SIGHI Histamine Elimination Diet: Managing Histamine Intolerance

Histamine intolerance can cause a wide range of symptoms, including digestive issues, migraines, skin reactions, and fatigue. The SIGHI Histamine Elimination Diet, developed by the Swiss Interest Group Histamine Intolerance (SIGHI), provides a practical, science-backed approach to managing histamine intolerance and related conditions, such as DAO (diamine oxidase) degradation disorders. Below is an in-depth guide to understanding and applying the principles of the diet to improve symptom management.

What is Histamine Intolerance?

Histamine intolerance occurs when the body accumulates histamine faster than it can be broken down, often due to reduced activity of the enzyme DAO. This condition is distinct from mast cell activation disorders (MCAD), although they share some overlapping symptoms.

Key Notes from SIGHI:

• This dietary guideline primarily addresses histamine intolerance caused by DAO degradation disorders.
• For those with MCAD, this guide may be insufficient.

The SIGHI List: Simplifying Food Choices

The SIGHI list categorizes foods into three groups:

1. To Avoid: High histamine foods, histamine liberators, and DAO inhibitors.
2. Risky: Foods that may cause symptoms depending on individual sensitivity.
3. Well Tolerated: Foods generally safe for individuals with histamine intolerance.

Downloadable Resources:

• Printable low histamine food list PDF and high histamine foods list PDF are available at histaminintoleranz.ch.

Principles of the SIGHI Diet

1. Focus on Freshness
   • Histamine levels increase as food deteriorates. Always prioritize freshness, especially with perishable foods like fish and meat.
   • Avoid leftovers unless frozen immediately after preparation.
2. Understand Individual Sensitivities
   • Everyone reacts differently to histamine-containing or histamine-liberating foods. Start with strict adherence to the SIGHI list, and adjust based on trial and error.
3. Check Ingredients
   • Processed foods often contain hidden histamine triggers like yeast extract, vinegar, or soy sauce. Always read labels carefully.
4. Avoid Histamine Pathway Blockers
   • DAO inhibitors can reduce the body’s ability to break down histamine. Substances like alcohol and mate tea should be avoided.

Foods to Avoid, Risky Choices, and Safe Alternatives

General Foods

• Avoid: Fermented products (alcohol, vinegar, yeast), canned foods, reheated meals, and restaurant-prepared dishes.
• Safe: Fresh, unprocessed foods stored and prepared with care.

Meat and Eggs

• Avoid: Processed meats (e.g., salami, bacon), aged cuts, and sausages.
• Risky: Prepacked minced meat and game meats.
• Safe: Fresh poultry, pork, lamb, and eggs.

Fish and Seafood

• Avoid: Smoked or canned fish (e.g., tuna, mackerel), shellfish, and fish sauces.
• Safe: Freshly caught fish or frozen fish thawed quickly.

Dairy Products

• Avoid: Aged cheeses, yogurt, and sour milk products.
• Safe: Fresh milk, mozzarella, ricotta, and cream.

Fruits and Vegetables

• Avoid: Overripe fruits, bananas, strawberries, citrus fruits, and tomatoes.
• Safe: Apples, peaches, melons, and most vegetables.

Grains and Fats

• Avoid: Yeast-fermented breads and malt.
• Safe: Rice, corn, potatoes, and vegetable oils.

Beverages

• Avoid: Alcohol, soy milk, and energy drinks.
• Safe: Herbal teas, almond milk, and plain water.

Understanding Histamine Triggers

Histamine levels in the body are influenced not only by direct histamine intake but also by foods and substances that indirectly affect histamine metabolism.

1. Histamine-Rich Foods
   • Includes aged or fermented products like cured meats, matured cheeses, and alcohol.
   • Examples: Sauerkraut, tomatoes, spinach, eggplant.
2. Histamine Liberators
   • These trigger the release of histamine stored in mast cells, even in the absence of dietary histamine.
   • Examples: Strawberries, citrus fruits, chocolate, seafood.
3. DAO Inhibitors
   • These block the activity of DAO, slowing histamine breakdown.
   • Examples: Alcohol, mate tea, certain medications.
4. Increased Intestinal Permeability
   • Substances like alcohol and hot spices can make the intestines more permeable, increasing histamine absorption.

Supplementary Strategies

1. DAO Enzyme Supplements
   • Products like DAOSIN can help break down dietary histamine when taken before meals.
2. Antihistamines
   • H1 and H2 blockers can alleviate acute symptoms.
3. Mast Cell Stabilizers
   • Cromolyn sodium may reduce histamine release for those with MCAD.

Detailed Food Category Highlights

High Histamine Foods

• Fish: Tuna, mackerel, herring, sardines.
• Meat: Dry-cured ham, aged beef.
• Vegetables: Spinach, eggplant, avocado.
• Other: Vinegar, soy sauce, alcoholic beverages.

Well-Tolerated Foods and Low Histamine Foods

• Fruits: Apples, melons, berries like cranberries and blueberries.
• Vegetables: Zucchini, carrots, and green beans.
• Proteins: Freshly cooked chicken, turkey, and eggs.

Practical Tips for Success

1. Start Strict, Then Adjust
   • During the elimination phase, follow the SIGHI list consistently. Gradually reintroduce foods to determine individual tolerances.
2. Emphasize Food Preparation
   • Let cooked food cool briefly, then freeze it immediately to prevent histamine build-up. Thaw rapidly before consuming.
3. Incorporate Medication Where Needed
   • Use supplements and antihistamines as advised by a healthcare professional.

Conclusion

The SIGHI Histamine Elimination Diet is a structured, adaptable approach to managing histamine intolerance. By understanding the role of histamine-rich foods, liberators, and inhibitors, individuals can take control of their symptoms. Combined with resources like the SIGHI list 2023 and professional guidance, this diet can significantly enhance quality of life.

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