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Intolerance to dietary biogenic amines: a review.

Abstract

OBJECTIVE

To evaluate the scientific evidence for purported intolerance to dietary biogenic amines.

DATA SOURCES

MEDLINE was searched for articles in the English language published between January 1966 and August 2001. The keyword biogenic amin* was combined with hypersens*, allerg*, intoler*, and adverse. Additionally, the keywords histamine, tyramine, and phenylethylamine were combined with headache, migraine, urticaria, oral challenge, and oral provocation. Articles were also selected from references in relevant literature.

STUDY SELECTION

Only oral challenge studies in susceptible patients were considered. Studies with positive results (ie, studies in which an effect was reported) were only eligible when a randomized, double-blind, placebo-controlled design was used. Eligible positive result studies were further evaluated according to a number of scientific criteria. Studies with negative results (ie, studies in which no effect was reported) were examined for factors in their design or methods that could be responsible for a false-negative outcome. Results of methodologically weak or flawed studies were considered inconclusive.

RESULTS

A total of 13 oral challenge studies (5 with positive results and 8 with negative results) were found. Three of them (all with positive results) were considered ineligible. By further evaluation of the 10 eligible studies, 6 were considered inconclusive. The 4 conclusive studies all reported negative results. One conclusive study showed no relation between biogenic amines in red wine and wine intolerance. Two conclusive studies found no effect of tyramine on migraine. One conclusive study demonstrated no relation between the amount of phenylethylamine in chocolate and headache attacks in individuals with headache.

CONCLUSIONS

The current scientific literature shows no relation between the oral ingestion of biogenic amines and food intolerance reactions. There is therefore no scientific basis for dietary recommendations concerning biogenic amines in such patients.

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  • Authors+Show Affiliations

    ,

    Department of Nutritional Epidemiology, TNO Nutrition and Food Research, Zeist, The Netherlands.

    , ,

    Source

    MeSH

    Administration, Oral
    Adult
    Biogenic Amines
    Cacao
    Child
    Clinical Trials as Topic
    Diagnostic Errors
    Diet
    Food Hypersensitivity
    Headache
    Histamine
    Humans
    Migraine Disorders
    Phenethylamines
    Research Design
    Tyramine
    Wine

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    14533654

    Citation

    Jansen, Sophia C., et al. "Intolerance to Dietary Biogenic Amines: a Review." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 91, no. 3, 2003, pp. 233-40; quiz 241-2, 296.
    Jansen SC, van Dusseldorp M, Bottema KC, et al. Intolerance to dietary biogenic amines: a review. Ann Allergy Asthma Immunol. 2003;91(3):233-40; quiz 241-2, 296.
    Jansen, S. C., van Dusseldorp, M., Bottema, K. C., & Dubois, A. E. (2003). Intolerance to dietary biogenic amines: a review. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 91(3), pp. 233-40; quiz 241-2, 296.
    Jansen SC, et al. Intolerance to Dietary Biogenic Amines: a Review. Ann Allergy Asthma Immunol. 2003;91(3):233-40; quiz 241-2, 296. PubMed PMID: 14533654.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Intolerance to dietary biogenic amines: a review. AU - Jansen,Sophia C, AU - van Dusseldorp,Marijke, AU - Bottema,Kathelijne C, AU - Dubois,Anthony E J, PY - 2003/10/10/pubmed PY - 2003/11/13/medline PY - 2003/10/10/entrez SP - 233-40; quiz 241-2, 296 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann. Allergy Asthma Immunol. VL - 91 IS - 3 N2 - OBJECTIVE: To evaluate the scientific evidence for purported intolerance to dietary biogenic amines. DATA SOURCES: MEDLINE was searched for articles in the English language published between January 1966 and August 2001. The keyword biogenic amin* was combined with hypersens*, allerg*, intoler*, and adverse. Additionally, the keywords histamine, tyramine, and phenylethylamine were combined with headache, migraine, urticaria, oral challenge, and oral provocation. Articles were also selected from references in relevant literature. STUDY SELECTION: Only oral challenge studies in susceptible patients were considered. Studies with positive results (ie, studies in which an effect was reported) were only eligible when a randomized, double-blind, placebo-controlled design was used. Eligible positive result studies were further evaluated according to a number of scientific criteria. Studies with negative results (ie, studies in which no effect was reported) were examined for factors in their design or methods that could be responsible for a false-negative outcome. Results of methodologically weak or flawed studies were considered inconclusive. RESULTS: A total of 13 oral challenge studies (5 with positive results and 8 with negative results) were found. Three of them (all with positive results) were considered ineligible. By further evaluation of the 10 eligible studies, 6 were considered inconclusive. The 4 conclusive studies all reported negative results. One conclusive study showed no relation between biogenic amines in red wine and wine intolerance. Two conclusive studies found no effect of tyramine on migraine. One conclusive study demonstrated no relation between the amount of phenylethylamine in chocolate and headache attacks in individuals with headache. CONCLUSIONS: The current scientific literature shows no relation between the oral ingestion of biogenic amines and food intolerance reactions. There is therefore no scientific basis for dietary recommendations concerning biogenic amines in such patients. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/14533654/Intolerance_to_dietary_biogenic_amines:_a_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)63523-5 DB - PRIME DP - Unbound Medicine ER -