additive monosodium glutamate (MSG), despite the additive’s widespread use by the Canadian food industry. Up to the present day, the “No MSG” signs emblazoned on the windows and menus of Chinese restaurants – but not on bags of potato chips or cans of soup – are a testament to its lingering effects. And as the history of this unique medical condition suggests, it was a disease whose spread owed as much to persisting prejudices about Chinese culinary practices and culture as it did to fears of the effects of MSG and other food additives.

The ‘discovery’ of the Chinese restaurant syndrome is generally attributed to an April 1968 letter from Dr. Robert Ho Man Kwok to the New England Journal of Medicine (NEJM).  Kwok, who was himself a Chinese immigrant living in the U.S., described a syndrome whose symptoms typically started 20 minutes after eating at American Chinese restaurants serving “northern Chinese food.” They included “numbness at the back of the neck, gradually radiating to both arms and the back, general weakness and palpitation.” In the letter, Kwok offered a number of theories about the cause of the syndrome, including Chinese cooking wine, the common use of MSG by Chinese cooks, or the high sodium content some dishes.[1]

The NEJM was quickly inundated with letters from readers describing their own unpleasant experiences after eating Chinese food and, within a few weeks, discussion of the ‘Chinese restaurant syndrome’ began to spread into Canada. Toronto Star reporter Sidney Katz identified a number of local sufferers, including his son who complained of “a tingling sensation at his temples” after eating Chinese food; a 36-year-old nurse who experienced “a constriction and mild paralysis on her throat area”; a 17-year-old high school student who reported getting “lightheaded and dizzy as though I’ve been drinking”; and a housewife complaining of “heart palpitations and tightness in the jaw muscles.” When interviewed about the syndrome, a prominent local Chinese restaurateur wondered whether “the afflicted diners probably had too many martinis or daiquiris with their won ton or shrimp with lobster sauce” while another “hinted darkly that it’s all a plot hatched by rival restaurant owners.”[2]

Unfortunately for these and other Chinese restaurateurs, the syndrome would prove to be more than passing health scare. By 1972, a number of studies published in prominent scientific and medical journals posited a direct link between consumption of the common food additive MSG and what was increasingly being referred to in the clinical literature as ‘Chinese restaurant syndrome’ or ‘CRS.’ While a number of other studies published during the period contradicted these findings and questioned the link between MSG and the symptoms described by Kwok, the fact that the condition had been made the focus of serious scientific study at all went a long way towards providing a real sense of medical legitimacy to the name ‘Chinese restaurant syndrome’ and the popular perception that Chinese food, in particular, really was making people sick.[3]

The problem with much of the popular and scientific discourse around the Chinese restaurant syndrome was that it often overlooked the fact that MSG was by no means unique to Chinese food. By 1968, MSG had been part of the Canadian diet for at least two decades. Initially patented in 1909 by a Japanese biochemist following investigations into the chemical components his wife’s dashi broth, MSG is essentially the sodium salt of glutamate – a naturally occurring amino acid and one of the basic building blocks of protein. What Ikeda discovered was that, when added to certain foods, glutamate often enhanced their inherent savoury qualities. This was, in essence, the culinary function typically performed by foods naturally high in glutamate such as sharp cheese, tomatoes, mushrooms, or seaweed. Ikeda’s main innovation was his discovery that, by stabilizing glutamate using ordinary salt, the resulting product was an inexpensive additive that had the capacity to dramatically improve the flavor of both fresh and processed foods.[4]

Immediately popular in Asia, it was primarily after the Second World War that MSG became widely used in North America. But by the end of the 1960s, it had become one of the most popular additives in the food industry’s arsenal and could be found in everything from canned soup to baby food to frozen vegetables. It also found a welcome place in many Canadians’ kitchens through products like the popular seasoning, Accent, which was regularly called for in recipes published by home economists and popular food writers.

But the popularity of MSG during the 1960s highlighted one of the main problems with the discourse around Chinese restaurant syndrome: if MSG really was causing widespread adverse reactions, why were such reactions being linked specifically to Chinese foods and why hadn’t anyone noticed it before? Recipes containing MSG often included such unambiguously ‘Canadian’ dishes as Toronto Star reader Herta Gerlach’s 1970 recipe for “Mississauga fried chicken” or Star food writer Bonnnie Cornell’s 1970 recipe for “Hockey short ribs.” In Pierre and Janet Berton’s 1966 Centennial Food Guide: A Century of Good Eating, MSG is frequently portrayed as being nearly as indispensable as salt and pepper. According to Pierre at least, MSG had been responsible for “a minor revolution in flavor” and was one of the key factors making modern foods “infinitely more tasty” than their historical predecessors.[5]

