Disclaimer: we do not have concrete evidence that this diet helps alleviate Long Covid symptoms for everyone and this blog is not advising anyone to follow this diet long-term.
Many are following a low histamine in an attempt to help their Long Covid symptoms. If not planned carefully, the low histamine diet could result in nutrient deficiencies (1).
Normally, if symptomatic, a dietitian would recommend following this diet for approximately 4 weeks. Reintroduction of histamine-containing foods would be done slowly, monitoring reactions or symptoms. However, a lot of long-haulers are now following this diet for longer periods. If this is you then here are some considerations:
Fibre
You may be avoiding high fibre foods like beans, lentils and certain fruit or vegetables. A lack of fibre may lead to bowel symptoms such as constipation. It can also impact gut health as fibre is important for our gut microbiome. It is important to try and get at least 5 portions a day of fruit and vegetables. Opt for wholegrain cereals, bread and pasta where you can. Broccoli, kale and courgettes are all good sources of low-histamine vegetables.
Protein
Protein is used for repair in our bodies therefore getting enough is vital for recovery (2). You may be avoiding foods like cheese, reheated or aged meats, some nuts, seeds, beans or lentils. Make sure you are getting good amounts of fresh or frozen fish, meats and poultry. Eggs are also a good source of protein and most people tolerate these. Try to include a protein source at each meal. If you are a vegetarian or vegan it can be very difficult to get enough protein especially if you normally get most of yours from soy products. Working with a dietitian may be helpful to ensure you are getting all the protein you need.
Calcium
Calcium intake may be low if you are avoiding dairy such as yogurts due to their probiotic content. Calcium is essential to ensure healthy bones. Long covid had been more prevalent in women aged 35-69 (3). This is the time when bone health can decline due to reduced oestrogen levels. Thus, calcium intake is even more important. Look for plant milks with added calcium and have small amounts of soft cheeses like feta or mozzarella. Quark is also a good source of low histamine calcium and protein. Kale is also a good vegetable source.
Polyphenols
Many fruits containing polyphenols, such as strawberries are also high in histamine. If we lack variety in our diets then we may be missing these beneficial components. They act as antioxidants reducing damage from harmful substances in the body (4). Plums, apples, and cherries are good sources and also low in histamine.
Omega 3 fatty acids
These are found in nuts and oily fish and help reduce inflammation in the body (2,5). These sources can be high in histamine. Try increasing your intake of low-histamine seeds and nuts such as pumpkin seeds and macadamia nuts. Choose rapeseed oil in cooking or add flax or chia seeds to meals.
Bottom line..
It is clear from speaking to clients that following the low histamine diet can remove some of the enjoyment food brings. Adding this to Long Covid symptoms can increase stress which won’t help recovery.
This diet can be restrictive and may lead to a lack of vital nutrients, so it is important to establish if you really need to be following this diet. This is especially true if you have been restricting foods for a long time but with no improvement.
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References:
1. BDA Allergy Specialist Group (2021) Low Histamine Diets and Long Covid Available at Low histamine diets and Long Covid | British Dietetic Association (BDA)
2. Barrea, L. et al. (2022). Dietary Recommendations for Post-COVID-19 Syndrome. Nutrients, 14(6), 1305. https://doi.org/10.3390/n from fr fr from fromfr hihiu14061305
4. Pham-Huy, L. A., He, H., & Pham-Huy, C. (2008). Free radicals, antioxidants in disease and health. International journal of biomedical science : IJBS, 4(2), 89–96.