For individuals experiencing symptoms potentially linked to histamine intolerance or Mast Cell Activation Syndrome (MCAS), dietary management can play a crucial role in alleviating discomfort. Some people with MCAS symptoms have a histamine intolerance. Histamine intolerance refers to when the body has difficulty breaking down histamine, so a buildup of this compound can lead to worsening MCAS-like symptoms since histamine is one of the many compounds released by mast cells that can lead to swelling, hives, diarrhea, and other issues. A low-amine diet, which includes a low-histamine diet, is often suggested as a strategy to minimize the intake of compounds that can trigger or exacerbate these conditions. This comprehensive guide provides insights into understanding amines, identifying high and low-amine foods, and implementing practical strategies for cooking and meal planning.
Understanding Amines and Their Impact
Amines are naturally occurring chemicals found in food, formed as a result of the breakdown of amino acids. They are a compound containing ammonia. While the body possesses enzymes to break down these compounds, some individuals may experience a buildup of amines due to impaired enzyme function, leading to various symptoms.
Histamine is a type of amine that often gets attention in discussions about food sensitivities. However, other amines like cadaverine, putrescine, tyramine, and dopamine also contribute to the overall amine concentration in foods and may be responsible for adverse reactions.
Symptoms of Amine Intolerance
Symptoms of amine food intolerance can manifest in a variety of ways, often resembling allergy-like reactions. It makes it very tricky to identify food triggers, and they may take 1 - 48 hours to manifest. Common symptoms include:
- Rash
- Headache
- Itching
- Swelling
- Flushing
- Irregular heartbeat
- Bloating
- Constipation
- Diarrhea
- Abdominal pain
- Nausea
- Vomiting
- Ulcers
- Fatigue
- Brain fog
- Heartburn
- Dermatitis
- Irregular menstrual cycle
- Migraines
- Tissue swelling
- High blood pressure
- Low blood pressure
- Anxiety
- Depressive mood
If these symptoms are a typical occurrence for you, try to identify if foods high in amines are the reason. If you don’t know where to start, working with a registered dietitian is a great place to start. Check out the Food Sensitivity Program.
Read also: The Hoxsey Diet
Key Principles of a Low-Amine Diet
Since amines are present in a wide variety of foods, completely eliminating them from the diet is impractical. Instead, the goal is to lower amine intake by making informed food choices and adopting appropriate cooking and storage methods.
The Importance of Freshness
The fresher the food is, the better it is. Freshness is a critical factor in managing amine levels. The longer food sits, the more amines it can develop. This is because histamine is produced when bacteria, found in the skin, gills and guts of the fish break down an amino acid called histidine. The enzyme that does this work is called histidine decarboxylase and can keep working even after the bacteria that produced it have been killed. Choose fresh ingredients over canned or processed options.
Cooking and Preparation Techniques
Certain cooking techniques can cause the food to release more amines. When avoiding amines, not only is the food important but also the way that it is prepared. Cooking methods like grilling, charring, fermenting, or overcooking can elevate amine levels. The best cooking methods will be steaming and boiling foods. Canned foods will be higher in amines than their fresh counterparts. And leftovers can develop a higher amine content while they sit in the fridge.
Personalized Approach
A low histamine diet is highly individual. The same foods that affect one person with a histamine intolerance may not affect the next person. A GI Registered Dietitian may even recommend a reduction in high histamine foods instead of a strict low histamine diet. A low-amine diet is highly individual. The same foods that affect one person may not affect another. A GI Registered Dietitian may even recommend a reduction in high-amine foods instead of a strict low-amine diet.
Foods to Include and Avoid on a Low-Amine Diet
Navigating a low-amine diet requires careful attention to food choices. The following lists provide guidance on foods that are generally considered low or high in amines. However, individual tolerance levels may vary, so it is essential to monitor your body's response to different foods.
Read also: Walnut Keto Guide
Low-Amine Foods (Generally Preferred)
- Proteins: Freshly cooked meats (beef, chicken, lamb), certain fresh or frozen fish (hake, trout, plaice), eggs including quail eggs.
- Fruits: Most fresh fruits (excluding citrus fruits, overripe bananas, kiwi, pineapple, grapes, berries, dried fruit, overripe avocado), apple, melon, and pear fruit salad, mango.
- Vegetables: Fresh vegetables (except tomatoes, eggplant, spinach, asparagus, broccoli), kale, zucchini, roasted carrots, new potatoes, green beans, sweet potato wedges, carrot sticks, celery sticks, lettuce, cucumber, radish, parsnips, cauliflower, broccoli, celery, cucumber, artichokes, watercress.
- Grains: White rice, rice noodles, white bread, rye bread, oats, puffed rice crackers, millet flour, pasta, quinoa, tapioca, cauliflower rice.
- Dairy: Fresh pasteurized milk, cream cheese, mozzarella, butter, goat/sheep milk, cottage cheese, ricotta, mascarpone, some plain soft cheese - select those without additives like thickeners or stabilisers.
- Other: Most cooking oils, herbal teas (excluding black tea and mate tea), most fruit juices without citrus, fresh herbs, beansprouts, garlic (when eaten in small amounts, and especially after cooking), sesame seeds.
