PRACTICE APPLICATIONS

Professional Practice

MSG Is A-OK: Exploring the Xenophobic History

U
NTIL 2020, MERRIAM- rhetoric and action against Asian cul- discovery in the early 1900s, it was not
Webster Dictionary has tures, specifically Chinese culture. introduced in the United States until
included and defined “Chi- Given the current evidence, which has the late 1920s or nationally produced
nese restaurant syndrome” shown that the link between MSG and until 1947.13 The consumption of MSG
(CRS) as “a group of symptoms (such aforementioned symptoms cannot be in the United States increased
as numbness of the neck, arms, and substantiated,7 it is important to following the wave of the industriali-
back with headache, dizziness, and pal- reframe MSG so nutrition educators zation of the food system and political
pitations) that is held to affect suscep- can become more culturally compe- changes: the seasoning began to be
tible persons eating food and tent. Moreover, the consumption of used in ready-made and processed
especially Chinese food heavily MSG in lieu of table salt shows promise foods in 1940s and the 1965 lift of race-
seasoned with monosodium gluta- for reducing salt intake,7 which in turn based immigration quotas led to an
mate.”1,2 In January 2020, a campaign may result in a lower sodium intake influx of Chinese immigrants who
pushing Meriam Webster to redefine and thus reduced risk of sodium- opened Chinese restaurants.3
CRS was driven by the assertion that related chronic diseases, such as hy- Shortly thereafter, in 1968, the first
the health consequences of monoso- pertension and cardiovascular dis- incidence of MSG malaise was docu-
dium glutamate (MSG) consumption ease.8-10 The aim of this article is to mented.14 The New England Journal of
is very weak, if existent, with the claim describe what MSG is and how it Medicine published Cantonese physi-
itself reflecting racialized, xenophobic became linked to health, explicate the cian Robert Ho Man Kwok’s letter
undertones.2-5 The campaign was racialized and negative associations of describing his symptoms of numbness
spearheaded by Ajinomoto, a Japanese consuming MSG, explain current sci- at the back of neck and arms, weak-
food and biotech company and leading entific literature about MSG consump- ness, and strong rapid heartbeat (pal-
producer of MSG worldwide, which tion, and provide evidence-based best pitations) after ingesting Chinese food
alerted the public to this controversial practices for nutrition educators. in the United States.13-15 Within several
term on Twitter with the hashtag weeks, more anecdotal reports were
#RedefineCRS.3-6 Though the campaign released by the same journal, and soon
was promotional, pushing for the DEFINING MSG AND HOW IT mainstream media began to publish
acceptance and use of MSG-based Aji- GAINED THE ATTENTION OF the findings. A New York Times piece
nomoto products, it still referenced HEALTH PROFESSIONALS titled “‘Chinese Restaurant Syndrome’
the long history of America’s racism to- MSG was discovered in 1907 by Japa- Puzzles Doctors” pointed at MSG as a
ward Asians in the food and culinary nese chemist Kikunae Ikeda. Attempt- potential culprit of these ailments.16
world, which has manifested itself in ing to uncover the taste components in This 1968 piece is what brought CRS
the mistrust of MSG.2 Merriam- food items like kelp and meat, Ikeda and concerns around MSG into the
Webster has agreed that it is a “dated” discovered MSG, a salt form of the public’s eye, sparking a research inter-
and “sometimes offensive” term and nonessential amino acid glutamate.11 L- est in connecting MSG to health
have since replaced “Chinese restau- Glutamic acid is synthesized in the outcomes.
rant syndrome” with “MSG symptom body and is found in a plethora of In 1969, 2 studies received recogni-
complex,” while noting that scientists foods; MSG is merely a water-soluble tion for legitimizing CRS as a credible
have not been able to link MSG to sodium salt of this acid.12 The flavor condition tied to MSG.17-19 In February
adverse reactions.1 Although the that MSG lends in foods such as to- 1969, Schaumburg and his colleagues
updated definition is a step in the right matoes, meat, Parmesan cheese, and published their findings in Science:
direction, there is still much work to be mushrooms has led to the establish- they exposed 2 subjects to wonton
done on dispelling the racism around ment of “umami,” the fifth taste in soup, 1 with and 1 without MSG, and
this seasoning. addition to salty, sweet, bitter, and found that the symptoms of CRS only
The health-related controversy of sour.12 Though MSG is found naturally came on after the ingestion of the
MSG in the United States is linked to a in foods, its isolated form has been MSG-dosed soup.18 They conducted a
history of prejudice and discriminatory used as a seasoning due to the strong follow-up study in which 4 more sub-
umami flavor it adds to food.11,12 jects consumed soup containing MSG
The use of MSG as a flavor enhancer and found similar results. This was
https://doi.org/10.1016/j.jand.2021.01.020 enough for the researchers to conclude
is relatively new. Although MSG has
Available online xxx
been used in Asian countries since its that “Chinese restaurant syndrome was

