Sesame: A New Food Allergy to Be Aware Of
If it seems like you’re seeing more patients with suspected or confirmed food allergies, you may be right. Studies suggest that the prevalence of food allergies is increasing in Western countries, especially the United States, the United Kingdom, and Australia.1 The increase in food allergies is also appearing across multiple age groups, with more diagnoses in older children and teens than in the past.1,2
An estimated 15 million Americans have food allergies.3 According to Food Allergy Research & Education (FARE), more than 170 different foods are reported to cause allergic reactions.3 The list of the most common food allergens has long included 8 foods: peanuts, tree nuts, fish, shellfish, milk, eggs, wheat, and soy. Recently, however, sesame been identified as an emerging concern, because of increased reports of allergic reactions. FARE recommends adding it to the list of common allergens that must be included on the ingredients label of processed foods, according to the Food Allergen Labeling and Consumer Protection Act (FALCPA).
Sesame allergy is most prevalent in the Middle East. It is the third most common food allergen in Israel. In the United States and Canada, sesame allergy is estimated to affect 0.1% to 0.2% of the population.4 While it is less prevalent than the other 8 common food allergens, it is a concern because sesame allergy is not usually outgrown, and the risk of accidental ingestion and reaction is high.4 Research on the amount needed to trigger a reaction has shown that eating just 2 sesame seeds could trigger a reaction in those who are susceptible.4 As with other food allergies, symptoms can range from mild to severe and include reactions that range from hives or itching to anaphylaxis.
Sesame seeds, paste, and oil are used in vast numbers of food products. Common sources include Asian and Middle Eastern foods and many crackers, baked goods, salad dressings, and sauces such as hummus. Because management of a food allergy is focused on avoiding the offending food or ingredient, patients with a sesame allergy or a suspected allergy should be educated that it is not currently among the foods covered by FALCPA. Therefore, it is important to examine food labels carefully.
The following foods and ingredients should be avoided:5
- Benne, benne seed, benniseed
- Gingelly, gingelly oil
- Gomasio (sesame salt)
- Sesame flour
- Sesame oil
- Sesame paste
- Sesame salt
- Sesame seed
- Sesamum indicum
- Tahini, tahina, tehina
Foods that often contain sesame in various forms include the following:5
- Asian cuisine (sesame oil is commonly used in cooking)
- Baked goods (such as bagels, bread, breadsticks, hamburger buns, and rolls)
- Bread crumbs
- Cereals (especially granola and muesli)
- Chips (such as bagel chips, pita chips, and tortilla chips)
- Dipping sauces (such as baba ghanoush, hummus, and tahini sauce)
- Dressings, gravies, marinades, and sauces
- Flavored rice, noodles, risotto, shish kebabs, stews, and stir fry
- Goma-dofu (Japanese dessert)
- Herbs and herbal drinks
- Pasteli (Greek dessert)
- Processed meats and sausages
- Protein and energy bars
- Snack foods (such as pretzels, candy, Halvah, Japanese snack mix, and rice cakes)
- Turkish cake
- Vegetarian burgers
FARE has a downloadable resource sheet that is useful in helping patients learn more about how to identify sesame on a food label.
Although anyone can develop a food allergy, it is more common in younger children than in adolescents and adults. Those with a family history of allergies, other types of allergies, or a history of eczema, asthma, or hay fever are also at increased risk.6
- Tang MLK, Mullins RJ. Food allergy: is prevalence increasing? Intern Med J. 2017;47(3):256-261.
- Sasaki M, Koplin JJ, Dharmage SC, et al. Prevalence of clinic-defined food allergy in early adolescence: the SchoolNuts study. J Allergy Clin Immunol. 2018;141(1):391-398.
- Common allergens. Food Allergy Research & Education. https://www.foodallergy.org/life-with-food-allergies/food-allergy-101/facts-and-statistics. Accessed December 5, 2018.
- Adatia A, Clarke AE, Yanishevsky Y, Ben-Shoshan M. Sesame allergy: current perspectives. J Asthma Allergy. 2017;10:141-151.
- Sesame allergy. Food Allergy Research & Education. https://www.foodallergy.org/common-allergens/sesame. Accessed December 5, 2018.
- Identifying causes of food allergy & assessing strategies for prevention. National Institute for Allergies and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/food-allergy-causes-prevention. Reviewed October 26, 2018. Accessed December 5, 2018.
Contributed by Anne Danahy, MS, RDN