MAOI Diet Update – Gateway Psychiatric

MAOI diet information on the Internet can be very confusing for someone just starting one of these antidepressant medications.

Monoamine oxidase inhibitors (MAOIs) are medications that inhibit the action of the enzyme monoamine oxidase. breaks down the three chemicals in the brain which may be deficient in people with depression: norepinephrine, serotonin, and dopamine. Almost all antidepressants in use today work, at least in part, by boosting one or more of these compounds in the brain. Monoamine oxidase inhibitors boost all three, which may be why they can be effective where other medications have not worked.

Unfortunately, monoamine oxidase plays a key role in preventing overly high levels of norepinephrine, which can, in turn, lead to the constriction of blood vessels and the development of severe hypertension.

The main risk of this is in someone who is on a monoamine oxidase inhibitor and eats a food with a high content of tyramine. Tyramine is an amino acid which is present in foods mostly because of the action of certain bacteria on protein. Thus tyramine containing foods are primarily those where the food is exposed to these bacteria, which are present in the air. Examples of these foods are: some cheeses (notably Stilton), air cured sausages and meats (salami and certain hams, like prosciutto) and some fermented soybean products (some soy sauces).

In order for there to be a significant risk of a hypertensive reaction, the food has to contain more than 6 to 8 mg of tyramine.

All of this seems pretty straightforward. However, in the 1980s and into the 1990s, there were case reports of hypertensive reactions associated with a very long and complicated list of foods. The problem was that these case reports got published without the author’s making any effort to verify that the foods actually contained tyramine.

People not taking monoamine oxidase inhibitors can have hypertensive reactions spontaneously. Thus, if someone is taking a monoamine oxidase inhibitor and develops a hypertensive state, that may or may not be related to the ingestion of food. Case reports of hypertensive reactions to MAOIs became something of a fad.

In the late 1990s, a number of experts in the treatment of depression began to be concerned that MAOIs were not getting prescribed in patients with severe and treatment refractory depression. They began to review the long lists of foods (lists of foods that were generated by simply searching for any case report of hypertension associated with an MAOI) that were to be found in “MAOI diets” (foods that people were told they should not take if they were on an MAOI).

They went to the lab to see if these foods actually had tyramine in them and they discovered that many of the foods on these long lists did not actually have any tyramine.

Almost 20 years later, there are still a number of lists circulating on the Internet that include foods without significant tyramine content.

One of these lists is to be found on the University of Pittsburg Medical Center website (usually a source of useful information). Glancing down the list I note that a number of the foods cited as “to be avoided” have been tested and found not to contain a high level of tyramine. And some of the material makes no sense just from inspection.

• For example, under the heading “Cheese and dairy products,” it is noted that cream cheese and commercially made sour cream and yogurt are safe and then on the next line down, under the heading “Desserts,” it says that cheesecake, which contains only cream cheese and sour cream, is “to be avoided.”
• Under the heading “Beverages” it says to avoid all alcoholic drinks, most especially beer and Chianti wine. But take a look in the graph to the left (created by psychopharmacology expert Steve Stahl) and you will see that commercially available Chianti wines have essentially no tyramine content.

Needless to say all of this can be pretty upsetting to someone just getting started on an MAOI.

David Flockhart, from the Indiana University School of Medicine published an update in the 2012 edition of the Journal of Clinical Psychiatry with a very brief list of foods to avoid.

Let’s take a look at that list.

On the first line it says to avoid “spoiled or improperly stored meat, poultry, fish, or animal livers.” This is important because it explains the presence on other lists of a number of foods. And it also explains why, some foods, are listed as being excluded on other lists if they are “imported.”

Recall that what mostly creates tyramine in food is the action of bacteria in the air on protein. Since this is also what leads to food spoilage, commercial producers of food in this country take a great deal of care to prevent it from happening. However small producers in other countries may not take the same care.

Even this relatively short list contains a few things that don’t seem to make much sense. The classic one is banana peels. Who eats banana peels?

It is a good starting place however and I like the fact that it contains information to help you judge whether or not a food is likely to be a risk (” cheese with fermentation holes, strong smells, or a salty or biting taste”) helps to clarify the process that makes certain cheeses a risk.

References

“Dietary Restrictions and Drug Interactions With Monoamine Oxidase Inhibitors: An Update”  J Clin Psychiatry 2012;73[suppl 1]:17–24.

Related

What foods should be avoided when prescribing MAOIs and how can patients recover from major depressive disorder?

Many Soyfoods Suitable for Low Tyramine Diets

Monoamine oxidase inhibitors (MAOIs) were first introduced in the 1950s to treat depression.^1,2 They are a separate class from other antidepressants, treating different forms of depression as well as other nervous system disorders.³ However, relatively soon after their introduction, MAOIs were quickly associated with a potentially fatal interaction with foods containing tyramine. Why is the interaction between tyramine and MAOIs relevant to a blog on soyfoods? Because there is erroneous information that all soyfoods need to be avoided by patients on MAOIs. This is simply not the case.

MAOIs inhibit the activity of monoamine oxidase, an enzyme which is responsible for degradation of brain neurotransmitters such as norepinephrine, serotonin, dopamine, and tyramine. Inhibiting degradation leads to higher brain levels of neurotransmitters, allowing them to continue to influence the cells that have been affected by depression.⁴

Patients that take MAOIs and consume tyramine-containing foods or drinks will exhibit high serum tyramine levels.^5,6 A high level of tyramine can cause a sudden increase in blood pressure, called the tyramine pressor response.⁷ Even though it is rare, a high tyramine level can trigger a cerebral hemorrhage, which can even result in death. Initially, the low-tyramine diets patients were prescribed was very restrictive and based on limited scientific evidence;⁸ that diet has evolved to be more focused and less restrictive.⁹ In terms of intake recommendations, researchers have observed increases in blood pressure in response to 6 mg of tyramine.^10,11 Bieck and Antonin¹² demonstrated that an 8 mg oral dose of tyramine is sufficient to increase systolic pressure by 30 mm Hg in 50% of subjects receiving the MAOI, tranylcypromine. Most researchers use a conservative upper limit of 6 mg of tyramine as a guideline for safe ingestion.¹³

More than 20 years ago, Shulman and Walker¹⁴ advised patients taking MAOIs to avoid all soy products. Much more recently, a 2018 article from the Mayo Clinic listed soybeans and soy products as foods high in tyramine.¹⁵ Soy sauce was also listed as being high in tyramine, which as will be discussed, is consistent with the literature. However, in contrast to the literature, tofu, which was classified as a pickled or fermented food, was also said to be high in tyramine.

A 1986 position paper of the Academy of Nutrition and Dietetics recommended that patients taking MAOIs use soy sauce with caution.¹⁶ One year later, a case reported described the hypertensive effects of miso in a MAOI patient.¹⁷ Since these reports were published, other investigators have also reported significant concentrations of tyramine in miso and soy sauce, and natto,¹⁸ although the amounts can be quite variable.^13,14,18-20 Miso, natto and soy sauce are fermented foods. Tyramine is present in extremely limited amounts in fresh foods; it results from the degradation of amino acids present in aging or deteriorating foods or fermented foods. But what about non-fermented soyfoods?

More than 20 years ago, it was reported that soymilk (250 ml) and tofu (100 g) contained 0.5 and 0.8 mg tyramine, respectively.¹³ Much more recently, Toro-Funes et al.²⁰ reported values in the literature for the tyramine content of a variety of foods. Tofu was found not to contain tyramine, as did one sample of soymilk, although another sample contained 0.4 mg/250 ml. The evidence indicates that unfermented soyfoods contain at most extremely low levels of tyramine. So, why do some sources list tofu as a high tyramine food? Because although most tofu around the world is consumed in unfermented form, fermented tofu is also consumed (often referred to as “stinky tofu”). It is the fermented tofu that contains tyramine.^21,22

Finally, no data on the tyramine content of soy protein isolate or concentrate was identified. However, given that soy protein isolate and concentrate are not fermented, and that soy protein has a long shelf-life, indicating it is relatively stable, it is reasonable to speculate that tyramine content of these products is extremely low.

In summary, for those on a low-tyramine diet, it may be prudent to avoid some fermented soy products. In contrast, the evidence indicates unfermented products do not pose a problem for MAIO patients. 