ª 2021 by the Academy of Nutrition and Dietetics. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 1
PRACTICE APPLICATIONS

caused by MSG.”18 Although the re- writer stated that many people “have growing disdain toward Chinese la-
searchers claimed to use wonton soup been sitting all tingling and tormented borers, which expanded rapidly into
due to its simple composition, they did but not saying anything, each utterly the restaurant sector, lead to a political
note that MSG is found in a plethora of sure that he alone was wretched, and push for the 1882 Chinese Exclusion
products and is a widely unregulated never dreaming that that contented- Act, which halted immigration from
food additive in America.18 Just 3 looking co-consumer of bird’s nest China to the United States for 10 years
months later, another study found that soup likewise was in agony.”22-24 and set the national tone for xeno-
when high doses of MSG were injected Together, these prejudiced comments, phobic sentiment.25
into the brains of pregnant and infant which depreciated Chinese food and The Chinese Exclusion Act (ie,
mice, obesity, brain lesions, and culture as a whole, used one man’s immigration ban) seemingly solidified
neurological issues were induced.19 anecdotal incident as a basis for biased anti-Asian sentiment, furthering
These 2 studies perpetuated the pub- claims about the effects of Chinese racism, violence, and bigotry toward
lic’s concern around MSG, along with food. Chinese communities at a national
Chinese and other Asian food. Although the MSG and CRS com- level. Media headlines continued to
In July 1969, these researchers and ments highlight the racism toward ridicule Chinese communities: an 1883
others joined together to urge a Senate Chinese populations at this time, anti- New York Times piece posed the ques-
committee to ban the use of MSG in Asian sentiment has been omni- tion, “Do the Chinese eat rats?,” before
baby foods and to remove MSG from present in the United States since the going on to discuss the stench from
the Food and Drug Administration’s influx of Chinese immigrants in the Asian food practices.29 In 1885, an Anti-
(FDA) Generally Recognized as Safe mid 19th century. In 1849, the Gold Asian riot broke out in Wyoming,
list.17 As a result, coupled with the Rush resulted in Chinese immigrants leading to the death of 51 Chinese la-
public’s growing concern and backlash flooding into California. Although borers, followed by a 1887 massacre of
toward MSG, baby food manufacturers, initially welcomed, anti-Asian rhetoric 31 Chinese miners in Oregan.30 The
such as Gerber and Heinz, discontinued soon swept over the state, as immi- political climate and policies in place
the use of MSG in their products.17,20,21 grants competed for work and allowed Chinese immigrants to be
Though MSG was not removed from accepted substandard wages.25 As a pushed out of the more profitable oc-
the Generally Recognized as Safe list, result of the cheap labor, in the 1860s cupations, such as mining, and in cities
the FDA did respond to the pushback the Central Pacific Railroad Company like New York and San Francisco, they
they were receiving. In 1970, a National imported thousands of Chinese were forced to live in specific neigh-
Research Council under the National workers to build the western portion of borhoods or regions, creating densely
