Dietary Considerations for Mast Cell Activation Syndrome

Eating to reduce MCAS symptoms requires removing high-histamine foods and eating a low-histamine diet that contains histamine liberators. There is conflicting information online about how to do this; this article should provide clarity and direction on where to start this major change in your diet and lifestyle—and take you another big step in your journey toward healing.

Foods That Aggravate Histamine Concerns

Often, people who struggle with histamine issues find it helpful to do an elimination diet wherein they remove all high-histamine foods for a period of time to allow the body to heal.

This isn’t an exhaustive list, and every individual’s response to these foods will vary. It’s helpful to not focus on removing foods but rather on finding replacements. This list can be a starting point to give you some guidance on what sort of high-histamine foods you may be eating regularly without knowing.

High-Histamine Foods

In general, foods that are processed, fermented, or aged are higher in histamines.

• Processed, shelf-stable food products
• Canned foods
• Fermented vegetables such as sauerkraut, kimchi, and other pickled vegetables
• Fermented dairy products including kefir, yogurt, sour cream, cream cheese, aged cheese, etc.
• Processed, cured, and aged meats, such as bacon, sausage, salami, etc.
• Vinegar-containing foods such as olives, pickles, and mayonnaise
• Alcohol
• Peanuts and cashews
• Chocolate
• Yeast products
• Fruit such as avocado, citrus, pineapple, and all dried fruit
• Vegetables such as spinach, tomatoes, and eggplant
• Spices such as cinnamon, nutmeg, anise, cloves, and cayenne pepper

Histamine-Releasing Foods

These foods can trigger white blood cells to release histamines.

• Alcohol
• Artificial preservatives and dyes
• Bananas
• Chocolate
• Dairy products
• Nuts
• Papaya
• Pineapple
• Shellfish
• Strawberries
• Tomatoes
• Wheat germ

Although cutting back on some of these foods can be helpful, the eventual goal should always be to support your histamine pathways to function properly so that over time, you can re-introduce any foods that were necessary to remove. Many high-histamine foods have great nutritional benefits (fermented foods, for example), so we don’t want to unnecessarily remove them permanently.

It may be recommended to remove high-histamine foods from your diet for about three to six months to give your body a chance to begin healing. It is typically recommended to consider supplementing with diamine oxidase enzymes, which are produced by the body to break down histamine, if you haven’t seen significant improvement during the elimination diet.

What Is a Low-Histamine Diet?

For those facing MCAS, it’s important to create an immune support diet by working to build better nutrient intake while limiting high-histamine or histamine-releasing foods. It is especially helpful to eat foods with anti-inflammatory properties that help your body cool inflammation so your mast cells stabilize naturally.

A few tips to keep in mind when choosing a low-histamine diet, to maximize your success:

• Freeze your leftovers: Leftovers sitting in the fridge give histamine levels a chance to increase each day the food is stored. Freezing them right away will avoid this.
• Avoid aged meat: Aging meat increases histamine levels. For example, beef is often aged for 14 to 21 days, giving histamine levels a chance to flourish. It’s best to consume meat that has been frozen immediately after being butchered. You can often find this from your local farmer or butcher, and many subscription services will deliver high-quality proteins, frozen solid right after butchering, directly to your doorstep.
• Limit sugar: While on a low-histamine diet, it is important to avoid blood sugar spikes. This includes removing all types of refined sugar, including maple syrup, rice syrup, agave, and coconut sugar, as well as honey, as it is also high in histamine.
• Limit eating out: It is incredibly challenging to stick to any low-histamine diet plan while eating at a restaurant, as even getting a list of ingredients used in your meal can be difficult. If you do need to eat out, it’s best to bring your own properly prepared meat protein to avoid reintroducing a potential trigger too early.
• Journal your food: Keeping a daily record of the foods you eat and any symptoms you identify can be extremely helpful in identifying triggers, including any sort of food sensitivity or intolerance you may have that is unrelated to histamine.
• Stay hydrated: Make sure that you are drinking plenty of clean, filtered water with added minerals to support your body. Staying hydrated will ensure your body is able to flush toxins.

Non-Inflammatory, Immune Supporting Foods

As a general rule, you want to focus on eating fresh, whole, nutrient-dense foods. Your body needs to be supported with as many bioavailable nutrients as possible to expedite the healing process. Try to buy from your local farmer or farmers markets to get them as fresh as possible. Even better is if you can grow more of your own fruits and vegetables. Including non-inflammatory foods in your diet will help support your body to absorb all of the available nutrients it needs. This is just a sampling of foods that are available to you on a low-histamine diet:

Vegetables

• Butter lettuce
• Scallions
• Onions
• Sweet potatoes
• Artichokes
• Arugula
• Cabbage
• Cauliflower
• Bok choy
• Radishes
• Butternut and spaghetti squash
• Zucchini
• Escarole
• Fennel
• Asparagus
• Leeks
• Broccoli
• Mustard greens
• Carrots

Herbs

• Chamomile
• Nettle
• Turmeric
• Galangal
• Basil
• Cilantro
• Garlic
• Chives
• Mint
• Rosemary
• Parsley
• Moringa
• Oregano

Nuts and Seeds

• Brazil nuts
• Quinoa
• Flax seeds
• Hemp seeds

Grains

• Cassava flour
• Tigernut flour
• Flax meal
• Coconut flour

Fruits

• Peaches
• Tart cherries
• Green apples
• Blackberries
• Mango
• Blueberries

Proteins

• Un-aged beef and bison
• Pastured chicken, pork, lamb, turkey
• Chicken, quail, or duck eggs
• Fresh fish

Fats

• Grass-fed ghee
• Coconut oil
• Avocado oil

Other Potential Food Triggers

At times, people who eat a low-histamine diet may notice they are still having symptoms. This can be discouraging, but it is an indicator that there may be more to consider. You may need to consider other food components that you are eating that could be aggravating your immune system, such as foods that are high in lectins or oxalates.

Lectins are a type of protein found in plants that bind to carbohydrates. They’re a part of some plants’ natural defense mechanisms, and that same mechanism is what causes them to be potentially inflammatory to the human body.

Common Foods That Contain Lectins

• Beans, lentils, peas, soybeans, peanuts
• Whole grains such as wheat
• Zucchini
• Nightshades, including tomatoes, potatoes, and peppers

Oxalates are found in many plants and are also part of their defense against threats. They are seen as an “antinutrient” because they block the body from absorbing calcium.

Foods High in Oxalates

• Beets
• Rhubarb
• Sweet potatoes
• Spinach
• Almonds and cashews
• Swiss chard
• Buckwheat
• Quinoa
• Kidney beans
• Peanuts
• Sesame seeds and pine nuts
• Chocolate

Many people with MCAS who adjust their diet will notice improvements in their symptoms over time. As the body comes back into balance, many find that they can eat certain high-histamine foods that used to trigger a flare-up in low quantities. Keep in mind that this diet is meant for a season, not to be adhered to forever. Strategically reintroducing foods one at a time is crucial to understanding the body’s response to them.