High-Amine Foods (Generally Avoided)
- Alcohol (all aged types)
- Pickled or canned foods, such as sauerkraut
- Aged cheeses (Cheddar cheese, Feta, Swiss Cheese, Blue cheese, Brie, Parmesan)
- Smoked meats (e.g., salami, ham, sausages)
- Shellfish
- Beans and pulses (chickpeas, soy flour)
- Long-stored nuts (peanuts, almonds, cashews, pistachios)
- Chocolate and cocoa-based products
- Fermented products (seitan, rice vinegar, yeast extract)
- Ready meals and processed snacks with preservatives
- Overripe avocado
- Overripe banana
- Berries
- Citrus
- Dried fruit
- Kiwi
- Pineapple
- Grapes
- Asparagus
- Eggplant
- Tomatoes (any kind or form)
- Spinach
- Broccoli
- Processed meat of any kind
- Battered
- Canned
- Smoked
- Hot dogs
- Chicken nuggets
- Bacon
- Sausages
- Deli meats
- Soymilk
- Almond Milk
- Apple juice and cider
- Beer
- Caffeinated drinks
- Chai Tea
- Chocolate drinks
- Vegetable juice
- Tequila
- Bran cereals
- Bran muffins
- Rolled oats
- Whole wheat bread
- Whole wheat pasta
- Graham Crackers
Histamine-Releasing Foods
These foods do not contain high histamine levels but can release histamine in the body:
- Most citrus fruits (lemons, limes, oranges)
- Papaya, pineapples, plums, kiwi, bananas
- Tomatoes
- Cocoa and chocolate
- Nuts (walnuts, peanuts)
- Additives (benzoates, sulphites, nitrites, glutamates, food dyes)
DAO-Blocking Foods
These foods inhibit the diamine oxidase (DAO) enzyme, which helps break down histamine:
- Alcohol
- Black tea and mate tea
- Energy drinks
Debatable Foods
- Yoghurt: Suitability depends on the bacterial cultures used.
- Egg White: Once thought to be a histamine releaser, this theory has been dismissed.
- Yeast and Yeast Extract: While yeast itself does not contain histamine, it may catalyze histamine production during leavening. Yeast extract is considered unsuitable due to high biogenic amine content.
Practical Tips for Grocery Shopping and Food Preparation
Amine allergies and amine sensitivities make grocery shopping an overwhelmingly difficult task. All the foods you would normally grab are now on the “can’t have it” list. Grocery shopping was daunting without a list. To navigate grocery shopping and food preparation effectively on a low-amine diet, consider the following tips:
- Plan meals in advance: This helps ensure you have the necessary ingredients on hand and reduces the temptation to opt for high-amine convenience foods.
- Buy fresh food: Shop more often, if necessary, to ensure you are purchasing the freshest possible ingredients.
- Eat foods as soon as possible after purchase: Minimize storage time to prevent amine buildup.
- Ask restaurants about their ingredients: When eating out, inquire about the ingredients and preparation methods used to avoid potential triggers.
- Keep a food journal: Record your symptoms and potential triggers to identify individual sensitivities.
- Choose fresh, whole, low-amine ingredients and produce: Start with fresh, whole, low-amine ingredients and produce.
- Drink only fresh juices from trusted sources: Juice is tricky.
- Keep high-amine processed foods out of your diet
Sample Low-Amine Meal Plan
The following is an example of a low histamine diet plan that someone could follow while monitoring their symptoms.
- Breakfast: Oatmeal made with water or coconut milk; Puffed rice with coconut milk; Apple, melon, and pear fruit salad with chopped pistachios; Smoothie made with mango, coconut milk, chia seeds, and kale.
- Lunch: Chicken and kale salad with chopped grapes; Chicken, lettuce, and grated carrot sandwich; Cottage cheese and cucumber on toast; Quinoa and herb salad.
- Dinner: Low histamine fish, such as trout or cod, freshly caught and served with zucchini and roasted carrots; Chicken with new potatoes, broccoli, and green beans; Pasta with olive oil, garlic, herbs, and chicken or borlotti beans; Homemade turkey burger with sweet potato wedges.
- Snacks: Blueberries; Pistachios; Carrot sticks; Cottage cheese; Grapes; Celery sticks; Apple slices and natural peanut butter.
Additional Considerations and Resources
Testing for Food Sensitivities
If you suspect that a high histamine diet may be the source of your discomfort, that means it is time to get tested! The Mediator Release Test (MRT) is a specialized test designed to identify sensitive foods and food-chemicals (like histamine) that cause an inflammatory response in your body. It is very accurate with 94.5% sensitivity and 91.7% specificity. 176 foods and chemicals are tested.
Read also: Weight Loss with Low-FODMAP
Consulting a Healthcare Professional
Before making significant dietary changes, it is essential to consult with a healthcare professional, such as a registered dietitian or allergist. They can help you determine if a low-amine diet is appropriate for your individual needs and provide personalized guidance on implementation.
Food Intolerance Apps
Tools like BALIZA’s guide for histamine, FODMAPs, and IBS.
Scientific Research
Studies such as Histamine and Histamine Intolerance by Maintz & Novak (2007) and “Histaminunverträglichkeit” by R. Jarisch.
Food Intolerance Networks
Platforms offering updated guidance and community support.