Academy of Science investigated MSG their railroad, leading to a further packed Chinese communities.30 By the
on behalf of the FDA but ultimately influx of Chinese immigrants.25 By late 1800s, these measures gave the
ruled that MSG was safe and suitable 1870, Chinese immigrants accounted idea that the “threat” of Chinese im-
for consumption by adults.17,22 for 8.5% of California’s population; migrants throughout America was
Although the FDA declared MSG safe, however, they were not well received contained.30 As fear around Asian
the public’s heightened fear around by all, as many White Americans, immigration subsided, Chinatowns
MSG persisted. particularly politicians, viewed these began to gain attention as tourist des-
immigrants as a threat to American tinations, piquing curiosity about Asian
laborers. As Chinese communities culture and introducing Asian food as a
BIAS, RACISM, AND THE MSG became established and immigrants more accepted cuisine. Though still
CONTROVERSY began to enter the workforce in a va- overwhelmingly regarded as lesser
The history of racism and xenophobia riety of fashions, violence and racism than White or American customs, Chi-
around Asian American food culture in were directed at Asian individuals, nese and Asian culture was seen as
the United States has influenced ill- resulting in a negative framework of exotic, avant-garde, and
informed attitudes and perpetuated a Asian culture including but not limited “harmless.”17,30
negative discourse around MSG. The to Asian food culture.25 In the early 1900s, Chinese restau-
start of the MSG controversy began In 1877, a cartoon titled “Uncle Sam’s rants throughout Chinatowns gained
with Dr Ho Man Kwok’s 1968 letter to Thanksgiving Dinner,” by artist George public attention as an accessible way to
the New England Journal of Medicine, Frederick Keller, represented the experience an exotic cuisine. The
which described a mélange of symp- American’s perception of Chinese affordability of Chinese food lent itself
toms that he experienced after cuisine and etiquette, as it depicted an to the common person looking to
consuming Chinese food in the United Asian man consuming a rat at the experience the unfamiliar. This pro-
States.14 Within weeks of Dr Ho Man dismay of his White dinner guests.26 clivity toward Chinese food is exem-
Kowk’s report, the Correspondence Various San Francisco guides in 1880s plified by a 1901 piece in the New York
section of New England Journal of referred to Chinese foods as Tribune, which stated that “so many
Medicine was filled with letters to the “disgusting,” urged tourists to bring who, while possessed of a small share
editors regarding their experienced, guides with them before entering into of this world’s goods, still affect sport-
albeit racialized, symptoms of CRS: Chinatowns and to only eat at restau- iness frequent the restaurant for its
writers referred to “Chinese temples” rants above the ground, condemned cheapness and grow to enjoyed the
and “Chinese headaches,” which was the filth and stench of Chinatowns, and highly flavored dishes.”31 The “cheap-
noted as an accepted “side dishes that referred to the White race as superior ness,” coupled with the exotic nature of
go along with the [Chinese] meal.” One to its Asian counterparts.27,28 The Asian cuisine, resulted in a spreading of