1. Culpepper L. Reducing the burden of difficult-to-treat major depressive disorder: Revisiting monoamine oxidase inhibitor therapy. Prim Care Companion CNS Disord. 2013;15.
2. Rapaport MH. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: the state of the art. J Clin Psychiatry. 2007;68 Suppl 8:42-6.
3. Thase ME. The role of monoamine oxidase inhibitors in depression treatment guidelines. J Clin Psychiatry. 2012;73 Suppl 1:10-6.
4. Baker GB, Coutts RT, McKenna KF, et al. Insights into the mechanisms of action of the MAO inhibitors phenelzine and tranylcypromine: a review. J Psychiatry Neurosci. 1992;17:206-14.
5. Flockhart DA. Dietary restrictions and drug interactions with monoamine oxidase inhibitors: an update. J Clin Psychiatry. 2012;73 Suppl 1:17-24.
6. Brown C, Taniguchi G, Yip K. The monoamine oxidase inhibitor-tyramine interaction. J Clin Pharmacol. 1989;29:529-32.
7. Sathyanarayana Rao TS, Yeragani VK. Hypertensive crisis and cheese. Indian J Psychiatry. 2009;51:65-6.
8. Sullivan EA, Shulman KI. Diet and monoamine oxidase inhibitors: a re-examination. Can J Psychiatry. 1984;29:707-11.
9. Gardner DM, Shulman KI, Walker SE, et al. The making of a user friendly MAOI diet. J Clin Psychiatry. 1996;57:99-104.
10. Blackwell B, Marley E, Mabbitt LA. Effects of yeast extract after monoamine-oxidase inhibition. Lancet. 1965;1:940-3.
11. Horowitz D, Lovenberg W, Engelman K, et al. Monoamine oxidase inhibitors, tyramine and cheese. JAMA. 1964;188:1108-10.
12. Bieck PR, Antonin KH. Oral tyramine pressor test and the safety of monoamine oxidase inhibitor drugs: comparison of brofaromine and tranylcypromine in healthy subjects. J Clin Psychopharmacol. 1988;8:237-45.
13. Walker SE, Shulman KI, Tailor SA, et al. Tyramine content of previously restricted foods in monoamine oxidase inhibitor diets. J Clin Psychopharmacol. 1996;16:383-8.
14. Shulman KI, Walker SE. Refining the MAOI diet: tyramine content of pizzas and soy products. J Clin Psychiatry. 1999;60:191-3.
15. Hall-Flavin DK. MAOIs and diet: Is it necessary to restrict tyramine? (Accessed February 4, 2021). In; 2018.
16. McCabe BJ. Dietary tyramine and other pressor amines in MAOI regimens: a review. J Am Diet Assoc. 1986;86:1059-64.
17. Mesmer RE. Don’t mix miso with MAOIs. JAMA. 1987;258:3515.
18. Mah JH, Park YK, Jin YH, et al. Bacterial production and control of biogenic amines in Asian fermented soybean foods. Foods. 2019;8.
19. Shulman KI, Walker SE, MacKenzie S, et al. Dietary restriction, tyramine, and the use of monoamine oxidase inhibitors. J Clin Psychopharmacol. 1989;9:397-402.
20. Toro-Funes N, Bosch-Fuste J, Latorre-Moratalla ML, et al. Biologically active amines in fermented and non-fermented commercial soybean products from the Spanish market. Food Chem. 2015;173:1119-24.
21. Yang J, Ding X, Qin Y, et al. Safety assessment of the biogenic amines in fermented soya beans and fermented bean curd. J Agric Food Chem. 2014;62:7947-54.
22. Wing YK, Chen CN. Tyramine content in Chinese food. J Clin Psychopharmacol. 1997;17:227; author reply -8.

Refining the MAOI diet: tyramine content of pizzas and soy products

Abstract

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. 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. 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. 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 age…Continue Reading

Citations

Jun 14, 2005·International Journal of Antimicrobial Agents·Louis SaravolatzBradley Belian

Jul 14, 2012·CNS Spectrums·Meghan M Grady, Stephen M Stahl

Nov 24, 2004·Journal of Psychiatric Practice·Jess G Fiedorowicz, Karen L Swartz

Jul 25, 2006·Expert Opinion on Drug Metabolism & Toxicology·Bin Gong, Paul J Boor

Dec 1, 2010·Asian Journal of Psychiatry·Junji TakeshitaRuss Muramatsu

Jun 19, 2013·International Journal of Rheumatic Diseases·Kayo MasukoToshihiro Matsui

Jun 2, 2011·Journal of Clinical Pharmacology·Jack J Chen, Jayne R Wilkinson

Jan 1, 2014·Clinical Pharmacology in Drug Development·Daniel BurchAlbert J Azzaro

Jan 7, 2005·Journal of the American Dietetic Association·Wendy Marcason

Dec 13, 2005·International Journal of Cardiology·Tsung O Cheng

Sep 17, 2002·Cephalalgia : an International Journal of Headache·S D Silberstein, P J Goadsby

Aug 8, 2002·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Janina Maria Sørensen

Jan 25, 2003·Menopause : the Journal of the North American Menopause Society·Gail B MahadyAlice Dan

Dec 31, 2010·Journal of Clinical Psychopharmacology·Peter Kenneth Gillman

Nov 7, 2019·Journal of Clinical Psychopharmacology·Jay D Amsterdam, Thomas T Kim

Monoamine Oxidase Inhibitors (MAOI) Article

Continuing Education Activity

Monoamine oxidase inhibitors (MAOIs) are a separate class from other antidepressants, treating different forms of depression and other nervous system disorders such as panic disorder, social phobia, and depression with atypical features. Even though MAOIs were the first antidepressants introduced, they are not the first choice in treating mental health disorders due to several dietary restrictions, side effects, and safety concerns. MAOIs are only a treatment option when all other medications are unsuccessful. This activity will highlight the mechanism of action, adverse event profile, pharmacology, monitoring, and relevant interactions of MAOIs, pertinent for members of the interprofessional team in treating patients with conditions where this drug class has a therapeutic purpose.

Objectives:

• Summarize the mechanisms of actions of the MAOI class of drugs.
• Identify the approved and off-label indications for MAOI therapy.
• Review the adverse event profile of MAOIs.
• Outline the importance of collaboration and communication among interprofessional team members to improve outcomes and treatment efficacy for patients who might benefit from MAOI therapy.

Indications

Monoamine oxidase inhibitors (MAOIs) were first introduced in the 1950s.[1][2] They are a separate class from other antidepressants, treating different forms of depression as well as other nervous system disorders such as panic disorder, social phobia, and depression with atypical features.[3] Examples of atypical features are oversleeping and overeating. Even though MAOIs were the first antidepressants introduced, they are not the first choice in treating mental health disorders due to several dietary restrictions, side effects, and safety concerns. MAOIs are only a treatment option when all other medications are unsuccessful.

Furthermore, examples of neurological disorders that can benefit from MAOIs are patients with Parkinson disease and those diagnosed with multiple system atrophy.[4][5]  Multiple system atrophy is a neurodegenerative disease that includes symptoms affecting movement as well as blood pressure. 

Mechanism of Action

Monoamine oxidase inhibitors are responsible for blocking the monoamine oxidase enzyme. The monoamine oxidase enzyme breaks down different types of neurotransmitters from the brain: norepinephrine, serotonin, dopamine, and tyramine. MAOIs inhibit the breakdown of these neurotransmitters thus, increasing their levels and allowing them to continue to influence the cells that have been affected by depression.[6]

There are two types of monoamine oxidase, A and B. The MAO A is mostly distributed in the placenta, gut, and liver, but MAO B is present in the brain, liver, and platelets. Serotonin and noradrenaline are substrates of MAO A, but phenylethylamine, methylhistamine, and tryptamine are substrates of MAO B. Dopamine and tyramine are metabolized by both MAO A and B. Selegiline and rasagiline are irreversible and selective inhibitors of MAO type B, but safinamide is a reversible and selective MAO B inhibitor.[7]

MAOIs are reversible or irreversible. Moclobemide is an example of a reversible MAOI I (RIMA), tranylcypromine, phenelzine, isocarboxazid, and selegiline irreversibly inhibit MAO. Selegiline in low doses is a selective, irreversible MAO B inhibitor, but it is no longer selective at higher doses.[8]

Administration

MAOI administration is almost always orally but sometimes comes in the form of a skin patch.[1] The skin patches were FDA approved and can be more beneficial to patients than oral dose forms. An example of this is selegiline, which can be given in a skin patch and causes fewer side effects than oral administration.[1] Patients with lower doses of MAOIs may not have to be as strict with their diet as those with higher doses.

The different types of MAOIs approved by the FDA include isocarboxazid, phenelzine, selegiline, and tranylcypromine.[9] When patients are prescribed antidepressants like MAOIs, they must be aware of the time it takes to start experiencing the therapeutic effects of the drug. Usually, the medication starts to become effective within two to three weeks. However, patients should take the antidepressant for at least six months for the maximal therapeutic benefit. Patients who take an antidepressant for less than six months are shown to have a high symptomatic relapse rate.

Adverse Effects

The most frequently encountered side effects are dry mouth, nausea, diarrhea, constipation, drowsiness, insomnia, dizziness, and/or lightheadedness. Furthermore, if applied via patch, a skin reaction may occur at the patch site.[9] Recommendations are that any patient scheduled for an elective surgery that requires general anesthesia should not take MAOIs for at least ten days before the surgery to avoid any drug interaction.[10][11]

Contraindications

MAOIs can potentially cause drug-to-drug interactions, drug-food interaction, and overdoses, of which the patient should be aware.[9] For example, patients should not be mixing MAOIs with other antidepressants like selective serotonin reuptake inhibitors (SSRIs).[12] These two drugs combined can cause serotonin syndrome, which is potentially fatal. The first cases of serotonin syndrome were reported during the 1960s when patients were on MAOIs and tryptophan. Patients showed signs and symptoms of fever, confusion, increased perspiration, muscle rigidity, seizures, liver or kidney problems, fluctuation of heart rhythms, and blood pressure. Furthermore, when changing MAOIs to another antidepressant, patients should give themselves 14 days to pass before initiating the new treatment, to prevent any drug interaction.

