Digestive health innovation: discover the untapped potential of DAO

Published: 19-Jan-2023

Anyone affected by digestive issues knows how difficult it can be to avoid certain triggers and find ways to ease any pain and discomfort. It’s even more problematic for those with food intolerances, reports Jaume Reguant, Healthcare Director at Bioiberica, who are often unable to enjoy the foods they love

For the 1–3% of the global population who suffer from histamine intolerance, effective strategies to manage this little-known and hard-to-diagnose condition can be hard to come by.1

In a landscape saturated with probiotic developments and solutions for general gut health, addressing histamine intolerance presents an exciting white space for digestive supplement manufacturers to explore. 

In this article, we delve into the rising relevance of food intolerances and look at how manufacturers can help to address histamine intolerance with one simple digestive health solution: diamine oxidase (DAO). 

A spotlight on food intolerances 
With factors such as ageing, poor dietary habits and lifestyle choices affecting digestive health, it's no wonder that a rising number of people worldwide are suffering from gastrointestinal issues.2–6

Digestive health conditions have traditionally been difficult to diagnose as many of the common symptoms — such as abdominal pain, diarrhoea, nausea and vomiting — can be attributed to multiple different causes. However, a growing awareness of digestive health combined with powerful diagnostic tools is putting a spotlight on dietary supplements targeting gut-related issues. 

Food intolerance is one area of digestive health that has become more prevalent in recent years. Unfortunately, though, it’s often a source of confusion for consumers. Commonly mistaken for a food allergy, which is an immune reaction to proteins found in a specific food, an intolerance is very different.

Also known as a food sensitivity, an intolerance refers to an abnormal non-immunological response to the ingestion of food or its components. Intolerances are estimated to affect up to 20% of the global population … but it’s hard to know how many people are truly affected because diagnosing food intolerances is difficult and requires thorough investigation.7,8

Some common food intolerances include lactose, wheat, caffeine and gluten. But have you heard of histamine intolerance?

Digestive health innovation: discover the untapped potential of DAO

Histamine intolerance: the forgotten digestive condition      
Histamine intolerance is a gastrointestinal condition that affects up to 3% of the global population. And yet, despite its prevalence, it has not been a focus of innovation in the dietary supplement space — until now. 

Histamine is a naturally occurring molecule that’s produced by the human body; but, it’s also present in many foods and beverages. It is usually broken down by a digestive enzyme called diamine oxidase (DAO) in the gastrointestinal tract.

However, some individuals do not produce enough DAO or the DAO enzyme that is present exhibits low activity, resulting in DAO deficiency. Some factors — including genetics, specific diseases, medications and alcohol — can also slow or inhibit DAO functionality, activity or production.

This leads to impaired histamine metabolism, whereby the compound is not degraded properly in the body. As such, an imbalance between the intake of histamine and the body’s ability to digest it occurs, creating an excess of the chemical in the body. 

This triggers undesirable, allergy like symptoms in histamine-intolerant individuals, including gastrointestinal issues (bloating, diarrhoea, abdominal pain, constipation and nausea) as well as itching, dizziness, headache, rhinorrhoea (runny nose), nose congestion, sneezing and more.9–13

In severe cases, histamine intolerance can significantly impact an individual’s quality of life. The condition affects individuals who are approximately 40 years of age, specifically women.

However, the number of consumers impacted by histamine intolerance is predicted to rise as both the medical community and consumers become more aware of the condition’s existence, better diagnostic tools are developed and more data becomes available.

This is powering demand for digestive health solutions that target the condition and allow consumers to live their lives without unwanted gut problems after eating or drinking certain foods.

Current recommendations for histamine intolerance 
There is no known cure for histamine intolerance … but there are steps that can be taken to manage it. The current recommendation is to follow a low-histamine diet. Foods and drinks that contain high levels of histamine include alcoholic beverages, cheese, spinach, tomatoes and aged/cured, processed or fermented meats, such as sausage and bacon.

Other foods — known as histamine liberators — help to release histamine from other foods, including strawberries, pineapples, bananas, citrus fruits, seafood and cocoa.

Although avoiding such foods can prevent an adverse reaction, it also means that individuals who suffer with histamine intolerance miss out on enjoying their favourite meals, struggle to order from restaurant menus and may end up lacking in essential nutrients because their diets have become so restrictive. 

In severe cases or when histamine ingestion cannot be completely prevented, antihistamine medication can be taken. However, antihistamines do not actually lower histamine levels. Rather, they mask the symptoms of the condition.

Digestive health innovation: discover the untapped potential of DAO

Plus, they can produce side-effects such as drowsiness, dry mouth and eyes, dizziness and headaches. What if there was a more convenient solution for consumers that could make histamine intolerance history? 

DAO supplementation: the new gold standard 
Enzyme-based supplements are emerging as a promising avenue for food intolerances linked to enzyme deficiencies, including lactose, fructose, sucrose and, now, histamine intolerance.

By helping to replace ineffective or low levels of enzymes in the body, they limit the impact of the related digestive issue — getting to the root of the problem rather than addressing the symptoms.

Key players in the market are now taking note, seeking to expand their digestive health portfolios to include enzyme-based products for improved digestion. 

The natural abilities of DAO lend itself to the development of products targeting histamine intolerance. Similar to the current management of lactose intolerance, the possibility of oral supplementation with exogenous DAO has been proposed to facilitate dietary histamine degradation, as it helps to increase the levels of DAO in the gut, making it an appealing option for consumers with the condition.

The rising number of cases of histamine intolerance is expected to boost demand for DAO-based solutions. In fact, DAO supplementation is estimated to increase at a CAGR of 10.4% between 2020 and 2028, signifying opportunities for innovation in this largely untapped market. Taken before meals, DAO supplementation helps to

  • boost levels of DAO enzyme in the gut 
  • break down histamine from foods and beverages 
  • decrease histamine levels 
  • support histamine digestion 
  • limit the need for dietary restrictions.  

Although there is some variability, available research exploring the effectiveness of exogenous DAO supplements largely demonstrates that it helps to alleviate the development and intensity of symptoms.

One trial showed that DAO intake significantly decreased the duration of migraines, with no recorded adverse side-effects, for example.14 Ultimately, the solution allows consumers to eat and enjoy the foods they love, while reducing unwanted allergy like side-effects.

But it’s important to choose quality ingredients — or enzymes in the case of histamine intolerance — that you can trust for digestive health innovation. 


  1. www.mdpi.com/2218-273X/10/8/1181.
  2. www.niddk.nih.gov/health-information/health-statistics/digestive-diseases.
  3. www.oncotarget.com/article/4030/.
  4. https://gutscharity.org.uk/wp-content/uploads/2016/08/DigestingTheFactsReport.pdf.
  5. https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-9-24.
  6. https://pubmed.ncbi.nlm.nih.gov/32395568/.
  7. https://pubmed.ncbi.nlm.nih.gov/19547751/.
  8. www.mdpi.com/2072-6643/11/7/1684.
  9. https://pubmed.ncbi.nlm.nih.gov/8645981/.
  10. https://europepmc.org/article/med/8348568.
  11. https://pubmed.ncbi.nlm.nih.gov/7540138/.
  12. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2222.1990.tb02796.x.
  13. https://link.springer.com/article/10.1007/BF01980899.
  14. https://pubmed.ncbi.nlm.nih.gov/29475774/.

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