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Intolerance to dietary biogenic amines: A review

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Author: Jansen, S.C. · Dusseldorp, M. van · Bottema, K.C. · Dubois, A.E.J.
Source:Annals of Allergy, Asthma and Immunology, 3, 91
Identifier: 237263
Keywords: Biology Nutrition · Food and Chemical Risk Analysis · amine oxidase (copper containing) · amine oxidase (flavin containing) isoenzyme A · amine oxidase (flavin containing) isoenzyme B · aryl sulfotransferase · biogenic amine · histamine · histamine methyltransferase · phenethylamine · tyramine · cacao · clinical article · clinical trial · controlled clinical trial · controlled study · correlation analysis · diet · double blind procedure · evidence based medicine · food allergy · food intake · headache · human · medical literature · migraine · nutritional intolerance · priority journal · provocation test · publication · randomized controlled trial · review · treatment outcome · urticaria · wine · Administration, Oral · Adult · Biogenic Amines · Cacao · Child · Clinical Trials · Diagnostic Errors · Diet · Food Hypersensitivity · Headache · Histamine · Humans · Migraine Disorders · Phenethylamines · Research Design · Tyramine · Wine


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.