Histamine Intolerance: Food List and Dietary Guidelines

Histamine Intolerance (HIT) is a condition that requires careful dietary management to alleviate symptoms and improve quality of life. The following guide offers insights into managing your diet, starting with an elimination process and progressing to identifying personal histamine thresholds.

The Importance of a Personalized Food List

The dynamic nature of food research means that food lists are only guidance tools and not definitive authorities. Histamine levels in foods can vary based on ripeness, processing, and storage conditions. Consultation with a doctor and dietitian is essential before beginning an elimination diet.

Key Steps in Histamine Intolerance Diet

1. Start with an Elimination Diet: Remove high-histamine foods for approximately four weeks. Monitor symptom improvements during this period.
2. Identify Your Threshold: After a successful elimination phase, reintroduce foods gradually to determine personal tolerance levels.
3. Maintain a Food Diary: Track everything you eat and any symptoms to identify triggers and patterns.
4. Emphasize Freshness and Cleanliness: Choose fresh ingredients, avoid lingering foods, and keep preparation areas hygienic.

Foods to Prefer and Avoid for HIT Management

Low-Histamine Foods (Preferred)

• Proteins: Fresh meats (beef, chicken, lamb), certain fresh or frozen fish (hake, trout, plaice), and eggs.
• Fruits: Most fresh fruits, excluding plantains and certain histamine liberators like citrus fruits.
• Vegetables: Fresh vegetables, except tomatoes, eggplant, and spinach.
• Grains: Products like rice noodles, white bread, rye bread, oats, puffed rice crackers, millet flour, and pasta.
• Dairy: Fresh pasteurized milk, cream cheese, mozzarella, butter, and goat/sheep milk.
• Other Foods: Most cooking oils, herbal teas (excluding black tea and mate tea), and most fruit juices without citrus.

High-Histamine Foods (Avoid)

• Alcohol
• Pickled or canned foods, such as sauerkraut
• Aged cheeses
• 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

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.

Tips for HIT-Friendly Cooking and Eating

• Buy Fresh: Choose fresh ingredients over canned or processed options.
• Cook at Home: Homemade meals give you control over ingredients and preparation methods.
• Monitor Food Storage: Refrigerate foods promptly and avoid consuming leftovers.
• Cleanliness: Maintain a clean but not obsessive kitchen environment.

Additional Resources for HIT Management

• 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.

Final Thoughts

Managing histamine intolerance is a journey of discovery, requiring patience, vigilance, and collaboration with healthcare professionals. By adhering to a tailored low-histamine diet and identifying your thresholds, you can improve your symptoms and enhance your overall quality of life.

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