While the Bertons were some of the more enthusiastic proponents of MSG, its place in their decidedly ‘Canadian’ cookbook was nonetheless indicative of the reality that most Canadians had long been exposed to the additive outside of their favourite Chinese restaurant. According to one industry estimate in the 1980s, food processors were using between 85 and 90 percent of Canada’s MSG supply. Even assuming that the remaining 10 to 15 percent was being exclusively used by Chinese restaurants, it was nonetheless clear that the vast majority of MSG being consumed by Canadians was in familiar processed foods and not in their Egg Foo Young or Sweet and Sour Pork.  This was just as true in 1968 as it was in 1980, yet the name Chinese restaurant syndrome and the associated idea that you were more likely to suffer an adverse reaction to MSG after eating Chinese food persisted.[6]

At the heart of the popular association between Chinese food and adverse reactions to MSG was the assumption that, while MSG was a common food additive, it was more likely to be misused by Chinese cooks. Both the press and many of the scientists investigating MSG regularly repeated claims that “large,” “liberal” or “lavish” amounts of MSG were being used in Chinese restaurants. This was despite the fact that almost no studies bothered to test the comparative MSG content of Chinese and non-Chinese foods or, for that matter, that a number of studies showed that less than 2 grams of MSG was sufficient to produce a reaction in susceptible individuals. Yet, in order to explain why the syndrome was largely limited to Chinese restaurants, one 1972 study even suggested that MSG was unlikely to produce reactions in “appropriate culinary quantities” but that “the exhibition of quantities that might properly be regarded as bizarre in the culinary setting increases the possibility of symptom occurrence.” [7]

The problem with this was, in the absence of evidence of the comparative MSG content of foods, it was unclear what constituted ‘bizarre’ and ‘appropriate.’ Was the MSG use in Chinese restaurants really more liberal than the Bertons’ recipe for “Pierre’s Scrambled Eggs,” which included 2 tsp. of MSG? Did Pierre’s eggs or a can of mushroom soup pose any less of a health hazard than an order of pork fried rice? Throughout the 1970s, scientists seemed unable to produce the necessary evidence needed to answer these questions.

Arguably, the idea that Chinese chefs were using “bizarre” quantities of MSG built upon long-held suspicions that Chinese culture and practices were somehow unclean, excessive, or inscrutable. From the late nineteenth century on, rumour and fear-mongering about supposed Chinese drug use, sexual mores, living conditions, and ‘deviant’ practices like serving unsuspecting patrons meat from dogs and cats were frequently invoked to justify everything from limiting Chinese immigration, preventing restaurateurs from employing white women, to limiting Chinese businesses to Chinatowns and other designated areas. While this kind of racial discourse tended to move from the level of official government policy to rumour and popular culture in the post-WWII era, the rapid spread of the Chinese restaurant syndrome – along with similar scares over the safety of barbecued meats in Vancouver’s Chinatown, despite no proven incidence of illness – suggests that such ideas likely continued to inform popular understandings of Chinese culture and practices.[8]

These fears also partly explain the Chinese restaurant syndrome’s transformation from a specific set of symptoms into a disease that encompassed nearly any adverse reactions following the consumption of Chinese food. While most of the initial studies stuck closely to Kwok’s original symptom complex of burning, numbness, and pressure, the definition shifted significantly over time. In 1978, for instance, sufferer Helen Egleston told the Globe and Mail that MSG consumption led to severe stomach cramps and “diarrhea so violent you’d swear I had a double dose of castor oil.” Later that same year the Toronto Star published an alarming story in which American psychologist Dr. Arthur Coleman claimed that his wife “became profoundly depressed, with drawn facial expression, motor slowing, doubt-ridden, gloomy fantasies and occasional unprecipitated outbursts of rage” for nearly two weeks after eating at in a Chinese restaurant. After later administering a “test dose” of wonton soup to his wife, only to produce a similar depressive ordeal, Coleman decided to put his family on an MSG-free diet. This supposedly both cured his wife’s depression and 9-year-old son’s “hyperactivity.” Even scientific studies followed this trend, with one 1977 study including everything from “depression,” “detachment” and “a sense of fullness after a limited amount of food” as probable symptoms of what it called “CRS.”[9]