MAOIs prevent the breakdown of tyramine found in the body and certain foods, drinks, and other medications. Patients that take MAOIs and consume tyramine-containing foods or drinks will exhibit high serum tyramine level.[13][14] A high level of tyramine can cause a sudden increase in blood pressure, called the tyramine pressor response.[14] Even though it is rare, a high tyramine level can trigger a cerebral hemorrhage, which can even result in death.

Eating foods with high tyramine can trigger a reaction that can have serious consequences.[14] Patients should know that tyramine can increase with the aging of food; they should be encouraged to have fresh foods instead of leftovers or food prepared hours earlier.  Examples of high levels of tyramine in food are types of fish and types of meat, including sausage, turkey, liver, and salami.[15][16] Also, certain fruits can contain tyramine, like overripe fruits, avocados, bananas, raisins, or figs. Further examples are cheeses, alcohol, and fava beans; all of these should be avoided even after two weeks of stopping MAOIs.[16] Anyone taking MAOIs is at risk for an adverse hypertensive reaction, with accompanying morbidity.

Tramadol, meperidine, dextromethorphan, and methadone are contraindicated in patients on MAOIs as they are at high risk for causing serotonin syndrome.[8]

In general, SSRIs, SNRIs, TCAs, bupropion, mirtazapine, St. John’s Wort and, sympathomimetic amines, including stimulants, are contraindicated with MAOIs.[8]

Monitoring

Even though MAOIs are no longer a first-line treatment option, they are still in use, and it is essential to note the precautions when initiating treatment.[12] Patients should be encouraged by health providers to carry identification cards or wear a wristband.[9] Patients always need to notify every doctor they encounter, whether dental or medical, to avoid any health consequences, especially due to the medications’ influence on the vasculature.

Toxicity

Patients taking MAOIs can overdose and may show similar side effects, as stated above, except with more severe presentation.[17] Anyone on MAOIs may experience symptoms slowly within the first 24 to 48 hours. However, symptoms can be nonspecific, which range from mild to severe to even life-threatening. Depending on the MAOI prescribed, some can cause patients to go into a coma, and others  (e.g., overdosing on tranylcypromine) can result in death.[9] The severity depends on the amount consumed and the type of MAOIs the patient took. For example, phenelzine and tranylcypromine being nonselective and nonreversible, increase the risk of a patient experiencing a hypertensive crisis when ingested with tyramine.  However, selegiline is a selective MAO-B inhibitor with less hypertensive risk.[4] Any patient experiencing any of the following: agitation, flushing, tachycardia, hypotension or hypertension, palpations, twitching, increased deep tendon reflexes, seizures, or high fevers should immediately report to a health provider.[9]

Enhancing Healthcare Team Outcomes

Safety and optimal treatment are vital to patient health. Patients with a history of seizures or epilepsy should avoid MAOIs; these medications can increase the occurrence of seizures. Also, people with a history of alcoholism, angina, severe headaches, blood vessel disease, diabetes, kidney or liver disease, history of a recent heart attack or stroke, overactive thyroid, and pheochromocytoma should not receive MAOI therapy; since this may cause a hypertensive crisis.[2] This caution is also necessary for patients with a family history of depression, any neurological disorders, or even if any family members have attempted suicide. Due to the high risks, patients must provide a complete family history. Educating the patient on the importance of possible risks and side effects of the drug is critical for their well-being. It provides them an opportunity for a better outcome.

Ads with other illnesses, depression, and other psychiatric treatment plans pose multiple dilemmas for physicians.[17] These patients may need to try various medication regimens before achieving effective treatment. Someone experiencing depression or panic attacks may have significant life changes, and usually, the family physician is aware of these changes. While a psychiatric physician is almost always involved with patients dealing with different types of mental health issues, it is important to consult with an interprofessional group specialist that includes a family physician, internal medicine, specialty-trained mental health nurse, neurologist, and pharmacist.[18] Also, all other health providers involved in the patient’s care are vital members of the interprofessional team, for example, other nurses and social workers. Each member provides an essential element to the patient’s treatment plan. Evidence has shown that promoting interprofessional communication by consulting specialists can improve the outcome of a patient’s health and their adherence to the plan.[19] [Level 5]

Monoamine Oxidase Inhibitor – an overview

PHARMACOLOGY AND PHARMACOKINETICS OF MONOAMINE OXIDASE INHIBITORS

The MAOIs are available only as oral preparations. In general, MAOIs are rapidly and completely absorbed from the gastrointestinal tract, with peak plasma concentrations ranging from 1 to 4 hours after ingestion.^16–18 Plasma elimination of these agents occurs largely by hepatic metabolism and is also rapid; half-lives range from 1 to 3 hours. In general, MAOIs are transported into cells by the neurotransmitter amine reuptake system. For irreversible MAOIs, maximal MAO inhibition takes 5 to 10 days after initiation of drug therapy. Thus, plasma drug concentrations do not correlate with the level of MAO inhibition.^16–18 For reversible MAOIs, however, maximal inhibition of MAO occurs within a few hours of the first dose.

As can be seen in Table 29-2, MAOIs are generally classified according to their preferential effect on the isoenzyme they inhibit. For most of these agents, however, the selectivity is not complete and tends to be lost at higher doses and especially in overdose. The selective MAO-B inhibitor selegiline has been reported to lose some of its selectivity at doses as low as 10 mg/day, a dose that is in the therapeutic range.¹⁹

MAOIs may also be classified as either reversible or irreversible inhibitors of MAO. The classic MAOIs are irreversible inhibitors of the enzyme. Although serum concentrations of the MAOIs decline rapidly after last use, their effects are long-lived. It is generally believed that a period of 2 to 3 weeks is necessary to regain MAO activity after the cessation of the administration of an irreversible inhibitor, because new enzyme must be synthesized.¹⁷

A new class of reversible inhibitors of MAO,^20–26 the prototype of which is moclobemide, have been developed (see Table 29-2). Other agents include befloxatone, brofaromine, cimoxatone, and teloxantrone. The reversible inhibitors act primarily on MAO-A and are therefore referred to as reversible inhibitors of MAO-A (RIMAs). The effect of RIMAs is short lived, with MAO activity being reconstituted within hours to days of the last dose. Because of the reversible nature of the binding of RIMAs with MAO, adverse reactions such as the pressor effect with tyramine ingestion (“cheese reaction”) are unlikely to occur.²⁴ Approximately 150 mg of tyramine is needed to cause an increase in blood pressure while taking moclobemide. This is the equivalent of eating approximately 300 g of a tyramine-containing cheese.²⁷ Thus, although a tyramine reaction is theoretically possible, it is highly unlikely to occur given the doses required. The reason why MAO-A inhibition by moclobemide does not predispose to a tyramine reaction is a result of competitive substrate binding; the tyramine displaces the RIMA from the enzyme active site, allowing normal metabolism of the substrate.

Several of the older MAOIs are substituted hydrazine (NH₂-NH₂) derivatives (see Table 29-2). These MAOIs tend to be metabolized into active products and, like the well-known hydrazine isoniazid, are inactivated by N-acetylation at a genetically determined rate. The human population can be broadly separated into fast and slow acetylators on the basis of the rate of this reaction. For example, approximately equal numbers of American and European whites may be classified as fast versus slow acetylators. The rate of slow acetylators is higher in Asian populations. Slow acetylators may be at greater risk for developing adverse effects (e.g., drug and dietary interactions) with therapeutic doses. Various adverse effects are specifically associated with the hydrazine-derived MAOIs.²⁸ Most prominent among these are the inhibition of multiple enzyme systems, hepatotoxicity, and the induction of pyridoxine (vitamin B₆) deficiency with the associated problem of seizures. The hepatotoxicity of MAOI hydrazines has been well reviewed.^29–31

Among the various other enzyme systems inhibited by hydrazine MAOIs, the most important are pyridoxal kinase, l-amino acid decarboxylase, diamine oxidase, and cytochrome P-450.²⁸ In addition, hydrazines tend to form soluble complexes with pyridoxine, resulting in a deficiency of this vitamin by enhancing its urinary excretion.

In addition to the induction of pyridoxine deficiency, hydrazines prevent the use of pyridoxine for important metabolic reactions. Pyridoxine is not active as an enzyme cofactor until it is phosphorylated to pyridoxal phosphate by the enzyme pyridoxal kinase. Among the reactions for which pyridoxal phosphate is a cofactor is the synthesis of γ-aminobutyric acid (GABA) by the decarboxylation of glutamic acid, catalyzed by l-amino acid decarboxylase. Reduced production of GABA may cause the development of profound seizures as a result of poisoning by hydrazine MAOIs. The specific treatment for these seizures is administration of pyridoxine.

Virtually all MAOIs have a terminal phenyl group attached to a short aliphatic side chain, thus mimicking the phenethylamine structure of amphetamines (Fig. 29-2). It is thus possible that excessive doses of these agents may cause amphetamine-like reactions. Conversely, amphetamine or its derivatives tend to have some inhibitory effects on MAO.

