297: Low-Histamine Diet: Which Foods Should Be Avoided to Prevent Histamine Intolerance?

Introduction

Histamine is a biogenic amine found in many human cells, essential to immune responses, regulation of gastric acid secretion in the gut, and neurotransmission in the central nervous system. Histamine intolerance is prevalent today with gastrointestinal, neurological, cardiovascular, respiratory, and skin symptoms. It can result from histamine metabolic enzyme deficiencies or use of DAO inhibitor medications. The symptoms are triggered by even very low levels of histamine in food. The European Food Safety Authority concluded that the no adverse health effect level is below the detectable limit per meal for histamine intolerants. Therefore, a histamine-free or low-histamine diet must be followed. However, information on which foods should be avoided is usually based on the history of outbreaks, and not based on the analytical quantification of histamine in food.

Methods

The objective of this study was to quantify histamine in different types of food (plant and animal origins) using a reliable method – HPLC and fluorimetric detection after o-phthalaldehyde derivatization.

Results

Among foods analyzed (>5,000 samples), no histamine was found in avocado, pineapple, banana, apple, papaya, lemon, mango, caja-manga, khaki, star fruit, rice, corn, sorghum, cashew nut, Brazil nut, almond, peanut, mushroom, fresh good quality milk, and meat. However, high histamine levels (>100 mg/kg) were found in dry-fermented sausage, aged cheese, grated cheese, artisanal cheese, crab, some fish, soy sauce, and salmon sashimi. Intermediate levels (10 to 99 mg/kg) were found in eggplant, tucupi, and bean sprouts. Low levels (<10 mg/kg) were found in beet, watermelon, melon, peach, grape, pumpkin, spinach, tomato, wine, and cowpea. Overall, the food must be the freshest possible and of good quality; fermented products should be avoided; and cooking or heat treatments do not reduce histamine levels. One must also consider histamine in each food that composes the meal.

Significance

The data obtained can be used as reliable scientific information about histamine levels in food to be used in the prescription of histamine-free or low-histamine diets.

Authors: Maria Beatriz A. Gloria, Fabiana B. Diniz, Biane Philadelpho, Bruno M. Dala-Paula, José E. Gonçalves, Ederlan S. Ferreira