National Institutes of Health researchers found 17% of children with other food allergies are also allergic to sesame. Their study was published in the journal Pediatric Allergy and Immunology.
The NIH scientists also found testing for sesame antibodies can accurately predict whether a food-allergic child is allergic to sesame. However, they noted the mathematical model used to predict probability needs to be validated by other studies before it can be used in clinical practice.
"It has been a challenge for clinicians and parents to determine if a child is truly allergic to sesame," Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said in a release. "Given how frequently sesame allergy occurs among children who are allergic to other foods, it is important to use caution to the extent possible when exposing these children to sesame."
The scientists evaluated the sesame antibody test in a group of 119 children with food allergies, but whose sesame-allergic status was unknown. Some were given an oral food challenge in which they ingested increasing amounts of sesame under medical supervision to see if they had an allergic reaction. Through this and the antibody tests, researchers found that 17% were definitively allergic to sesame.
Food allergies are on an upward trend. An estimated 15 million people in the U.S. — including about 5.9 million children — have them, according to Food Allergy Research & Education. In 2013, the U.S. Centers for Disease Control and Prevention published a study showing food allergies among children increased about 50% between 1997 and 2011.
Although sesame allergy isn't as common as some others — milk, egg, soy, tree nut and peanut are better-known problem foods — a 2018 report from the Center for Science in the Public Interest said more than 300,000 people in the U.S. cannot eat sesame. According to former Food and Drug Administration Commissioner Scott Gottlieb, this appears to be more than 0.1% of the population.
Because of the increasing incidence of allergies to the seed and the severity of reactions, FDA is considering adding sesame to its list of eight food allergens that must be declared on product packaging. The current list includes milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans — which together cause about 90% of food-related allergic reactions in the U.S.
No doubt the FDA is aware of this recent NIH study and will take its findings under advisement as it analyzes whether to add sesame to the official list of food allergens. Besides doing its own investigation, the FDA has received petitions from medical professionals and consumer advocacy groups asking that sesame-based ingredients be specifically listed on all food labels under their generic name for easy identification.
Should sesame become the ninth food allergen on FDA's list, manufacturers using it in their products would likely face increased costs for research, labeling and consumer outreach. Becoming certified as allergen-free requires paperwork and lots of tests — and potentially separate production facilities to try and isolate allergens from other ingredients. Adding another allergen to that list would mean some facilities would have to go through the certification steps all over again while some allergy-friendly food makers have already eliminated sesame because it's a prevalent allergen worldwide.
As the number of people with food allergies grows, there is a big incentive for food makers to explore allergen-free options. Since sesame can be found in products throughout the grocery store — ranging from baked goods to Asian foods to soups — manufacturers may want to either consider reformulating or use label claims to show that products are sesame-free. And since sesame allergies seem to be more prevalent among children with other food allergies, it may make sense for manufacturers to go the route of companies such as Enjoy Life Foods and produce products that are free of both sesame and other common allergens.