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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 36. Go back in thread:
Posted by anastasia56 on January 2, 2005, at 23:20:08
In reply to Re: more MAOI diet questions - thank you, posted by KaraS on January 2, 2005, at 17:36:31
Dan put it most succinctly in his reply so i'd like to second that.
I was on Parnate for a year or so and I don't think I avoided anything really and I was fine...not to say you should do that. My pdoc said most food stuffs in moderation would be fine. I think I was only really aware of the aged meat thing and simply avoided salami. Other than that tho, i didn't even know about soy so never avoided it.
By the way, Parnate was great.
anastasia
Posted by Larry Hoover on January 3, 2005, at 8:24:40
In reply to Re: more MAOI diet questions - thank you, posted by anastasia56 on January 2, 2005, at 23:20:08
> Dan put it most succinctly in his reply so i'd like to second that.
>
> I was on Parnate for a year or so and I don't think I avoided anything really and I was fine...not to say you should do that. My pdoc said most food stuffs in moderation would be fine. I think I was only really aware of the aged meat thing and simply avoided salami. Other than that tho, i didn't even know about soy so never avoided it.
>
> By the way, Parnate was great.
>
> anastasiaThere are some people who are nearly totally resistant to the tyramine pressor effect while on MAOIs. There are others who are exquisitely sensitive to it. If you gathered one hundred people on Parnate together, and fed them identical foods, the blood pressure response would graph as a bell curve. Some would have no response, most would have a moderate response, and some would have an extreme response.
What is critical for any individual using an irreversible MAOI is that they learn about their own sensitivity to tyramine. Stories from others about their own sensitivities do not inform one on this critical issue.
Lar
Posted by sfy on January 3, 2005, at 12:43:36
In reply to more MAOI diet questions - sorry, posted by KaraS on January 2, 2005, at 16:07:19
> I wish I could get a copy of the full Sunnybrook report. I know that someone else here asked for it recently but I don't think they received a link for it or instructions on how to get it. I hate all of the gray area here. It's driving me bonkers!!!
>
> k
>I have a copy of the full Sunnybrook article (it was given to me in a packet of articles by the uber-pdoc who recommended Parnate for me). It's actually rather brief (only 4 pages long) and the Sunnybrook Health Science Centre MAOI Diet is a simple half-page chart. It wouldn't take me too long to type up the chart and make it available. (I could also scan the whole article but there are copyright implications I would run into.)
Posted by sfy on January 3, 2005, at 12:54:44
In reply to more MAOI diet questions - sorry, posted by KaraS on January 2, 2005, at 16:07:19
> I have a few more questions I'm confused about.
>
> I read a summary of the Sunnybrook study and it said that pepperoni is ok to eat - yet I could have sworn that Scott got a hypertensive crisis from pepperoni. It said that cured and aged meats are off limit but then said that pepperoni is ok. Isn't pepperoni cured? Is baked ham ok?The Sunnybrook study says pepperoni is NOT okay to eat. It's specifically listed as one of the foods to avoid. Baked ham isn't a problem - it's not a fermented or dried meat product.
> I read here that only the fermented soy products are the ones you need to stay away from yet I also read a post in the archives here of someone who claimed to have a crisis from pancakes made from a mix. She later looked at the label and saw that it contained soy powder. If you were to go to a restaurant and order pancakes, are you taking a risk?
As Larry said, this would depend on your individual risk factor.
> Do I need to stay away from all Chinese food? Or do I remember some of you saying that you only go to ones you really trust. Even if it's a good restaurant, how can you know how old the stock is that they use?
Sunnybrook says that soy sauce and other soybean condiments are to be avoided so Chinese food might prove a dicey proposition.
> The summary I read also said to stay away from kava beans and pods. I have no idea what foods they're used in. It also said to stay away from "Chinese pea pods etc." That's the first I had heard of chinese pea pods being a problem and what does the "etc." refer to?
Sunnybrook says avoid fava beans or "broad bean pods." I don't know if that includes Chinese pea pods or not.
> Don't remember seeing anything about avocadoes in that summary? Are they ok or not?Avocadoes are OK. The only fruit-related item listed to avoid is banana peel.
Posted by KaraS on January 3, 2005, at 12:57:07
In reply to Re: more MAOI diet questions - thank you, posted by anastasia56 on January 2, 2005, at 23:20:08
> Dan put it most succinctly in his reply so i'd like to second that.
>
> I was on Parnate for a year or so and I don't think I avoided anything really and I was fine...not to say you should do that. My pdoc said most food stuffs in moderation would be fine. I think I was only really aware of the aged meat thing and simply avoided salami. Other than that tho, i didn't even know about soy so never avoided it.
>
> By the way, Parnate was great.