MAOIs enhance synaptic biogenic amine transmitter concentrations by various mechanisms (Box 29-1). By inhibiting the enzymatic degradation, the cytoplasmic concentrations of these neurotransmitters are increased, resulting in the tendency for release of these biogenic amines by a mass action effect. In addition, the act of transporting the MAOI into the cell by the amine reuptake system causes the ligand-binding site of the membrane-bound transporter molecule to face inward, and it thus becomes available for the transport of neurotransmitter out of the cytoplasm into the synapse or neuroeffector junction. By being transported into the cell by the amine reuptake pump, the MAOIs act as competitive inhibitors of bioactive amine transport out of the synapse by this system. All of these factors tend to increase both intracellular and extracellular amine levels.

Being amphetamine congeners, MAOIs provoke release of stored amines from presynaptic vesicles, and thus the free intracellular concentrations of these molecules are increased. Given the decreased degradation of these amines by virtue of inhibition of MAO, any free bioactive amine molecules resulting from either release from vesicles or from reuptake are relatively protected from catabolism.

As noted in Table 29-2, the MAOIs differ in their characteristics. Several of them, however, merit specific comment.

Although no longer available as a therapeutic agent, clorgyline is the prototypic inhibitor of MAO-A. By virtue of the fact that nanomolar concentrations of this agent irreversibly inhibit MAO-A in a selective manner, this particular isoenzyme was defined.

Moclobemide is the prototype RIMA.^20–26 Although not available in the United States, moclobemide is available in most other parts of the world. In general, it appears that moclobemide and other RIMAs are safer than the traditional MAOIs.

In addition to the MAOIs noted in Table 29-2, various other agents have weak inhibiting properties of this enzyme. For example, procarbazine (Matulane, Sigma-Tau Pharmaceuticals, Gaithersburg, MD), a chemotherapeutic agent used in regimens to combat Hodgkin’s disease, is also a weak, nonselective, irreversible MAOI. Linezolid (Zyvox [Pfizer, New York, NY]), a novel antimicrobial, is a reversible, nonselective MAOI. In addition, St. John’s wort, an herbal supplement, has been noted to have weak MAOI activity. Fortunately, MAO inhibition by these agents is unlikely to have significant therapeutic implications.

Tranylcypromine is an MAOI with great structural similarity to amphetamine. It may be metabolized to amphetamine, which may have a role in some of the toxicity of this agent. In addition, tranylcypromine can inhibit the action of GABA at the GABA_A receptor by preventing chloride influx. This inhibition of GABA activity by tranylcypromine may be responsible for the seizures observed with therapeutic doses of this agent. A similar effect on GABA channels is possible with isocarboxazid.

Selective MAO-B inhibition with selegiline is utilized in the treatment of Parkinson’s disease since it inhibits striatal dopamine degradation. Selegiline is metabolized to l-methamphetamine, which is substantially less active than its d-isomer. Although the serum half-life of selegiline is short (0.15 hour), it is an irreversible inhibitor of MAO-B and thus its effects are long-lasting. Although relatively safe compared with the nonselective MAOIs, when selegiline and levodopa are concurrently administered, dopaminergic effects (hallucinations and dyskinesia) may occur.

Low-Tyramine Diet for Migraine Disease • National Headache Foundation

25 Oct Low-Tyramine Diet for Migraine Disease

Tyramine is produced in foods from the natural breakdown of the amino acid tyrosine. Tyramine is not added to foods. Tyramine levels increase in foods when they are aged, fermented, stored for long periods of time, or are not fresh.

Meat, Fish, Poultry, Eggs or Meat Substitutes

Allowed

• Freshly purchased and prepared meats, fish, and poultry
• Eggs
• Any allowed items that are canned or frozen

Use with caution

• Any with nitrates or nitrites added

Avoid if on MAOI

• Fermented sausages: pepperoni, salami, mortadella, summer sausage, etc.
• Non-fresh or improperly stored meat, fish, poultry, or pickled herring
• Limit processed meats to 4 oz. per meal
• Limit tofu or tempeh to 10 oz. per day

Dairy

Allowed

• Milk: whole, 2 percent, or skim
• Fresh cheese: American, cottage, farmer, ricotta, cream cheese, mozzarella, Velveeta, or other processed cheese, etc.
• Soy milk
• Soy cheese

Use with caution

Avoid if on MAOI

• Cheddar cheese
• Limit other aged cheeses to 4 oz. per meal, e.g. blue, brick, brie, cheddar, Swiss, roquefort, stilton, parmesan, provolone, emmentaler, etc.
• Limit any combination of aged cheese and processed meats to a total of 4 oz. per meal

Bread, Cereal, and Pasta

Allowed

• All bread, biscuits, pancakes, coffee cakes, etc.
• All cooked and dry cereals
• All pasta: spaghetti, rotini, ravioli, macaroni, and egg noodles (with allowed ingredients)

Vegetables

Allowed

• All except in the caution section (including dried beans, except fava or broad beans)

Use with caution

Avoid if on MAOI

• Fava or broad beans, sauerkraut
• Limit fermented soy products like miso, soy sauce, and teriyaki sauce to 1 oz. per day

Fruits

Allowed

• All except in the caution section

Use with caution

• Limit intake to 1/2 cup per day from citrus types: orange, grapefruit, tangerine, pineapple, lemon, and lime

Soups

Allowed

• Soups made from allowed ingredients, homemade broths

Beverages

Allowed

• Decaffeinated coffee or tea, club soda, caffeine-free carbonated beverages

Use with caution

• Limited caffeinated beverages to no more than two servings per day (less than 200 mg total)
• Consult with your physician and pharmacist regarding alcoholic beverages

Avoid if on MAOI

• No more than two domestic bottled or canned beers or nonalcoholic beers
• No more than 4 oz. wine per day
• No tap beers

Desserts and Sweets

Allowed

• Any made with allowed foods and ingredients: sugar, jelly, jam, honey, hard candies, cakes, and cookies

Use with caution

• Chocolate-based products: ice cream (one cup), pudding (one cup), cookies (one averaged size cookie), cakes (3 in. cube), and chocolate candies (1/2 oz.)
• *All count as one serving of a caffeinated beverage

Ingredients Listed on Food Labels

Allowed

• Any not listed in the caution section

Use with caution

• Monosodium Glutamate (MSG)
• Nitrates
• Nitrites
• Sulfites
• Aspartame

Fats, Oils, and Misc.

Allowed

• All cooking oils and fats
• Commercial salad dressing with allowed ingredients, vinegar
• All fresh nuts and seeds
• All spices and extracts not listed in restricted ingredients

Avoid if on MAOI

• Concentrated yeast extract, i.e. Marmite or Vegemite

General guidelines

• Eat three meals each day with a snack at night or six small meals spread throughout the day
• Avoid eating high sugar foods on an empty stomach, when excessively hungry, or in place of a meal
• All food, especially high protein foods, should be prepared and eaten fresh. Be cautious of leftovers held for more than one or two days at refrigerator temperature. Freeze leftovers that you want to store for more than two or three days
• Cigarette and cigar smoke contain a multitude of chemicals that will trigger or aggravate your headache. If you smoke, make quitting a high priority
• The foods listed in the “Caution” column have smaller amounts of Tyramine or other vasoactive compounds. Other foods in the “Caution” column do not contain Tyramine but are potential headache triggers
• Each person may have different sensitivities to a certain level of Tyramine or other vasoactive compounds in foods
• If you are not on an MAOI medication, you should test the use of foods in the “Avoid” column in limited amounts
• If you are taking an MAOI medication, do not consume foods in the “Avoid” column. Consult with your prescribing physician for additional precautions

Adapted from the Saint Joseph Hospital and Diamond Headache Clinic Headache Diet

90,000 Maggi Diet for 4 weeks: menu, principles, table

Diet “Maggi” promises to lose weight by 20 kilograms in 4 weeks. The name of this method is associated with the name of the famous British politician Margaret Thatcher, who was really slender (but not in good health) until old age. However, there is no convincing evidence that the “Maggi” diet has anything to do with Prime Minister Thatcher. Nevertheless, the technique is popular all over the world.

Basic principles of the “Maggi” diet

It is believed that this method of losing weight was developed by the American Mayo Clinic specifically for British Prime Minister Margaret Thatcher.According to legend, a description of the diet was found among the politician’s documents after her death and published under a changed name. The original recipe seems to be designed for 2 weeks, but later other versions appeared based on this technique.

The “Maggi” diet is a high-protein nutritional system, designed for a period of 7 to 14 days. It does not require calorie counting, and its supporters claim that with this approach, a person does not suffer from hunger, so the diet is easily tolerated. In theory, the effect of weight loss should be dictated by a change in chemical processes in the body.However, it is precisely this assertion that causes the most fierce criticism from doctors.

Nutritionists explain that a large amount of protein is not as harmless as it might seem. Protein food contains the essential amino acid methionine. It is vital for health and must be ingested with food, but its excess can disrupt metabolism, cause inflammation and provoke premature aging. Too much protein increases your risk of developing neurodegenerative diseases like Alzheimer’s or Parkinson’s.Moreover, most of all methionine is found in animal proteins and eggs, on which the “Maggi” diet is based.

Nutritionists also criticize the Maggi diet for a small amount of vegetables, but a large amount of sweet fruits. But sugar from fruits does not fundamentally differ from that which you get from desserts. Against the background of an overabundance of protein foods, an abundance of sweet fruits only increases the risk of developing kidney, heart and nervous system diseases. By the way, even if you take the word that Margaret Thatcher adhered to this so-called “Maggi” diet, it is worth remembering that the famous Prime Minister also suffered from neurodegenerative diseases, which doctors warn about.

