At Last, the FDA Will Require Food Labeling for Sesame Allergies

Back in the 1950s, sesame allergies were almost unheard of in the U.S. Today, they’re the ninth most prevalent allergen and affect up to 1.6 million kids and adults.

Experts from the pediatric allergy and immunology department at Johns Hopkins School of Medicine have called sesame allergy the fastest increasing food allergy of the past 10 to 20 years. Others have dubbed it “the new peanut allergy.” But for all of this, those with sesame allergies have been disadvantaged by the fact that, unlike other allergens, sesame is not clearly identified on food labeling.

At Last, the FDA Will Require Food Labeling for Sesame Allergies

(Pezibear / pixabay)

Fortunately, this is changing. After more than a decade of effort to codify requirements for sesame labeling, advocates have been heard by the U.S. Food and Drug Administration. On January 1, 2023, the FDA will require that packaged foods clearly identify sesame as an ingredient.

This requirement has traditionally been reserved for the “Big 8” food allergens (peanuts, tree nuts, fish, shellfish, milk, eggs, soy, and wheat). But now, the U.S. will join Europe, the U.K., Australia, and Canada in recognizing sesame as a major allergen.

Why is sesame allergy so prevalent now?

Our diet is becoming more international. As such, foods like sushi, hummus, baba ganoush, and Asian dishes cooked in sesame oil are more common. That said, sesame allergies still aren’t nearly as bad in the U.S. as they are in some other countries. In Israel, for example, where sesame is incorporated into many dishes, sesame is the third leading cause of food allergy and the second most common trigger for anaphylactic reactions.

Aside from the increased prevalence of sesame in the U.S. diet, there’s the broader problem of food allergies increasing across the board. According to Kari Nadeau, a Stanford University allergy specialist who explores food allergy trends, 3% of the world had food allergies back in 1960 compared to 7% of the world in 2018. Here in the U.S., the Centers for Disease Control and Prevention tracked a 50 percent rise in food allergies from 1997 to 2011.

While research cannot definitively point to any one factor causing this surge in food allergies, there are plenty of theories. They include the hygiene hypothesis, which suggests that we’ve become so clean that our immune systems aren’t good at deciding what they should react to. Thus, they’re prone to mistaking a food protein for something insidious (like a germ) and overreacting to it.

Other scientists tie the rise in food allergies to a lack of healthy bacteria in the gut. Still others believe that our policies of keeping infants and young children away from allergenic foods is backfiring. Yet one more theory is that falling vitamin D levels in the general population are depriving us of one of the key nutrients for building immune health.

What are the symptoms of sesame allergy?

Reactions vary from person to person, with some being mild and others severe. They include:

  • Runny or congested nose
  • Hives
  • Eczema
  • Angioedema (swelling of the face and throat)
  • Gastrointestinal distress
  • Wheezing
  • Anaphylaxis

Research shared at the 2019 American Academy of Allergy, Asthma and Immunology conference showed that 38% of sesame allergy sufferers reported having at least one severe reaction to sesame (with 33% of all sufferers having to use an Epi-pen to treat their reaction).

What foods should I avoid?

The FDA requirement will lift a huge burden off of sesame allergy sufferers, who must currently scour labels for sesame derivations, which often go by other names (benne, gingelly, halvah, sesemolina, sim sim, and tahini). Until the FDA requirement takes effect, you should watch for these terms on ingredient lists and also avoid sesame-related foods such as sesame seeds, flour, paste, salt, and oil.

Asian cuisine can be problematic because it is often cooked in sesame oil. So can ethnic foods such as falafel, hummus, and tempeh. Watch for sesame seeds on hamburger buns, bagels, and other baked goods. Cereals such as granola can often contain sesame as can chips, crackers, and granola bars. Even margarine, processed meats, and condensed soups can contain sesame as can medication and nutritional supplements.

Why can’t I eat sesame oil if people with peanut/soybean allergies can often eat related oils without reacting?

Many people with peanut and soy allergies can still ingest highly refined oils made from these foods without reacting. However, unlike peanut and soybean oils, sesame oil is not highly refined and can still trigger allergy symptoms.

Should I avoid non-food items that contain sesame?

Hair care products, creams, soaps, perfumes, and oils may contain sesame and could cause reactions, the most common of which are a skin rash known as contact dermatitis.

Who is at risk for sesame allergy?

Sesame allergies can develop at any time but are most likely to develop in children. Unlike other allergies that subside by adulthood, only about 20 to 30% of kids outgrow sesame allergies.

A Jama Network Open article reports that four out of five people who are allergic to sesame are also allergic to at least one other food allergy (primarily peanuts and tree nuts). Thus, if you are allergic to other foods, especially peanuts and tree nuts, you may have allergic sensitivities to sesame.

At AllergyEasy, we’re thrilled about the upcoming food package labeling requirements for sesame. We know that this has been a long time coming for sesame allergy sufferers, and we laud all of the advocacy efforts that have helped bring this to fruition.

If you have food allergies, we invite you to read food labels carefully and also to consider treatment options. While avoidance used to be the only option for those with food allergies, food allergy treatment programs are now available through sublingual immunotherapy. With a few liquid allergy drops under the tongue each day, you can train your immune system to tolerate more of the foods you love. Contact us today about food allergy treatment.

About The Author

Stuart H. Agren, M.D.

Stuart H. Agren, M.D. completed his undergraduate studies at the University of Utah and went on to earn his Doctor of Medicine from Tulane University School of Medicine in 1974. He completed additional training at L.D.S. Hospital in Salt Lake City, Utah and then established his private medical practice starting in 1975. Dr. Agren completed a mini-residency in Industrial Medicine at the Robert Johnson School of Medicine at Rutgers University and also completed training to become a certified Medical Review Officer.

Dr. Agren was the Medical Director at TRW and McDonnell Douglas in Mesa, Arizona and at Stauffer Chemical and Kennecott Copper in Salt Lake City, Utah. He also served as an adjunct faculty member at Arizona State University.

In his private medical practice, Dr. Agren specialized in family practice and allergy. In his work as a private practice allergist, he was one of the first doctors in the country to prescribe sublingual immunotherapy to his patients as an alternative to subcutaneous immunotherapy (allergy shots). He has also been a trailblazer in the field of food allergy treatment and research, developing a program to treat multiple food allergies simultaneously using sublingual immunotherapy. Dr. Agren has been featured on local CBS, NBC, and ABC news affiliates and won the peer-nominated “Top Doc” award from Phoenix Magazine.

After 20 years in private practice, Dr. Agren became the Founder and President of AllergyEasy, which helps primary care physicians around the country offer allergy testing and sublingual immunotherapy treatment to their patients. Over 200 physicians in over 32 states use the AllergyEasy program to help their patients overcome environmental and food allergies and asthma.