>
> anastasia
Thanks. Why did you stop the Parnate? Did it poop-out?K
Posted by KaraS on January 3, 2005, at 13:00:17
In reply to Re: more MAOI diet questions - sorry » KaraS, posted by sfy on January 3, 2005, at 12:43:36
> > I wish I could get a copy of the full Sunnybrook report. I know that someone else here asked for it recently but I don't think they received a link for it or instructions on how to get it. I hate all of the gray area here. It's driving me bonkers!!!
> >
> > k
> >
>> I have a copy of the full Sunnybrook article (it was given to me in a packet of articles by the uber-pdoc who recommended Parnate for me). It's actually rather brief (only 4 pages long) and the Sunnybrook Health Science Centre MAOI Diet is a simple half-page chart. It wouldn't take me too long to type up the chart and make it available. (I could also scan the whole article but there are copyright implications I would run into.)
>
>Hi,
Larry included some great sources in his first response here. One of them had a chart that was a half page long. Is that the same chart by any chance? If not, then I would definitely be interested in seeing the one from Sunnybrook.
Thank you!K
Posted by sfy on January 3, 2005, at 15:42:59
In reply to Re: more MAOI diet questions - sorry » sfy, posted by KaraS on January 3, 2005, at 13:00:17
> Hi,
>
> Larry included some great sources in his first response here. One of them had a chart that was a half page long. Is that the same chart by any chance? If not, then I would definitely be interested in seeing the one from Sunnybrook.
> Thank you!
>
> KThe article Larry posted a link to (http://www.vh.org/adult/provider/psychiatry/CPS/19.html)
reproduces the Relative Restrictions of Foods and Beverages With MAOI Use table (Table 7) from the Sunnybrook study. However, the Sunnybrook MAOI Diet table is not included. I'm going to try and put it together by tomorrow.I would also pay heed to Dr. Ivan Goldberg's comments on http://www.dr-bob.org/tips/maoi.html. (He is a friendly and knowledgeable pdoc I first encountered on another support site some 10 years ago who has welcomed brief email inquiries in the past)
Posted by jclint on January 3, 2005, at 15:49:17
In reply to Re: more MAOI diet questions - sorry » sfy, posted by KaraS on January 3, 2005, at 13:00:17
>Larry included some great sources in his first response here. One of them had a chart that was a half page long. Is that the same chart by any chance? If not, then I would definitely be interested in seeing the one from Sunnybrook.
Thank you!>K
Me too. I would appreciate it greatly. It sucks that such information is so hard to obtain.
J
Posted by jclint on January 3, 2005, at 16:09:11
In reply to Re: more MAOI diet questions - sorry, posted by jclint on January 3, 2005, at 15:49:17
Also, this post linked on the pyscho-babble MAOI Diet page may be the same text perhaps.
Posted by KaraS on January 3, 2005, at 16:37:48
In reply to Re: more MAOI diet questions - sorry » KaraS, posted by sfy on January 3, 2005, at 15:42:59
> > Hi,
> >
> > Larry included some great sources in his first response here. One of them had a chart that was a half page long. Is that the same chart by any chance? If not, then I would definitely be interested in seeing the one from Sunnybrook.
> > Thank you!
> >
> > K
>
> The article Larry posted a link to (http://www.vh.org/adult/provider/psychiatry/CPS/19.html)
> reproduces the Relative Restrictions of Foods and Beverages With MAOI Use table (Table 7) from the Sunnybrook study. However, the Sunnybrook MAOI Diet table is not included. I'm going to try and put it together by tomorrow.
>
> I would also pay heed to Dr. Ivan Goldberg's comments on http://www.dr-bob.org/tips/maoi.html. (He is a friendly and knowledgeable pdoc I first encountered on another support site some 10 years ago who has welcomed brief email inquiries in the past)
>
>Funny you should mention Dr. Goldberg as I've been reading on his site all morning. I'll read your links as well. Thanks again for all your help!
Posted by anastasia56 on January 3, 2005, at 16:42:03
In reply to Re: more MAOI diet questions - thank you » anastasia56, posted by KaraS on January 3, 2005, at 12:57:07
oddly enough it was plain old allergies that induced me to get off parnate. I have a boatload of allergies and apparently you cannot take the emergency drugs for a bad allergy attack when you are on parnate. I can't remember if it was the emergency epinephrine shot or not. I was going to start a thread to see if anyone has first hand experience with this as i would like to go back on parnate. I just panicked and went off it without doing a lot of research.
anastasia
Posted by KaraS on January 3, 2005, at 16:53:53
In reply to Re: more MAOI diet questions - thank you » KaraS, posted by anastasia56 on January 3, 2005, at 16:42:03
> oddly enough it was plain old allergies that induced me to get off parnate. I have a boatload of allergies and apparently you cannot take the emergency drugs for a bad allergy attack when you are on parnate. I can't remember if it was the emergency epinephrine shot or not. I was going to start a thread to see if anyone has first hand experience with this as i would like to go back on parnate. I just panicked and went off it without doing a lot of research.