The official position of doctors regarding the diet proposed by the “Maggi” diet is as follows: fruits should be replaced with vegetables, and “any meat” – with fish and lean poultry. Then the diet will be healthier. In the form in which the “Maggi” diet is popular now, it is poorly compatible with a healthy diet, since it excludes many essential foods: berries, nuts, cereals.

Varieties of the “Maggi” diet

Depending on the main product, the following types of the “Maggi” diet are distinguished on the menu:

• egg;
• cheese;
• curd.

The classic version of this diet is egg. She assumes that you eat 3-4 eggs every day, and they are the main source of protein. However, you can replace eggs with low-fat cottage cheese: no more than 5% fat. Do not buy a completely fat-free product, since without fat, calcium and other nutrients will not be absorbed from cottage cheese. If neither eggs nor cottage cheese are suitable as the main food ingredient, you can take low-fat cheese as the basis of the diet: up to 25% fat.Suitable varieties such as feta, tofu, feta cheese, ricotta, mozzarella, brie.

Risks of the “Maggi” diet

In theory, the “Maggi” diet promises that the weight lost with its help will not return, and if it does return, then not earlier than in a year and a half. However, in itself, weight loss through radical changes in the diet for a short time is associated with risks. This is stress for the body, against the background of which chronic diseases can worsen. In addition, weight lost on diets always returns, in 100% of cases, unless you adjust your daily diet and introduce regular physical activity into your regimen.

Moreover, after experiencing a shake-up on the diet, the body can begin to store fat faster. The body perceives any dietary restrictions as a period of hunger, so then it begins to “store” fat tissue to ensure survival in the next “hunger period”. The more often you resort to dieting, the faster your metabolism will be disrupted and the body will “store” fat.

Fascination with diets can lead to the fact that you stop losing weight altogether, even with real fasting.Not to mention the high likelihood of dealing with eating disorders triggered by what some doctors call “diet thinking.” And eating disorders, or EDIs, are difficult to treat. Therefore, instead of experimenting with diets, it is better to give preference to a balanced diet and moderate but regular physical activity. This will not bring an instant result, but the normalization of weight will indeed be stable, and the lost kilograms will not return after a while.At the same time, the state of health will improve.

One more delicate moment is connected with the “Maggi” diet: it requires strict adherence to the prescriptions. If you have violated the diet and ate something “forbidden”, for example, a piece of cake at your birthday, continuing the diet is inappropriate according to the version of its inventors. It is necessary to start all over again, avoiding deviations from the prescribed menu. Also, the body can adapt to the proposed diet option, and by about day 20, the weight will cease to decrease.

Diet “Maggi”: contraindications

• Pregnancy and lactation.
• Acute or chronic kidney and liver diseases.
• Individual intolerance to dairy products, eggs, citrus fruits.
• Diseases of the gastrointestinal tract.
• Any disturbances in the work of the heart.

Diet “Maggi” for 2 weeks: menu

We present the menu of the classic version of the “Maggi” diet for 14 days.It is also called “egg”, although it includes other products in the menu: cottage cheese, meat, fruits, vegetables. So, the diet requires drinking 2 liters of water every day. We completely exclude from the menu:

• sugar;
• oil
• desserts;
• mayonnaise;
• meat broths;
• ketchup and other sauces.

You cannot interrupt the diet, just as you cannot make changes to the menu and portion sizes.You can’t starve, but you need to eat everything that is provided for in the diet. You also need to walk every day for at least an hour in the fresh air and get enough sleep. You can drink only green tea without sugar, boil vegetables in water without salt and spices, but you can add onions, garlic and peppers. If you feel hungry between meals, you can eat a cucumber, carrot, or salad. But not earlier than 2 hours after the previous meal. If serving sizes are not listed on the menu, you can eat this food until you are full.

Diet “Maggi” involves three meals a day with dinner no later than six in the evening.The menu for every day assumes the same breakfast: 1 grapefruit, 2 boiled eggs, a cup of coffee without sugar. But lunch and dinner are different:

• First day. Lunch: herbal tea, two boiled eggs, tomato. Dinner: one grapefruit, two eggs, green tea, vinaigrette without oil.
• Second day. Lunch: grapefruit, two boiled eggs. Dinner: salad of tomatoes, cucumbers, celery and baked lean meats.
• Third day. Lunch: herbal tea and spinach.Dinner: cabbage, beets, green tea and two boiled eggs, cottage cheese.
• Fourth day. Lunch: coffee and spinach, two boiled eggs. Dinner: coffee, vinaigrette, 150 grams of lean fish.
• The fifth day. Lunch: two eggs, spinach, herbal tea. Dinner: coffee, cauliflower, vinaigrette, fish.
• Sixth day. Lunch: salad of grapefruit, tangerine, pineapple, kiwi. Dinner: coffee, salad of tomatoes, cucumbers, onions, celery, steak.
• Seventh day.Lunch: grapefruit, tomato, boiled chicken fillet. Dinner: coffee, baked turkey, coleslaw, tomato and carrot salad.

The Maggi two-week diet suggests that after seven days we will repeat the menu in the same order. The expected result is a weight loss of 10-12 kg.

Menu of the “Maggi” diet for 4 weeks

The monthly diet “Maggi” is based on the same principles as the two-week version of the menu. But the expected result is a weight loss of 20 kg.In the first week, the standard breakfast for every day is half a grapefruit or orange and two boiled eggs (only chicken eggs!), But lunches and dinners vary:

• First day. Lunch: during the day we eat either apples, or oranges, or melons, or pineapples, but only one type of fruit. You can also choose pears, watermelon, apricots. Dinner: meatballs or boiled chicken fillet.
• Second day. Lunch: boiled turkey without skin. Dinner: 1 slice of bran bread, 2 boiled eggs, an orange, a salad of tomatoes, cucumbers, carrots and bell peppers.
• Third day. Lunch: 1 toast, tomatoes, low-fat cheese. Dinner: boiled chicken fillet or steamed chicken cutlet without salt and spices.
• Fourth day. Lunch: apples. Dinner: carrots, spinach, lettuce and boiled lean meat.
• The fifth day. Lunch: beans, 2 boiled eggs. Dinner: grapefruit, 150 grams of hake, steamed, onions and cucumbers.
• Sixth day. Lunch: apricots. Dinner: boiled rabbit fillet, tomato, cucumber and spinach salad.
• Seventh day. Lunch: steamed turkey without skin, orange, tomato, boiled carrot and zucchini puree. Dinner: tomatoes, onions, eggplants, peas – boiled.

The Maggi diet for a month assumes that the diet will change for the second week, although the breakfast will remain the same:

• Monday. Lunch: boiled rabbit fillet, carrot and cucumber salad. Dinner: grapefruit, tomatoes, 2 boiled eggs.

• Tuesday.Lunch: boiled chicken breast, stewed eggplant and zucchini. Dinner: an orange and 2 boiled eggs.

• Wednesday. Lunch: steamed turkey, cucumbers and spinach. Dinner: tangerines, 2 soft-boiled eggs, spinach, cucumbers.

• Thursday. Lunch: boiled green peas, low-fat white cheese, 2 soft-boiled eggs. Dinner: 2 boiled eggs, a slice of watermelon.

• Friday.Lunch: low-fat fish fillet cutlet or boiled cod fillet. Dinner: 2 boiled chicken eggs.

• Saturday. Lunch: pears, steamed rabbit fillet, a glass of tomato juice. Dinner: salad of melon, peach, orange and apple.

• Sunday. Lunch: 2 tangerines, boiled skinless chicken fillet, boiled green beans and squash. Dinner: boiled turkey fillet, grapefruit, tomatoes, zucchini and carrot puree.

In the third week, the diet changes again. On the first day, we eat any fruit in any quantity and nothing else. However, bananas, grapes, figs, dates or mangoes cannot be selected on this day. On the second day, we eat only salads from fresh and boiled vegetables. On the third day, we eat vegetables and fruits in any quantity, it is advisable to boil vegetables. The fourth day – only boiled vegetables, except for white cabbage and salad. Steamed fish is also allowed. On the fifth day – boiled lean meat and boiled vegetables.Seventh day – one type of fruit throughout the day. That is, only apples or only oranges (tangerines, pineapples).

The fourth week of the diet:

• First day: 200 grams of boiled chicken fillet, four cucumbers, an orange or grapefruit, 4 tomatoes, 1 toast a day, tuna without oil.
• Second day: one type of fruit – in any quantity, 4 cucumbers and tomatoes, one toast, 200 grams of boiled turkey.
• The third day: boiled vegetables, 1 tablespoon of low-fat cottage cheese, grapefruit or two tangerines, 200 grams of cheese.
• Fourth day: grapefruit, toast, cucumber, tomato, half a kilo of chicken breast.
• Fifth day: salad of sweet peppers, carrots, cucumbers and tomatoes, 2 hard-boiled eggs, an orange.
• Sixth day: 100 grams of low-fat cottage cheese, one toast, two tangerines, a tomato, a cucumber, a glass of yogurt, 2 steamed chicken breasts.
• Seventh day: tuna without butter, one toast, orange, 200 grams of low-fat cottage cheese, 2 tomatoes, 3 cucumbers.