This is not to say, of course, that individuals did not experience adverse reactions to MSG. To this day, studies continue to be inconclusive regarding the additive’s health effects, with passionate debate on either side of the issue.[10] By the late 1980s, moreover, it became much more common for activists to point to the larger health implications of MSG use in the industrial food chain. But throughout the 1970s the assumption that adverse reactions to MSG were mostly limited to Chinese restaurants tended to hinder this research as well as to contribute to the broader uncertainty about the additive’s real impact. The unquestioned assumption that Canadians were more likely to get sick at a Chinese restaurant, however, spoke to something else altogether. The story of the ‘discovery’ and ‘spread’ of the Chinese restaurant syndrome – and its central idea that you were more likely to suffer an adverse reaction to MSG after eating Chinese food – therefore provides an instructive example of the ways in which ideas about supposedly ‘foreign’ food and food cultures can often bring to the surface a range of prejudices and assumptions grounded in ideas about race and ethnicity that, even in supposedly pluralistic and multicultural societies like Canada, continue to inform perceptions of the culinary ‘other’.



[1] R.H.M. Kwok, “Chinese-Restaurant Syndrome” NEJM 278 (April 4, 1968), 796.

[2] Sidney Katz, “Do Chinese foods make you dizzy?” Toronto Star, 22 July 1968, 47.

[3] See, for instance, H.H. Schaumburg et. al. “Monosodium L-Glutamate: Its Pharmacology and Role in the Chinese Restaurant Syndrome,” Science 163, 3869 (21 February 1969), 826-828 or  R.A. Kenney, C.S. Tidball, “Human susceptibility to oral monosodium l-glutamate”, The American Journal of Clinical Nutrition 25 (February 1972), 140-146. For more on the scientific debate and context, see my more detailed study, Ian Mosby, “‘That Won Ton Soup Headache’: The Chinese Restaurant Syndrome, MSG and the Making of American Food, 1968-1980” Social History of Medicine 22, 1 (April 2009), 133-151.

[4] For background, see Jordan Sand, ‘A Short History of SMG: Good Science, Bad Science, and Taste Cultures’, Gastronomica 5, 4 (2005), 38-4

[5] Anne Wanstall, “Fried chicken is a family favorite,” Toronto Star, 28 February 1970, 52; Bonnie Cornell, “Hockey stars watch diet,” Toronto Star, 12 September 1970, 87; Pierre and Janet Berton, The Centennial Food Guide: A Century of Good Eating (Toronto: Canadian Centennial Library, 1966), 79.

[6] Madeleine Grey, “Experts agree that MSG is not hazard to most people” Toronto Star, 7 December 1988, E3.

[7] Kenney and Tidball, “Human susceptibility,” 146. Also see Shaumburg et al. “Monosodium L-Glutamate.”

[8] For an excellent account of Canadian attitudes and the BBQ meat scare, see K.J. Anderson, Vancouver’s Chinatown: Racial Discourse in Canada, 1875-1980 (Montreal-Kingston: McGill-Queens UP, 1991).

[9] L. Reif-Lehrer, ‘A questionnaire study of prevalence of Chinese restaurant syndrome’, Federation Proceedings 36, 5 (1977) 1617-1623; Ellen Roseman, “Finding UFOs in your food is bad enough, but the ones you can’t see are worse,” Globe and Mail, 16 January 1978, 26; “Chinese food can depress you, doctor says” Toronto Star, 1 November 1978, B19.

[10] See, for instance, “The Return of the MSG BoogeymanSalon.com, 17 March 2010; or Alex Renton, “If MSG is so bad for you, why doesn’t everyone in Asia have a headache?The Observer, Sunday 10 July 2005.

2 comments

  1. nick

    A complete pile of left-wing zealous skepticism. Chinese food syndrome is REAL, I used to wake up in the middle of the night after having eaten chinese food and all 4 limbs would be completely paralyzed, somewhat like the effect you get from a ‘dead arm’ , for example you have slept on your side and your head has been resting on your arm, cutting off the blood supply. However this is for all 4 limbs. It takes up to 15 minutes for the feeling to return once you have woken up. To claim that ‘Chinese restaurant syndrome’ is an invention of racists is pure communism – you wait till you wake up at 4 in the morning like a paraplegic and then see how you feel about the subject. I suffered this for years – I used to eat Chinese food a lot – but as soon as I made the connection, I stopped, and I have not suffered since. It’s possible its a genetic thing – maybe that’s why studies have been inconclusive, but to write off a real medical / health issue as one of racism is gross journalistic irresponsibility.

    • Joe

      Then you… Have some issues. Look at every ingredient now or days and you will find MSG. I have eaten food with MSG for about 25 plus years and have no problems.. And so has my children and my parents and my family generation. Bring the physical scienfic facts to prove this is real instead of making your assumptions…

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