>
> anastasiaI recently have developed asthma but have a lot of other allergies too. Actually I'm hoping that it's all stress and panic instead of asthma but I will be checking this out with a doctor and researching treatments myself before I go on an MAOI. I'll let you know if I find anything important.
K
Posted by KaraS on January 3, 2005, at 17:02:17
In reply to Re: more MAOI diet questions - sorry, posted by jclint on January 3, 2005, at 15:49:17
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."
Posted by eeyorena on January 3, 2005, at 18:19:50
In reply to Re: more MAOI diet questions - thank you » anastasia56, posted by KaraS on January 3, 2005, at 16:53:53
I've been on Parnate for a little over two years and it is (seriously!) one of the best AD's I've tried. I resisted it SO MUCH because of the tyramine diet. But I tried everything else to no avail.
I have chronic allergies and you cannot take many over the counter allergy meds.
But there are certain allergy medications you can take. I've been on Allegra along with Parnate with the blessing of two doctors. So there are some oral med allergy treatments. And there are many nasal sprays that are also excellent.
Take care--
Posted by Dan Perkins on January 3, 2005, at 18:38:30
In reply to Re: more MAOI diet questions - pepperoni issue, posted by KaraS on January 3, 2005, at 17:02:17
I can only speak for myself, but I ate numerous slices of pepperoni pizza from several different pizza places while I was on Parnate (70-90mg/day) and never had a problem.
Posted by sfy on January 3, 2005, at 19:54:20
In reply to Re: more MAOI diet questions - sorry, posted by jclint on January 3, 2005, at 16:09:11
> Also, this post linked on the pyscho-babble MAOI Diet page may be the same text perhaps.
>
> http://www.dr-bob.org/babble/20010804/msgs/73614.htmlNo, this is a companion study. The article with the Sunnybrook diet in it is:
Gardner DM, Shulman KI, Walker SE, Tailor SA.
The making of a user friendly MAOI diet.
J Clin Psychiatry. 1996 Mar;57(3):99-104.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8617704
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.
Posted by KaraS on January 3, 2005, at 20:40:18
In reply to Re: more MAOI diet questions - thank you, posted by eeyorena on January 3, 2005, at 18:19:50
> I've been on Parnate for a little over two years and it is (seriously!) one of the best AD's I've tried. I resisted it SO MUCH because of the tyramine diet. But I tried everything else to no avail.
>
> I have chronic allergies and you cannot take many over the counter allergy meds.
>
> But there are certain allergy medications you can take. I've been on Allegra along with Parnate with the blessing of two doctors. So there are some oral med allergy treatments. And there are many nasal sprays that are also excellent.
>
> Take care--
>
>
> http://happynothappy.blogspot.com
Thanks. I think that most antihistamines are fine. It's the more hardcore asthma treatments that I'm worried about (like the bronchodilators). We'll see. Good to know you're doing so well on Parnate. Hope it's as good for me.Take care and thanks for the blog link.
K
Posted by KaraS on January 3, 2005, at 20:58:10
In reply to Re: more MAOI diet questions - pepperoni issue » KaraS, posted by sfy on January 3, 2005, at 20:05:14
> > 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.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10192596
>
>Yes, I had read that abstract about the pepperoni being safe. That was one of the reasons for my confusion because I had also read about others (including SLS) having reactions to pepperoni. I think that what Todd said makes sense. The abstract measured the pepperoni from the pizza chains. The pepperoni from the chains is probably ok but the better, more aged pepperoni may be dangerous.
I also noticed that one of the links that Larry provided showed from their tests that mozarella was a problem too. Yet every other source seems to say that mozarella is no problem. Judging from the number of people who are successfully eating it, I'm not really that concerned about it though. Also, I haven't read where a single person has had a bad reaction to it yet.
K
Posted by KaraS on January 3, 2005, at 21:01:05
In reply to Re: more MAOI diet questions - pepperoni issue, posted by Dan Perkins on January 3, 2005, at 18:38:30
> I can only speak for myself, but I ate numerous slices of pepperoni pizza from several different pizza places while I was on Parnate (70-90mg/day) and never had a problem.
I wonder if you always get your pizza from a chain or whether you've tried all different levels of aged pepperoni. Sometimes, as Larry said, it just comes down to individual chemistry. Are you able to eat a lot of things that are on the newer prohibited lists?