You need to leave the “Maggi” diet gradually, gradually adding other products. Although if you want to gain a slim figure, and there is no time to cook unusual dishes, plan a diet, it is better to order a balanced meal from BeFit: Light Program. You can choose a weekly menu with a specified calorie content – and you will get delicious, healthy and varied dishes.

Maggi Diet – reviews, results, recipes, secrets

Maggi Diet is one of the varieties of the egg diet.

It got such a “bouillon” name by the name of its creator, and not because it is based on the use of the famous bouillon cubes.

The Maggi diet has already fallen in love with many Russian fat women: its observance guarantees very good results.

Most of those who have sat on such a diet enthusiastically claim that extra pounds melt very quickly, and the figure changes its contours before our eyes.

Features of the Maggi diet

The duration of the Maggi protein diet is four weeks , during this time you can lose weight by 10-20 kg . This is one of the few diets on which one does not have to starve and dream of an extra piece of meat. Her diet includes a sufficient amount of meat, fruits, vegetables and eggs.

The Maggi diet menu is designed in such a way as to force the body to burn accumulated fats on its own using active chemical processes.Products are selected in such a way that, after eating them, they cause chemical reactions in it that contribute to the elimination of toxins and the breakdown of fatty tissues.

Benefits of Maggi Diet

• This diet does not belong to the strict and is suitable for all ages.

• This diet has a very stable result : the pounds lost in 4 weeks usually do not return. Provided that after the end of the diet, the number of calories consumed per day will increase gradually.An effective maggi diet, the results of which are visible after a few days, contributes not only to shedding excess weight, but also to consolidating the magic figure that the scales show after following the four-week menu.

• During the Maggi diet, there is no need to count calories , their number does not matter at all. The main thing, as mentioned above, is the chemical reactions that continuously occur in the body.

• Many people like the Maggi diet for the simplicity of preparing dishes from the menu.You don’t have to be a chef or spend a lot of time in the kitchen. The Maggi diet offers quite simple recipes for cooking.

• Unless there is a specified food ration for a specific meal, this product can be consumed in any amount .

• During weight loss with the help of the Maggi diet, additional intake of complexes of vitamins and minerals is not required: they enter the body along with food.

Disadvantages of the Maggi diet

The main drawback of this diet is absolutely complete and exact adherence to the menu regime.This can create certain inconveniences for those who are forced to go to work during the diet and are not able to eat at a certain time every day. And it is very important to follow the Maggi diet regimen constantly – without this it will not bring the desired result.

Another drawback of the Maggi diet is the use of a large number of eggs during the diet. Of course, it has long been proven that without the use of fat and butter, you can eat as many eggs as you like and you can not fear for your health.That is why the rules of this diet prohibit the use of any oils and fats. But you should still carefully monitor your health, especially with a tendency to allergic reactions to eggs.

Maggi Diet Rules

• Basic rule – strict adherence to the prescribed diet . This is exactly the diet, during which “a step to the right, a step to the left – shooting”, in this case – this is uselessly wasted time and the remaining extra pounds.

• Under no circumstances should you change the daily menu , replace some foods with others or change their places (ie you need to eat grapefruit for breakfast, and you eat it for lunch).If there is a desire, you can simply remove some product from the diet, but not replace it with another.

• You should consume at least 2, or even better – 3 liters of water per day .

• It is allowed to drink coffee and tea without sugar and milk at any time, regardless of the meal. The use of a sweetener is allowed.

• Vegetables are prepared (ie boiled) without the addition of broth , oils and fats.

• You can use salt, various spices, onions, garlic.

• If the diet for some reason was interrupted (even for half a day) or a mistake was made (products are mixed up), you need to start observing it from the very beginning.

• Recommended at least light exercise .

Diet menu

Diet Reviews

On any resource about diets and weight loss, opening the page “ Maggi Diet Reviews “, you can find a huge number of enthusiastic comments and reviews about this diet: “magic weight loss”, “effective diet”, “really lose weight”…

Women of all ages share their impressions: one lost 16 kilograms in 4 weeks, the other managed to lose 9 extra kilograms, the third is glad that her stomach was removed after giving birth.

Most interesting of is the fact that none of the Maggie dieters complained that they had to endure hunger.

menu, essence, principles and contraindications

The Maggi Diet is a good method of losing weight without a hint of hunger, which allows you to lose up to 10 kilograms in four weeks with the help of the main ingredient – eggs.What is the essence, as well as what other products the Maggi diet consists of, the editors of HOCHU.ua figured out.

Some people sincerely think that the popular Maggi Egg Diet has something to do with the fast food cubes of the same name. In fact, this is not the case: this diet is named after the legendary Margaret Thatcher, who was popularly called simply Maggi.

The presented egg diet menu was found in her personal archive. In addition to the menu itself, there was a note that you cannot sit on the diet for more than two weeks (due to the low carbohydrate content), as well as a note that whiskey may be on the menu on days when there is meat in the diet.

Maggi Diet: the essence and main rules

The Maggi Diet, also known as the Egg Diet, lasts 4 weeks and promises to help you lose up to 10 kilograms in 14 days. It should be noted right away that the Maggi diet belongs to the category of protein diets: its menu contains a scanty amount of carbohydrates. The main rule of the Maggi egg diet is strict adherence to the prescribed diet. It is not recommended to sit on the Maggi diet more than once a year.

The products of the egg diet menu are selected so that, after eating them, they cause chemical reactions in the body that contribute to the elimination of toxins and the breakdown of adipose tissues.The main product of the Maggi diet, as we said, is boiled eggs.

Judging by the numerous reviews of girls on the Internet, the egg diet is easy to tolerate, and its result is impressive. The main thing is to limit yourself in physical activity during this period, because without carbohydrates, the effectiveness of training is close to zero. But a little physical activity should still be present.

The Maggi Diet is not suitable for people with kidney problems, high blood pressure, pregnant women and those with heart problems.

The lost weight will not return if, after the end of the Maggi Egg Diet, the number of calories consumed per day increases gradually. If the diet was interrupted for some reason (even for half a day) or a mistake was made in observing the menu (products are mixed up), you need to start observing it from the very beginning.

Maggi Diet: menu for every day

Maggi’s egg diet menu is rather meager in variety, so get ready that you will have to eat the same.But the result is worth it. Note that products from the menu, in which there is no portion weight, can be eaten as much as you want.

On the Maggi diet, you need to consume at least 2 liters of water daily. It is allowed to drink coffee and tea without sugar and milk at any time, regardless of the meal. Below is a menu for 4 weeks.

Maggi Diet: First Week Menu

Breakfast – daily 1/2 grapefruit or orange, also, according to the diet menu, you need to eat 1-2 boiled eggs for breakfast.

• 1 day
  Lunch – any fruit in any quantity (apples, pears, oranges, watermelon, melon, etc.).
  Dinner – any meat other than lamb (slices or lean mince).
• Day 2
  Lunch – skinless chicken.
  Dinner – 2 eggs, tomato salad, lettuce, cucumber, carrot, pepper, 1/4 flatbread, or 1 toast, 1 grapefruit or orange.
• 3 days
  Lunch – low-fat cheese in any quantity, tomatoes, 1 toast.
  Dinner – any meat other than lamb (slices or lean mince).
• Day 4
  Lunch – any fruit in any quantity.
  Dinner – any meat other than lamb (slices or lean mince), salad.
• Day 5
  Lunch – 2 eggs, boiled vegetables of your choice: zucchini, carrots, green peas, beans.
  Dinner – fish, salad, 1 citrus fruit.
• Day 6
  Lunch – fruits in any quantity.
  Dinner – any meat other than lamb (slices or lean mince).
• Day 7
  Lunch – skinless chicken, vegetables, tomato, citrus fruit.
  Dinner – boiled vegetables.

Maggi Diet: Second Week Menu

Breakfast – daily 1/2 grapefruit or orange, 1-2 boiled eggs.

• 1 day
  Lunch – meat, salad.
  Dinner – 2 eggs, one citrus fruit.
• Day 2
  Lunch – meat, salad.
  Dinner – 2 eggs, one citrus fruit.
• Day 3
  Lunch – meat, salad.
  Dinner – 2 boiled eggs, one citrus fruit.
• Day 4
  Lunch – 2 eggs, any low-fat white cheese, boiled vegetables.
  Dinner – 2 eggs.
• Day 5
  Lunch – fried or boiled fish.
  Dinner – 2 eggs.
• Day 6
  Lunch – meat, tomatoes, 1 grapefruit or orange
  Dinner – fresh fruits (orange, melon, apple, peach, tangerine).
• Day 7
  Lunch – skinless chicken, tomatoes, vegetables, 1 grapefruit or orange
  Dinner – the same as for lunch.

Read alsoWhen losing weight can be dangerous?

Maggi Diet: Third Week Menu

The products on the menu should be eaten throughout the day.

• 1 day
  Any fruit other than banana, date, mango, fig, grapes in any quantity.
• Day 2
  Any salads and boiled vegetables, except dry cereals and potatoes.
• 3 day
  Any fruits, except prohibited ones, any vegetables, salads, jams in any quantity and at any time.
• Day 4
  Fried or boiled fish, salad (cabbage and lettuce), boiled vegetables – all in any quantity.
• Day 5
  Lean meat (not lamb) or chicken, boiled vegetables.
• 6, 7 days
  1 type of fruit in any quantity (apples, pears, peaches, apricots).

