DAOkids®: dietary management of DAO deficiency for children from 3 years old

Foods for special medical purposes are intended to meet all or part of the dietary needs of patients whose ability to ingest, digest, absorb, metabolize or excrete normal foods or certain nutrients or metabolites thereof is limited, impaired or impaired, or who are in need of other clinically determined nutrients, whose dietary management cannot be accomplished solely by modification of the normal diet, by other foods intended for special feeding, or by both (1). They are not drugs or food supplements.

Oral DAO supplementation is a key strategy in the dietary management of migraine and other pathologies associated with DAO deficiency, since histamine is present to one degree or another in many foods in the normal diet, and for a patient with DAO deficiency it is very difficult to suppress histamine foods since the histamine content is not normally specified by the manufacturers.

Foods for special medical purposes containing DAO prevent the systemic absorption of exogenous histamine, providing the patient with the necessary amount of DAO that complements the body’s own enzyme, strengthening the ability to break down histamine from food locally in the small intestine and restoring the natural balance of histamine and DAO, thus reducing the symptomatology of concomitant pathologies (2).

Bibliography & links

1. Alimentos para usos médicos especiales. Disponible en: http://www.aecosan.msssi.gob.es/AECOSAN/web/seguridad_ alimentaria/subdetalle/alimentos_usos_medicos.htm
2. Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, Lorente-Gascón M, Duelo A, Soler-Singla L, et al. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: a randomized double-blind trial. Clin Nutr. 2019; 38: 152-158.

DAOkids® is used for the dietary management of neurological, gastrointestinal, muscular and dermatological pathologies caused by DAO deficiency / histamine intolerance in children from 3 years of age.

Although it is recommended to consume each tablet with a little water 20 minutes before each main meal (a total of 3 times a day: breakfast, lunch and dinner), because the DAO enzyme activity of DAOkids® is maintained for 4-5 hours, each tablet can also be consumed a maximum of 2-3 hours before each meal. 

The Diamine Oxidase (DAO) enzyme in DAOkids® maintains its metabolic activity of dietary histamine for 4-5 hours after supplementation. 

It can be consumed before a meal up to a maximum of 3 tablets, being advisable not to consume more than 3 tablets daily. Thus, if 2 or 3 tablets are consumed before a meal rich in histamine in one day, it is advisable that if 2 tablets have been consumed, only one more tablet is consumed in the next meal during that day, and if 3 tablets have been consumed, no more tablets should be consumed during that day.

The results of dietary management begin to show after 15 days of supplementation and within the first 30 days.

It is recommended to have an objective diagnosis of DAO deficiency, follow a low histamine diet and take one tablet at least 3 times a day (take one tablet with a little water 20 minutes before each main meal).

DAOkids® can be taken indefinitely and is suitable for diabetics, celiac and/or people with food intolerance, it does not contain allergens, gluten, lactose, histamine or sugars and does not cause side effects, so its use is indicated for the dietary management of gastrointestinal, cutaneous and muscular neurological pathologies associated with DAO deficiency / histamine intolerance.

Each tablet contains 0.3 mg of Diamine Oxidase enzyme (DAO). It is recommended not to exceed a maximum daily dose of 12.6 mg of pork kidney protein extract rich in DAO enzyme, so it is advisable to take a maximum of 3 tablets per day (each tablet contains 4.2 mg of pork kidney protein extract rich in DAO enzyme). 

The primary origin of DAO deficiency is due to genetic factors (DAO gene variants associated with low enzyme activity) and is diagnosed by means of the Diamine Oxidase (DAO) activity molecular genetic study (AOC1-V). It can be found in pharmacies specializing in DAO deficiency, online pharmacies and amazon. 

The secondary origin of DAO deficiency may be due to the consumption of drugs that inhibit the DAO enzyme, the intake of foods rich in histamine and/or other biogenic amines, or the intake of foods that inhibit DAO, such as alcohol. Certain pathologies affecting the intestinal mucosa, such as Crohn’s disease, Ulcerative Colitis and intestinal operations are also at the origin of DAO deficiency.  For the diagnosis of these secondary causes, a plasma DAO activity assay is performed. This analysis can be requested and performed in public and private hospitals.