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High-Histamine Foods – Overview & Dietary Tips

High-histamine foods contain elevated levels of histamine and can trigger intolerance reactions in sensitive individuals. Common sources include aged cheeses, red wine, canned fish, and fermented products.

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Things worth knowing about "High-Histamine Foods"

High-histamine foods contain elevated levels of histamine and can trigger intolerance reactions in sensitive individuals. Common sources include aged cheeses, red wine, canned fish, and fermented products.

What Is Histamine in Food?

Histamine is a biogenic amine that occurs naturally in the human body but can also be found in significant amounts in certain foods. It is primarily formed through the bacterial breakdown of the amino acid histidine, a process that takes place during the ripening, fermentation, or improper storage of food. In individuals with histamine intolerance or reduced activity of the degrading enzyme diamine oxidase (DAO), high-histamine foods can cause a wide range of symptoms.

How Does Histamine Form in Food?

Histamine formation in food is closely linked to microbial activity. Bacteria, particularly lactobacilli and certain gram-negative bacteria, possess the enzyme histidine decarboxylase, which converts histidine into histamine. This process is promoted by the following factors:

Long ripening and fermentation periods
Elevated storage temperatures
Improper refrigeration of fish and meat
Certain production methods such as smoking or pickling

Food Groups with High Histamine Content

Fish and Seafood

Fish is among the foods with the highest potential histamine content. Particularly problematic are:

Tuna, mackerel, sardines, herring – especially in canned or smoked form
Anchovies and other pickled fish products
Fish that has not been adequately refrigerated

Aged Cheeses

Aged and fermented cheeses often contain very high histamine levels. These include:

Camembert, Brie, Emmental, Parmesan, Gouda
Blue cheeses such as Roquefort or Gorgonzola
The longer the ripening process, the higher the histamine content

Alcoholic Beverages

Red wine is considered one of the most significant sources of histamine. Other fermented alcoholic drinks are also affected:

Red wine (especially tannin-rich varieties)
White wine and sparkling wine (to a lesser extent)
Beer, especially unfiltered wheat beer
Champagne and sparkling wines

Processed Meat and Charcuterie

Fermented and cured meat products also contain elevated histamine levels:

Salami, pepperoni, chorizo
Dry-cured ham (e.g., prosciutto, Serrano ham)
Smoked sausages and deli meats

Fermented Foods

Fermentation increases histamine content in many plant-based and animal-based foods:

Sauerkraut and other lacto-fermented vegetables
Kimchi
Soy sauce, miso, and other fermented soy products
Vinegar and vinegar-based products

Other Histamine-Containing Foods

Tomatoes and tomato-based products (ketchup, tomato sauce)
Spinach and avocado
Strawberries and citrus fruits (also act as histamine liberators)
Chocolate and cocoa
Yeast and yeast-containing products

Histamine Liberators and DAO Inhibitors

In addition to foods with directly high histamine content, there are so-called histamine liberators – foods that stimulate the release of the body's own histamine without necessarily containing large amounts themselves. These include citrus fruits, strawberries, tomatoes, nuts, and chocolate. Furthermore, certain foods and substances inhibit the activity of the histamine-degrading enzyme DAO, including alcohol and certain medications.

Symptoms of Histamine Intolerance

People with histamine intolerance often experience the following symptoms after consuming histamine-rich foods:

Headaches and migraines
Skin reactions such as flushing, itching, or hives
Gastrointestinal complaints (bloating, diarrhea, nausea)
Runny nose and sneezing
Heart palpitations and circulatory issues

Dietary Recommendations for Histamine Intolerance

When histamine intolerance has been confirmed, nutrition specialists recommend a low-histamine diet. Well-tolerated alternatives include:

Fresh, unprocessed meat and fish (prepared immediately after purchase)
Fresh vegetables such as zucchini, carrots, and broccoli
Mild fresh cheeses (e.g., mozzarella, ricotta, cottage cheese)
Rice, potatoes, and egg-free pasta
Herbal teas instead of wine or beer

Individual dietary counseling by a qualified professional is recommended if histamine intolerance is suspected, as tolerance levels vary considerably from person to person.

References

Maintz L, Novak N. Histamine and histamine intolerance. American Journal of Clinical Nutrition. 2007;85(5):1185-1196.
Reese I et al. Guideline on the management of suspected intolerance to orally ingested histamine. Allergo Journal International. 2017;26(2):72-79.
European Food Safety Authority (EFSA). Scientific Opinion on risk based control of biogenic amine formation in fermented foods. EFSA Journal. 2011;9(10):2393.

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