Posted by sfy on January 3, 2005, at 21:18:40
In reply to Re: more MAOI diet questions - sorry, posted by sfy on January 3, 2005, at 19:54:20
I typed up the Sunnybrook Health Science Center MAOI Diet as published in Gardner DM, Shulman KI, Walker SE, Tailor SA. The making of a user friendly MAOI diet. J Clin Psychiatry. 1996 Mar;57(3):99-104.
I tried to copy the formatting as closely as possible as the original. Anyone who wants a copy can find it here:
http://s93235047.onlinehome.us/Sunnybrook.doc
Posted by KaraS on January 3, 2005, at 22:08:39
In reply to Sunnybrook MAOI Diet, posted by sfy on January 3, 2005, at 21:18:40
> I typed up the Sunnybrook Health Science Center MAOI Diet as published in Gardner DM, Shulman KI, Walker SE, Tailor SA. The making of a user friendly MAOI diet. J Clin Psychiatry. 1996 Mar;57(3):99-104.
>
> I tried to copy the formatting as closely as possible as the original. Anyone who wants a copy can find it here:
> http://s93235047.onlinehome.us/Sunnybrook.doc
Love you!Thanks so much for doing that.
K
Posted by SLS on January 4, 2005, at 2:15:53
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.
The only food that I have ever had a severe hypertensive reaction to is pepperoni. It didn't take much. I ingested no more than a couple of slices on a pizza. The plain cheese pizza from the same restaurant never bothered me. I experienced the classic occipital headache - pounding at the base of the skull in the back. For me, it is a certainty that pepperoni is on my foods to avoid list.
I was taking Parnate 60mg + desipramine 150mg at the time.
- Scott
Posted by Larry Hoover on January 4, 2005, at 8:51:28
In reply to Re: more MAOI diet questions - pepperoni issue, posted by SLS on January 4, 2005, at 2:15:53
> > 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.
>
> The only food that I have ever had a severe hypertensive reaction to is pepperoni. It didn't take much. I ingested no more than a couple of slices on a pizza. The plain cheese pizza from the same restaurant never bothered me. I experienced the classic occipital headache - pounding at the base of the skull in the back. For me, it is a certainty that pepperoni is on my foods to avoid list.
>
> I was taking Parnate 60mg + desipramine 150mg at the time.
>
>
> - ScottAbout pepperoni. More than you ever wanted to know. Probably.
Traditionally produced or air-dried pepperoni is purposefully allowed to be contaminated with bacteria from the air. In fact, the meat mixture is sometimes left standing for a period of time to ensure full colonization. When the meat mixture is packed into natural casings, fermentation by-products and the salts added during blending combine to produce a sausage that is fully preserved. Because this process depends on wild-type bacteria and yeast, and because the casing is oxygen permeable, the fermentation products cover a wide range of compounds. Dominant among them is lactic acid, produced by an anaerobe. This gives the sausage a bit of a bite. The air-drying/aging process takes many weeks.
Producers which have been in the business for some time tend to develop "pepperoni friendly" levels of these microbes on the premises, but each producer might have a slightly different mixture or genetic strain of the fermenting critters. This leads to a bit of snobbery around the "vintage" of certain sausages.
Modern commercial pepperoni, the cheap stuff, uses a different method entirely. Rather than depending on wild-type bacteria, they use a commercial frozen starter. Fermentation is done inside plastic (air-sealed) casings, and occurs within twenty-four hours. Little, if any, air drying occurs.
This means that the two products are the same in name only. Air-dried sausage has been exposed to the activity of aerobic bacteria, yielding tyramine. Commercial sausage has not. Air-dried sausage is always in real casings, producing an irregular shape. Commercial sausage is always perfectly round. Air-dried sausage also shrinks irregularly, which further distorts the shape. Air-dried sausage tends to have a moderate to low moisture content, making it a little chewy. Commercial sausage has a much higher moisture content, making it soft and even mushy. Air-dried sausage requires no refrigeration. Commercial pepperoni does.
I think the confusion about pepperoni stems from this: two distinct products, the same in name only. Commercial chain pizzerias are almost certainly going to use the cheaper commercial product available to them. But when you start moving upscale, your risk will increase that they use an air-cured sausage.
One caveat: Cheap commercial pepperoni *can* develop tyramine, depending on how it is handled after it is produced. Although the fresh product has zero tyramine, the longer it is in the distribution chain, or the more handled it has been (e.g. pre-slicing), the greater the possibility that a wee beastie that eats protein and poops out tyramine is in residence.
Lar
P.S. The last paragraph applies to mozzarella, too.
Posted by jclint on January 4, 2005, at 10:17:46
In reply to Sunnybrook MAOI Diet, posted by sfy on January 3, 2005, at 21:18:40
Fantastic stuff. Thanks very much, it'll be very useful!
J
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