Maggi Diet: Fourth Week Menu

The products indicated in the menu are consumed throughout the day at any time, but without additions.

• 1 day
  1/4 boiled chicken, or 4 slices boiled or fried meat, 4 cucumbers, 3 tomatoes, 1 can of tuna with or without oil, or washed with water, 1 toast, 1 citrus fruit.
• Day 2
  Not more than 200 g of meat, 4 cucumbers, 3 tomatoes, 1 toast, pear or apple or citrus fruit or 1 wedge of melon.
• Day 3
  1 spoonful of cottage cheese or any low-fat white cheese, a small plate of cooked vegetables, 2 cucumbers, 2 tomatoes, 1 toast, 1 grapefruit or orange.
• Day 4
  1/2 chicken, 1 cucumber, 3 tomatoes, 1 grapefruit or orange, one of the permitted fruits.
• Day 5
  2 eggs, 3 tomatoes, 1 salad, grapefruit or orange.
• 6 days
  2 chicken breasts, 125 g feta cheese or cottage cheese, 1 toast, 2 tomatoes, 2 cucumbers, curdled milk, 1 grapefruit or orange
• Day 7
  1 spoonful of cottage cheese, 1 can of tuna without oil, a small portion of boiled vegetables, 2 cucumbers, 2 tomatoes, 1 toast, 1 citrus fruit.

We told you everything about the effective Maggi egg diet, shared its principles and a detailed menu for 4 weeks. Try to confidently approach your cherished goal – you will succeed!

See also: French diet for weight loss: essence, menu, reviews and results

Materials on the topic:

90,000 Maggi Diet: How To Lose Weight In 4 Weeks Without Harm And Hunger | Proper nutrition | Health

The Maggi Diet, also known as the Egg Diet, has recently become popular, in part due to the fact that it is based on chemical reactions in the body, and not on restricting the calorie content of food.

The diet is designed for exactly 4 weeks and promises that during this time the metabolism in the body will normalize and unnecessary kilograms will disappear.

There is a version that this diet owes its name to the 71st British Prime Minister Margaret Thatcher , whose name “popularly” was shortened to “Maggi”. According to this version, the Maggi diet is based on the principles of nutrition of the “iron lady”. It is believed that the diet was developed specifically for Thatcher by the specialists of the Mayo Clinic from the USA, but, passed by word of mouth, as well as over time, the weight loss system has undergone tangible changes.

Pros and cons

In fact, the Maggi Diet is an extremely low carbohydrate protein diet. It is suitable for people of all ages, but it is recommended to use it no more than once a year. The result of losing weight will last long enough, but only if there is a competent way out.

The Maggi diet is a fairly balanced system and therefore has practically no contraindications, except for individual intolerance or allergies to certain types of foods.

This diet is categorically unsuitable for pregnant and lactating women, everyone who suffers from citrus allergies, people with diseases of the gastrointestinal tract, as well as those who take pressure-reducing medications.

Features

The basis of the Maggi diet is a combination of eggs and citrus fruits. Eggs contain a large amount of trace elements important for humans, and citrus fruits provide the body with a dose of vitamins.

In general, the diet is planned out in such a way, and all food products are selected in such a way as to stimulate chemical reactions that accelerate the processing of fat cells.

Weight loss conditions

The diet assumes extremely strict adherence to all the rules, in particular:

– you can eat only the specified amount of the product;

– if the quantity of the product is not indicated, then it can be consumed in any quantity;

– Dinner and lunch cannot be swapped;

– you can remove any product from the diet, but you cannot replace it with another;

– You can dull a strong feeling of hunger by eating a carrot, cucumber or salad, but only 2 hours after the recommended food.

– you need to drink as much water as possible, but besides the usual one – also consume soda or a couple of cans of diet carbonated water;

– you can drink coffee and tea without milk and sugar at any time;

– sugar is categorically excluded from the menu, but substitutes can be used;

– you need to weigh yourself 1 time a day after using the toilet, but it is not necessary to do this every day;

– if you decide to repeat the diet again, it is better to repeat the first and fourth week twice;

– vegetables must be boiled in plain water, but without adding broths;

– when cooking vegetables, it is permissible to use seasonings, pepper, salt, onions and garlic;

– in no case should you use chemical seasonings and flavor enhancers;

– during cooking, you should avoid fats and do not add oil;

– if during the diet you stopped at some stage, or made a mistake, overeat, and so on – it makes no sense to continue the diet, you need to start all over again;

– it is desirable to go in for sports to achieve greater effect.

Daily diet schedule

First week

Second week

Third week

Foods to eat throughout the day are indicated.

Fourth week

Products are consumed throughout the day at any time, but without additions.

Related article: How to force yourself to go on a diet →

The Maggi Diet: the secret of the harmony of the “Iron Lady”

From the Mayo diet to the Maggi diet

The meal plan known as the “Maggi diet” (although it would be more correct, of course, to pronounce “Meiji”, that is, Margaret “), an intriguing story.

During the lifetime of former British Prime Minister Margaret Thatcher (she died in 2013), historians began to dismantle her archive left at Westminster Palace. And, among other documents, a typewritten sheet with a certain menu was found in a diary dated 1979. Judging by the note, it was compiled for the “iron lady” individually by specialists from the Mayo Clinic from the United States. This diet became known overnight as the “Maggi Diet”.

In addition to the meal plan itself, the leaflet contained a warning in large letters “Do not stay on this diet for more than two weeks.”

The Mayo Clinic of North America has gained worldwide fame for developing the universal two-week Mayo Diet. The correct proportions of food were presented in the form of a pyramid, prescribing to consume a lot of fiber from fresh vegetables and fruits, a little less – slow carbohydrates and protein, very little fat (mostly unsaturated vegetable) and a minimum of sweets.

The original Mayo diet involves replacing five unhealthy eating habits (adding sugar, snacking on sweet and fatty foods, eating large portions, eating junk food in restaurants, eating in front of the TV) with five healthy ones (eating breakfast, eating at least four servings of vegetables and three servings fruits a day, eat whole grains, eat healthy fats, exercise for 30 minutes daily).

However, when passed on by word of mouth, the Mayo diet has transformed beyond recognition: today, under the guise of this meal plan, you can find a variety of dietary advice.

For Margaret Thatcher, nutritionists at the Mayo Clinic (by the way, she opened in the United States in 1889, but began to specialize in dietetics closer to the middle of the twentieth century, when there was an increased demand for these services) developed a meal plan that can be called one of the first protein diets.

Today, such diets are not uncommon – protein diets for weight loss in different variations are very popular, also due to their long-lasting effect.However, the peculiarity of the Maggi diet for 2 weeks is that grapefruit is responsible for the fruit component in it – a fruit with which those who lose weight associate special hopes.

Maggi diet: menu for a week, 4 weeks – reviews on the Maggi diet – April 23, 2021

The Maggi diet is also called egg because of the large number of eggs in the diet. According to one version, it was named after Margaret Thatcher, whose name was shortened to Maggi. It is believed that the program was designed specifically for the British Prime Minister, the principles of which have long been kept secret.The meal plan is designed for a month, which is enough to trigger metabolic processes and chemical reactions in the body for weight loss.

It’s important to remind you that the healthiest and safest way to lose weight is to be in a calorie deficit. Meals should be varied and balanced, include a large amount of fiber and the correct ratio of proteins, fats, carbohydrates. Before practicing any diet, you need to familiarize yourself with the contraindications and consult your doctor.

Features of the Maggi diet

The principle of nutrition is based on reducing fats and carbohydrates and increasing animal protein.Eggs are the main source of protein, and you can also eat fruits, vegetables, cottage cheese and diet meats. You can also use cottage cheese with a fat content of up to 3-5% as the main product.

The diet is designed for two weeks, the ingredients for breakfast, lunch and dinner must not be interchanged. It is recommended to practice the diet no more than once a year.

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Benefits of the Maggi Diet

• Constant feeling of fullness;
• quick and easy preparation;
• healthy foods in the composition;
• does not need to be considered KBZHU;
• balanced diet;
• fast results.

Disadvantages of the Maggi diet

The Maggi diet, like any strict diet with strong restrictions, has disadvantages and contraindications.

A diet high in protein can damage the internal organs, especially the kidneys and liver. Protein in the body is digested by digestive enzymes, which are produced in limited quantities. If the incoming protein is much larger, it rots in the intestines, resulting in constipation, diarrhea, bloating, fermentation and inflammation of the gastrointestinal tract.

Contraindications to the Maggi diet

• diseases of the digestive system, heart, kidneys;
• pregnancy and breastfeeding;
• allergies to eggs, cottage cheese, cheese, citrus fruits;
• high cholesterol.

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Maggi Diet Rules

The effectiveness and result of the diet depends on how strictly you adhere to the rules. Any deviation from the recommendations can harm the result you want to get.

