Stop Eating These “Gut Health” Foods.

Why fermented foods could be negatively affecting your health.

Jakub Kapusnak on Unsplash

Talk to anyone, be they at your local bank, hair salon, or sporting event (pre-pandemic that is), and tell them you have digestive issues. You might get this response: “Have you tried drinking kombucha? Adding kimchi to your breakfast? Putting kefir in your smoothie? Those will help!” This advice comes from a place of good intentions, however, in certain cases, these foods can exacerbate digestive issues.

How could that be? Aren’t these foods sources of probiotics that are supposed to help digestive issues? What in these foods could be causing someone’s gut health to get worse? Can/should these foods be added into my diet?

Fermented Foods

Foods such as kefir, kimchi, and kombucha, are created by way of fermentation. Fermentation happens when the microorganisms added to the food (bacteria, yeast, fungus) chemically breakdown the sugar previously present in the food. If you’ve ever made your own kombucha, you know that without adding sugar to the recipe, nothing really happens. If you’re buying yogurt or kombucha at the store, look for the phrase ‘live culture’ on the ingredient label. This lets you know microorganisms were added. If you buy kimchi, look for the ingredient ‘napa cabbage.’ This type of cabbage is created via lacto-fermentation, meaning species of Lactobacillus were used for the fermentation process (If you’d like to learn more about how bacteria are named, check out this article).

Since species that make up many probiotic supplements (Lactobacillus) are often added to fermented foods, people consider them as beneficial for gut health. That can definitely be true. However, the underlying health of each individual’s gut should first be taken into consideration. For those with previous digestive issues, some of these foods can actually be problematic. Dairy proteins, in yogurt and kefir, can be bothersome. The garlic, onion, and red pepper in kimchi can flare up those with FODMAP sensitivities, same goes for the sugar in kombucha. Fermented foods are also high in histamine.

Histamine Intolerance

Histamine, a molecule made from the amino acid histidine, is present in aged cheeses, canned fish (sardines, oysters), left-over meat, avocados, nuts, red wine, coffee, and as previously mentioned, fermented foods. Histamine is also involved in allergic reactions. It’s responsible for some of the main symptoms from an allergic reaction: trouble breathing, elevated heart rate. A much milder condition, Histamine Intolerance, can happen when an imbalance occurs between the amount of histamine you eat and the amount your body can clear. When too much histamine builds up in your body, you may get symptoms such as runny nose, nasal congestion, hot flashes, headaches, diarrhea, stomach aches, or low blood pressure (1).

There are several enzymes within the small intestine responsible for breaking down histamine. If there is any sort of gut infection, dysbiosis, leaky gut, or even alcohol consumption, the body’s ability to produce these enzymes and clear histamine becomes compromised (1). Think of a factory that breaks down giant trees for lumber. If any of their machinery is not working properly, they will have a build up of giant trees that aren’t useful for much.

The main enzyme responsible for breaking down histamine is called Diamine Oxidase (DAO). Fun (or not so fun) fact, DAO is inhibited by red wine, part of the reason some people feel ‘flushed’ when they have wine. I hear your thoughts, “If I’m having problems breaking down histamine, or I want to drink some red wine, can’t I just take DAO as a supplement?” It may help reduce the ‘time with pain’ in those with migraine headaches (2), and may help reduce the severity of hives (3). Unfortunately no data yet on its prophylactic use with red wine. Of course, you might have normal DAO levels, and just might be eating too many high-histamine foods.

Dietary Approaches

If you think you’re struggling with histamine intolerance, speak with your health care provider about potential options. They may recommend a low-histamine diet. This includes eliminating high histamine foods for as little as 3–7 days to as long as 4 weeks, then slowly reintroducing the most desired foods. It’s not uncommon for people to feel some relief of symptoms within the first day on the diet.

Low-histamine diets need to be curtailed to the individual, as some people may react to red wine, but are fine with chocolate and black coffee. To me, it makes sense to first focus on the high-histamine foods you’re eating the most. If you’re drinking two kombuchas a day, but only have kimchi once a week, eliminating kombucha might be the biggest bang for your buck. You can also eat foods that help with the production of DAO such as Vitamin B6, Vitamin C, and copper. If you’re an organ meat lover, beef kidney can be a great source of DAO (DAO is also stored within the kidneys).

If you’re looking for specifics on how to structure a low-histamine diet, I highly encourage you to seek out a Functional Medicine Practitioner who has experience in working with the gut and histamine issues. They will help get to the root cause of what’s causing your histamine and fermented food woes.

This is by no means me hating on fermented foods. I actually think fermented foods can be a great addition to one’s diet. High consumption of fermented foods has actually been associated with positive health outcomes (1). I personally love kimchi, greek yogurt, and kombucha, I just try not to overdo them. However as we’ve discussed, if you have digestive issues, cutting these foods out in the short term can act as a sort of ‘gut reset.’ The healthier one’s gut is, the wider array of foods they can likely handle. Simple lifestyle interventions such as diet, stress management, movement, and probiotics, are great tools to assist you along your gut health journey.

If you have any questions, comments, or concerns on anything we discussed, feel free to email me at nicholas.belden16@gmail.com. You can also reach out to me on Twitter, or Instagram, or you could always pose a question in the comment section of this article.

As always, Trust in, Your Gut.

Disclaimer: The contents of this article are for educational purposes only, and are not intended to diagnose or treat any condition. Do not apply any of the information in this article without first speaking with your doctor.

Text-References

1. Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007;85(5):1185–1196. doi:10.1093/ajcn/85.5.1185
2. Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, et al. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial. Clin Nutr. 2019;38(1):152–158. doi:10.1016/j.clnu.2018.01.013
3. Yacoub MR, Ramirez GA, Berti A, et al. Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomized, Double-Blind Placebo-Controlled Study. Int Arch Allergy Immunol. 2018;176(3–4):268–271. doi:10.1159/000488142