2 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS -- 2021 Volume - Number -

Chinese restaurants outside of China- portraying them as more healthful et al found that “many of the reported
town in the early 1900s to 1920s. than their MSG-using counter- negative health effects of MSG have
However, the spread of Chinese res- parts.17,35,36 Even in 2019, Lucky Lees, a little relevance for chronic human
taurants should not be mistaken for an Chinese restaurant headed by a regis- exposure and are poorly informative as
acceptance of this culture, as authentic tered dietitian nutritionist in New York they are based on excessive dosing that
delicacies of Chinese cuisine, such as City, was marketed as the “clean” does not meet with levels normally
shark fin soup, were still seen as un- version of Chinese food, boasting about consumed in food products.”38 In
palatable and alien by most, and thus their menu of foods free from MSG, addition to high doses that would
cheaper.30 A 1910 New York Tribune refined sugar, food coloring, and otherwise not be ingested, issues
article stated that although native genetically modified oil.37 identified include failure to include a
dishes are featured on the menus of The blatant stereotyping of Chinese control or placebo group, injections of
Chinese restaurants, “the ordinary pa- food as unhealthy, disregard of regional MSG rather than administration via
tron of the Chinese restaurants, how- differences in Chinese cuisines oral route, failure to mask the taste of
ever, confines himself to chop suey or (demonstrated by aggregating them as MSG, and causality established as a
yakamain, which costs him 25 and 15 a singular type of food), and including result of animal studies.12,13,17,38
cents,”32 speaking to the perception of MSG with undesirable ingredients such In 2017, The Academy of Nutrition
Chinese food as a cheap cuisine, and as refined sugar and food coloring and Dietetics (the Academy) published
the dwindling down of a rich food (which are known to have adverse a 23page report on the science and use
culture to a single Americanized dish health effects) reinforce insular beliefs of umami.8 It stated that that since its
like chop suey. and perpetuate the communication of research inception in 1995, the Acad-
By the 1960s, with Chinese and other bad science to the public. Though the emy has been unable to link MSG to
Asian restaurants established restaurant received backlash and has any serious or adverse health reactions
throughout the United States, the in- since shut down, it exemplifies the and that the FDA has continued to
quiries into MSG resurrected the deep- engrained discrimination that still declare MSG safe for consumption.8
rooted prejudice and xenophobia persists toward Asian food and culture Moreover, the document clarifies the
around Asian culture. The 1968 letter today. It is of utmost importance to issues in previous studies, specifically
that sparked the CRS concerns even understand the current literature noting the unprecedented high doses
stated that the illness “develop[ed] available on MSG and dispel myths of MSG used in these studies, ranging
regardless of the geographical style of around MSG’s connection to health. from 1.25 to 10 g of MSG, when in ac-
the Chinese cooking. One writer said tuality estimated average intake is be-
Japanese food affected him the same tween 0.3 and 2.4 g across all countries
way,” suggesting that the health con- HIGH-QUALITY LITERATURE (with the United States at 0.55 g per
cerns are tied to all Asian cuisines.16 In DISPELS MSG MYTHS day).8 In line with this, various sys-
1976, the Los Angeles Times published a The medical and health community’s tematic reviews on the literature of
piece that stated that when MSG is response to Dr Ho Man Kwok’s New MSG have overwhelmingly shown that
consumed “by itself in concentrated England Journal of Medicine letter was MSG cannot be causally linked to any
amounts, as in Chinese restaurants, one initially biased, reflecting the racist adverse health effects.7,38,39,41,42
out of every four people react, suffering norms of the time. The research pub- Several studies have even pointed to
varying degrees of discomfort,” pro- lished about MSG shortly after the let- potential benefits of MSG
voking fear around the consumption of ter’s publication was methodologically consumption.9,9,10,39,40,43-45 Re-
Chinese food in America.33 Moreover, a flawed. The outrageous conclusion that searchers have found that energy
1979 Chicago Tribune reprint of a 1907 MSG caused CRS was based on a single intake from high-fat savory foods may
article by Carol Kleiman, which first human study with a sample of only 6 be decreased following the consump-
appeared in the Lenoir Topic, a news- people and a second animal study tion of MSG, which can result in an
paper in North Carolina, stated that whose findings were never tested or overall calorie reduction.40 The Acad-
“one thing that remained constant in confirmed in human beings. The most emy has also noted that studies have
both the cultural and medical con- current scientific research available has shown that MSG consumption may
struction of the condition [CRS] was all shown MSG is safe for consump- result in a small calorie deficit.8 More-
the idea that it was largely a problem of tion.7,8,15,38-40 However, engrained over, studies have recently cited the
Chinese (or ‘oriental’) cooking prac- prejudice in our culture has resulted in consumption of MSG as a way to lower
tices,” disregarding the fact that MSG a persisting fear around MSG and la- sodium intake.8-10,39,45 MSG contains 3
was found in a plethora of American beling of Asian food as unhealthy. times lower sodium levels than table
and fast-food products as well.34 Various ailments have been linked to salt and has been shown not only to
The fear of MSG and thus Asian MSG such as allergy-like symptoms, enhance the flavor foods in a similar
cuisine persisted throughout the 20th obesity and other metabolic reactions, way but to decrease the need of salt. A
and into the 21st centuries. To counter respiratory incidents such as asthma, recent study, which looked at the
the stigma around MSG, Asian restau- effects on the nervous system, and palatability of low-sodium foods
rants began removing the seasoning drowsiness.12,15,15,17,18,41 However, seasoned with MSG, found that the use
from their menu. By the end of the much of the research conducted on of MSG can reduce sodium levels in
20th century, reports of Chinese and MSG has proven to have various food by up to 30%.9 This has been
Asian restaurants touting “NO MSG” methodological issues. A 2019 review consistent with previous research,
signs were recorded and praised, of available literature by Zanfirescu which has shown that a modest

