Posted by sfy on January 3, 2005, at 20:05:14
In reply to Re: more MAOI diet questions - pepperoni issue, posted by KaraS on January 3, 2005, at 17:02:17
> I have read a study (and saw it referred to on PB) about the safety of pepperoni. I've also seen it placed on safe lists for MAOIs. Someone on the MAOI Yahoo board has been telling everyone that it's safe to consume. She's been stating that as a certainty.
>
> I've also seen pepperoni listed as dangerous on other current lists. Then I came across this post from Todd (King Vultan) that I think explains the situation well. I will try to repost this on the Yahoo board:
>
> "Pizza can be a problem, especially pepperoni, and especially on Parnate because that is the more dangerous of the two MAOIs as far as generating hypertensive crises. I've read at least two anecdotes by different people on Parnate who suffered hypertensive crises after eating pepperoni pizza. However, studies done up at Sunnybrook, Toronto by Dr. Shulman, et al, showed nearly zero tyramine in Pizza Hut and Domino's double cheese double pepperoni pizzas. I do believe the two people who suffered hypertensive crises on Parnate did eat at smaller, unaffiliated local pizza places, with perhaps more aged/authentic pepperoni. I get pizzas myself from the Papa Murphy's take them home and cook them chain, and I do not select their pepperoni, because my impression is that it is higher quality and possibly more aged than what you might find on a Domino's pizza. I also specify mozzarella only, as Papa Murphy's normally use a three cheese blend."
>This companion study by Drs. Shulman and Walker was published in 1999, three years after the Sunnybrook Diet study was issued. It also looked at soy products. The abstract reads:
BACKGROUND: Continuous refinement of the monoamine oxidase inhibitor (MAOI) diet has resulted in much reduced and simplified recommendations that attempt to balance safety and practicality. In the spirit of evidence-based practice, dietary restrictions should be based on carefully documented case reports and valid tyramine analyses. Residual concerns have focused on combination foods such as pizza and a variety of soy products. We determined the tyramine content of pizzas and a variety of soy products in order to refine dietary recommendations for use with MAOIs. METHOD: High-pressure liquid chromatography analysis of tyramine content was performed on a variety of pizzas, soy sauces, and other soybean products. A tyramine level of 6 mg or less was considered safe. RESULTS: No significant tyramine levels were found in any of the pizzas, including those with double pepperoni and double cheese. Marked variability was found in soy products, including clinically significant tyramine levels in tofu when stored for a week and high tyramine content in one of the soy sauces. CONCLUSION: Pizzas from large chain commercial outlets are safe for consumption with MAOIs. However, caution must be exercised if ordering pizzas from smaller outlets or gourmet pizzas known to contain aged cheeses. All soybean products should be avoided, especially soy sauce and tofu. Individualized counseling and continuous surveillance of compliance are still essential.
Shulman KI, Walker SE.
Refining the MAOI diet: tyramine content of pizzas and soy products.
J Clin Psychiatry. 1999 Mar;60(3):191-3.
poster:sfy
thread:436844
URL: http://www.dr-bob.org/babble/20050103/msgs/437360.html