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Title: TYRAMINE IN FOODS AND MONOAMINE OXIDASE INHIBITOR DRUGS: A CROSSROAD WHERE MEDICINE, NUTRITION, PHARMACY, AND FOOD INDUSTRY CONVERGE.

Author
item McCabe Sellers, Beverly
item Staggs, Cathleen
item Bogle, Margaret

Submitted to: Journal of Food Composition and Analysis
Publication Type: Literature Review
Publication Acceptance Date: 12/19/2005
Publication Date: 8/1/2006
Citation: McCabe Sellers, B.J., Staggs, C.G., Bogle, M.L. 2006. Tyramine in foods and monoamine oxidase inhibitor drugs: a crossroad where medicine, nutrition, pharmacy, and food industry converge. Journal of Food Composition and Analysis. 19(S1):S58-S64.

Interpretive Summary: Individuals who are taking monoamine oxidase inhibitor (MAOI) drugs must avoid food high in tyramine because of the risk of extreme rises in blood pressure. Since tyramine forms when food is not properly prepared and stored, published values are not easy to obtain. This study provides a critical review of the published values and advances made to improve handling, storage, and packaging to reduce the risk of tyramine formation. Together, food scientists, dietitians, physicians, pharmacists, and the food industry are making the food supply safer and lowering the risk of this serious food-drug interaction.

Technical Abstract: Objective: Since identification of the 'cheese reaction' hypertensive crisis induced by dietary tyramine with monoamine oxidase inhibitors (MAOIs) drugs, numerous articles have addressed the biogenic amine (BA) content of foods. This review presents the reasons why many published analyses are no longer valid. Methods and Materials: Compilation of published values into common units after critical review of published reports. Preparation of recommendations based on newer reports about foods and drugs. Results: Reliance on case reports without analysis led to questionable dietary restrictions. Extrapolation from one analysis led to lengthy lists of banned foods. Early analyses are no longer valid for several reasons: better methods to accurately identify these amines, better packaging methods, recognition of critical points in prevention of BA formation, better storage and handling procedures, and substitution of cultures less likely to form amines have reduced the risks of these food-drug interactions. New generations of MAOIs and different administration allow smaller effective dosage and lower risks for interactions. Significance: This review of biogenic amines illustrates variability of food components over time, progress of food industry toward a safer food supply, development of better drugs, and the necessity for medicine, nutrition, pharmacy, and food industry to work together.