Sesame Allergy: The New Peanut Allergy?

Sesame Allergy: The New Peanut Allergy?

The United States has seen a rapid rise in the development of sesame allergy over the last 20 years.  Some experts consider sesame allergy to have “increased more than any other food allergy over the past 10 – 20 years” in the United States.  Increasing prevalence of sesame allergy has led to suggestions that our government issue regulations that require food labels to note the presence of sesame. Currently U.S. federal law does not require sesame contents in food packaging to be declared by food manufacturers.  These manufacturers are currently required to list the eight most common food allergens including milk, eggs, peanut, wheat, soy, tree nuts, fish, and shellfish.  

Sesame seeds are a major allergen for some individuals in Australia where the incidence of sesame allergy is estimated at 0.42%.  In the United Kingdom, the incidence of sesame allergy is lower at 0.04%. Sesame is one of the three most common allergens in Israel.  

What is sesame and where did it come from?

Sesame is a flowering plant in the genus, Sesamum, also called benne.  It is widely grown in tropical regions around the world and is cultivated for its edible seeds.  Global production in 2016 was 6.1 million tons with the largest producers being in Tanzania, Myanmar, India, and Sudan.  Sesame is drought-tolerant, making it easier to grow in temperate climates. Sesame seed is the oldest oilseed crop known, domesticated for over 3000 years.  Sesame has one of the highest oil contents of any seed, with a rich, nutty flavor. It is a common ingredient in many cuisines across the world. Japan is the world’s largest importer of sesame, China is second.

Where might you find sesame in your food?

Sesame seeds are sometimes added to breads including bagels and sprinkled on the tops of hamburger buns.  About 75% of Mexico’s sesame crop has been purchased by McDonald’s for use on their sesame seed buns worldwide. Sesame seeds may be baked in crackers and in some European countries, they are used in making bread.  Sesame is very popular in a variety of cuisines including Middle Eastern, Chinese, Japanese, Vietnamese, and Korean. Sesame oil is frequently used to marinate meats and vegetables for deep frying.

Sesame seed cookies and wafers, both sweet and savory, are popular in the Charleston, South Carolina area where sesame seeds are called “benne.”  They are believed to have been brought to Charleston in 17th century colonial America by West African slaves.  Sesame seeds may also be made into a paste called Tahini and used in making hummus.  Candies with sesame are popular in South Asia, Middle Eastern countries, and Eastern Asia.  Mexican cuisine refers to sesame seeds as “ajonjoli” and they are used mainly as sauce additives in mole and adobo.

What do you need to know about the newest most common allergen?

A recent study published in the JAMA (Journal of American Medical Association) network currently estimates that the number of sesame allergic Americans can be as high as 0.49% or around 1.6 million. Sesame is now being referred to as the “9th most common food allergy in the United States.” 

The author of this new study, Dr. Ruchi Gupta, documented increased incidence of sesame allergy. He indicated that sesame can be trickier to avoid than other major allergens because it’s often sprinkled on food, added to dressings, or added into condiments in small quantities which are not always labeled clearly.  On July 26, 2019, Illinois passed a law mandating sesame labeling on food packaging.  Because many processed foods cross state borders, the impact of this new law is yet to be seen.  It is hopeful that this is the first step that will lead to enactment of a national law requiring sesame labeling on packages containing this product.

If an individual is allergic to sesame, they should avoid all foods containing sesame. Most highly processed oils from allergenic foods, such as, peanut or soy are safe for cooking for individuals allergic to those foods, however, sesame oil is not highly processed and remains dangerous for sesame-allergic individuals. 

What is your next step in determining if you have a sesame allergy?

For a proper diagnosis, make an appointment with a board-certified allergist. They will administer a physical exam, take a detailed history and likely suggest a skin test. A skin test, the gold standard in allergy testing, is simple, quick and provides results within minutes. 

Anyone diagnosed with a food allergy needs to be cautious and diligent when reviewing labels. As outlined above, especially with sesame allergy since it is not mandatory to be a listed ingredient and is found in just about everything. If you are concerned that you might have an allergy to sesame, come in and see any of our board-certified allergists for a proper evaluation today. 

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