• three meals a day; 90 022 90 021 dinner – until 18:00;
• Drink one and a half to two liters of clean water a day;
• snacks are excluded;
• the product can be removed, but cannot be replaced by another;
• meals must not be swapped;
• Empty coffee and tea is allowed, without milk and sugar;
• in case of severe hunger, you can eat carrots, cucumbers or salad, but not earlier than 2 hours after eating;
• sugar is excluded;
• you can eat dietary meat, rarely and in small quantities;
• of vegetables allowed: carrots, zucchini, cucumbers, broccoli, green beans and green leafy;
• Excludes flour, baked goods, pasta, cereals and cereals;
• Citrus fruits, apples and pears are allowed;
• Pollock, flounder, haddock, shrimp are allowed;
• from dairy products you can use cottage cheese up to 5% fat, cheese up to 20% fat, natural yogurt and kefir;
• No oil is added during cooking: dishes are steamed, boiled, baked or eaten raw, but not fried;
• in case of violation of the rules, you need to start the diet again, from the first day;
• in parallel, it is recommended to go in for sports.

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Maggi Diet: menu for 2 weeks

Day 1

breakfast: grapefruit or orange, two boiled eggs, a cup of tea or coffee
lunch: herbal tea, two boiled eggs, tomato
dinner : grapefruit, green tea, two boiled eggs, vinaigrette without oil

Day 2

breakfast: a slice of whole grain bread
lunch: stewed turkey, cucumber and tomato salad
dinner: a glass of yogurt, grapefruit Day 30004 903

breakfast: grapefruit or orange, two boiled eggs, a cup of tea or coffee
lunch: spinach, herbal tea, two boiled eggs
dinner: cabbage, beets, green tea, two boiled eggs, cottage cheese

Day 4

breakfast: two boiled eggs, half an orange
lunch: any of the fruits in any quantity to choose from: apples, pears, kiwi, oranges
Dinner: boiled or baked dietary meat

Day 5

breakfast: a slice of whole grain bread, two boiled eggs, sugar-free tea
lunch: lean fish, stewed beans
dinner: steamed vegetables

Day 6

breakfast: orange, protein omelet
lunch: beans stew
dinner: salad of cucumbers and tomatoes, chicken breast

Day 7

breakfast: grapefruit or orange, two boiled eggs, a cup of tea or coffee
lunch: boiled meat
dinner: two boiled eggs, tomato salad, lettuce, cucumber, carrot, pepper, grapefruit or orange.

Day 8

breakfast: two boiled eggs, half an orange
lunch: any of the fruits in any quantity to choose from – apples, pears, kiwi, orange
dinner: two boiled eggs, salad of carrots, tomatoes, cucumbers and sweet pepper, dietary meat

Day 9

breakfast: grapefruit or orange, two boiled eggs, a cup of tea or coffee
lunch: dietary fish cutlet from low-fat varieties without added spices or boiled pike perch or cod fillet
dinner: two boiled eggs

Day 10

breakfast: grapefruit or orange, two boiled eggs, a cup of tea or coffee
lunch: tomato juice, steamed meat, pear
dinner: fruit salad of peach, orange and apples

Day 11

breakfast: orange, protein omelet
lunch: stewed vegetables
dinner: turkey stew, cucumber and tomato salad

Day 12

breakfast: grapefruit t or orange, two boiled eggs, a cup of tea or coffee
lunch: beans, two boiled eggs
dinner: grapefruit, steamed hake fillet, cucumbers

Day 13

breakfast: two boiled eggs, half a grapefruit
lunch: grain bread toast, low-fat cheese, tomato salad
dinner: boiled or baked meat

Day 14

breakfast: orange, protein omelet
lunch: steamed turkey, spinach, cucumbers
dinner: two eggs, tangerines

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Maggi Diet: -20 kilograms per month

Incredibly effective, with enough meat, fruits, vegetables and eggs – this diet is gaining popularity!

For starters – the name of the diet has nothing to do with bouillon cubes.It was just a nutritionist named Maggi who came up with it, that’s all.

What are the advantages of the Maggi diet:

no need to count calories
no need to weigh food
no need to measure portions
no need to prepare complex dishes
you can use salt, various spices, onions, garlic

The only negative is that it is necessary to strictly, scrupulously observe the diet. If it is said that you need to eat an apple for breakfast, then you need to do it. Products cannot be substituted for analogues, the meal time must be strictly constant.There are no options on the Maggi diet. You can choose what time you will have breakfast, lunch and dinner (snacks are prohibited), but this time will need to be strictly observed throughout the entire diet, that is, you cannot have breakfast at 8 on weekdays, and at 11 on weekends. This is the essence of the Maggi diet.

You can drink whatever you like, sugar is not prohibited, but the result will be better if you increase the amount of clean drinking water.

And now we will tell you about the Maggi diet menu in detail. Have you started?

Maggi Diet: Daily Menu

First week

Monday

Breakfast: 2 hard-boiled eggs, half a grapefruit.

Lunch: fruits in any quantity, but only one kind: apples, pears, kiwi, oranges

Dinner: any meat, except lamb, boiled or baked

Tuesday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: chicken meat in any form (including fried), portion size – any

Dinner: 2 hard-boiled eggs, salad of carrots, tomatoes, cucumbers and bell peppers, 1 orange, grain bread toast

Wednesday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: grain bread toast, low-fat cheese, tomato salad

Dinner: any meat, except lamb, boiled or baked

Thursday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: fruits in any quantity, but only one kind: apples, pears, kiwi, oranges

Dinner: 2 hard-boiled eggs, salad of carrots, tomatoes, cucumbers and bell peppers, any lean meat

Friday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: 2 soft-boiled eggs, steamed vegetables of your choice: carrots and green peas or green beans and zucchini.

Dinner: whole grapefruit, salad of carrots, tomatoes, cucumbers and bell peppers, white fish (boiled, baked or fried)

Saturday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: fruits in any quantity, but only one kind: apples, pears, kiwi, oranges

Dinner: salad of carrots, tomatoes, cucumbers and bell peppers, any lean meat, fried or baked

Sunday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: chicken, boiled or fried, tomato salad, steamed vegetables to choose from: carrots and green peas or green beans and zucchini, one orange

Dinner: steamed vegetables of your choice: carrots and green peas or green beans and zucchini

Second week

Monday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: salad of carrots, tomatoes, cucumbers and bell peppers, any lean meat, fried or baked

Dinner: 1 whole grapefruit, 2 soft-boiled eggs, salad of carrots, tomatoes, cucumbers and bell peppers

Tuesday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: salad of carrots, tomatoes, cucumbers and bell peppers, any lean meat, fried or baked

Dinner: 1 grapefruit and 2 soft-boiled eggs

Wednesday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: cucumber salad and any lean meat, fried or baked

Dinner: 1 grapefruit and 2 soft-boiled eggs

Thursday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: 2 soft-boiled eggs, low-fat cheese, steamed vegetables (carrots and peas or green beans and zucchini)

Dinner: 2 hard boiled eggs

Friday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: fish (any, prepared in any way, in any quantity)

Dinner: 2 soft-boiled eggs

Saturday

Breakfast: 2 hard-boiled eggs, half a grapefruit

Lunch: boiled lean meat, tomatoes, orange

Dinner: fruit salad (melon, tangerine, peach, orange and apple)

Sunday

Breakfast: 2 hard-boiled eggs, half an orange

Lunch: tomato salad, steamed zucchini and green beans, chicken, 1 grapefruit

Dinner: tomato salad, steamed carrots and green peas, chicken, 1 grapefruit

Third week

Monday

For breakfast, lunch and dinner – any fruit (except bananas and grapes)

Tuesday

For breakfast, lunch and dinner – raw or boiled vegetables (except potatoes)

Wednesday

For breakfast, lunch and dinner – any fruit (except bananas and grapes)

Thursday

For breakfast, lunch and dinner – fish in any quantity, green salad or cabbage, vegetables (except potatoes)

Friday

For breakfast, lunch and dinner – lean boiled or fried meat or chicken, boiled vegetables (except potatoes)

Saturday

For breakfast, lunch and dinner – any fruit (except bananas and grapes)

Sunday

For breakfast, lunch and dinner – any fruit (except bananas and grapes)

Fourth week

Monday

Divide into three meals: chicken breast, 1 can of canned tuna, 4 cucumbers, 4 tomatoes, 1 toast from cereal bread, grapefruit.

Tuesday

Divide into three meals: 4 slices of lean meat, 4 cucumbers, 3 tomatoes, 1 toast from cereal bread, 1 orange, 1 apple

Wednesday

Distribute into three meals: 1 tbsp. cottage cheese, 200 g low-fat cheese, boiled vegetables (except potatoes), 2-3 cucumbers, 2 tomatoes, 1 orange

Thursday

Divide into three meals: chicken breast, 1 cucumber, 3 tomatoes, 1 toast, 1 grapefruit

Friday

Divide into three meals: 2 hard-boiled eggs, 3 tomatoes, lettuce (tomatoes, cucumbers, carrots, peppers) and 1 grapefruit

Saturday

Divide into three meals: 2 boiled chicken breasts, 100 g low-fat cottage cheese, 2 cucumbers, 2 tomatoes, 1 glass of yogurt, 1 orange

Sunday

Distribute into three meals: 2 tbsp.l. low-fat cottage cheese, 1 can of canned tuna, 2 cucumbers, 2 tomatoes, 1 grain bread toast, boiled vegetables (except potatoes), and 1 grapefruit.