-- 2021 Volume - Number - JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 3

addition of MSG in traditionally salty communicate the most current scien- 10. Jinap S, Hajeb P, Karim R, Norliana S,
Yibadatihan S, Abdul-Kadir R. Reduction
foods, such as soups and meat prod- tific researchers. Given that over 81% of
of sodium content in spicy soups using
ucts, can reduce sodium consumption registered dietitians identify as White, monosodium glutamate. Food Nutr Res.
without compromising taste.10,39,45 with only 3.9% identifying as Asian, the 2016;60(1). https://doi.org/10.3402/fnr.
This is notable, especially for those need to reflect on one’s positioning is v60.30463.
diagnosed with or trying to prevent critical to confront implicit biases and 11. Kurihara K. Glutamate: From discovery as
hypertension—MSG should be consid- attitudes, understand the historical a food flavor to role as a basic taste
(umami). Am J Clin Nutr. 2009;90(3):
ered as a potential tool and superior lens of current food perceptions, and 719S-722S.
seasoning for lowering sodium intake. enhance knowledge of other cul- 12. Williams AN, Woessner KM. Monosodium
In light of decades of research that tures.50,51 This need to build self- glutamate “allergy”: Menace or myth?
has failed to find negative health im- awareness and cultural knowledge Clin Exp Allergy. 2009;39(5):640-646.
pacts from consuming MSG in combi- does not stop at Asian cultures—many 13. Sand J. A short history of MSG: Good sci-
nation with the FDA’s recognition that marginalized communities’ cuisines ence, bad science, and taste cultures.
Gastronomica. 5(4), 2005, 38-49. https://
MSG is safe for consumption, the cur- are labeled as inferior to more Euro- doi.org/10.1525/gfc.2005.5.4.38
rent public mistrust in MSG is not centric cuisines. Although viewpoints 14. Ho Man Kowk R. Chinese-restaurant
driven by evidence-based science. on foods can change over time based syndrome. N Engl J Med. 1968;278(796).
Given this inadequate scientific evi- on trends, it is critical to promote the https://doi.org/10.1056/
NEJM196804042781419.
dence, MSG’s framing as an exclusively message that no single culture’s cuisine
15. Kazmi Z, Fatima I, Perveen S, Malik S.
Asian seasoning, and the history of is entirely healthy or unhealthy and to Monosodium glutamate: Review on clin-
anti-Asian sentiment in national rhet- not let racial or cultural bias replace ical reports. Int J Food Prop. 2017;20(2):
oric and the culinary world, there is a sound science. S1807-S1815.
need to critically examine how racial 16. Lyons R. “Chinese restaurant syndrome”
biases have affected research and puzzles doctors. New York Times. Pub-
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AUTHOR INFORMATION
Address correspondence to: Kate Gardner Burt, PhD, RDN, Lehman College, City University of New York, 250 Bedford Park Boulevard West, Bronx,
NY 10468. E-mail: [email protected]
This article was written by Amanda Wahlstedt, graduate student, Teachers College, Columbia University, New York, New York; Elizabeth
Bradley, graduate student, Teachers College, Columbia University, New York, New York; Juan Castillo, graduate student, Teachers College,
Columbia University, New York, New York; and Kate Gardner Burt, assistant professor, Lehman College, City University of New York, Bronx, New
York.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST
No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT
There is no funding to disclose.
AUTHOR CONTRIBUTIONS
E. Bradley and J. Castillo conceptualized of the health component of the manuscript. A. Wahlstedt and K. G. Burt identified the racial component.
E. Bradley and J. Castillo wrote the initial draft(s) under the guidance of K. G. Burt. A. Wahlstedt wrote significant portions of the revision. K. G. Burt
advised, editing, and provided additional information throughout the process.

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