Sesame could become the newest allergen added to the list of foods required to be named on labels, US Food and Drug Administration Commissioner Dr. Scott Gottlieb announced on November 12.
Eight major food allergens must currently be declared on US labeling using their common names: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans.
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These foods accounted for over 90% of documented serious food allergies in the country when the Food Allergen Labeling and Consumer Protection Act, which required the clear labeling of ingredients, was passed in 2004.
The FDA cites the undeclared presence of allergens as one of the leading reasons for food recalls and a public health issue.
"Unfortunately, we're beginning to see evidence that sesame allergies may be a growing concern in the US," Gottlieb said. "A handful of studies, for example, suggest that the prevalence of sesame allergies in the US is more than 0.1 percent, on par with allergies to soy and fish."
Lisa Gable, CEO of the nonprofit group Food Allergy Research and Education, said research suggests that over 300,000 Americans are affected by sesame allergies. "The consensus of both doctors and advocacy groups that support people with food allergies is that sesame is growing into being a national problem and should absolutely be added as one of the allergens to be disclosed on labeling," she said.
The group says sesame reactions can vary from person to person and can range from hives to anaphylaxis. The possibility of such severe reactions is why it believes that the labeling requirements for sesame need to change.
"People with life-threatening food allergies and the family and friends that support them are very careful to read labels," Gable said. "They need to be able to clearly look at a label and make sure that they're not facing a situation of cross-contamination, that an ingredient isn't hidden because it's utilized under a different name. They need to see what the plain English is."
Dr. Robert Wood, president of the American Academy of Allergy, Asthma and Immunology, agrees: "Sesame could be in an ingredient list under a word like tahini or even under a very generic term like 'natural flavor,' so the worry is that it could be something that even a very careful patient or family might not know is in the food."
Dr. Scott Sicherer, director of the Jaffe Food Allergy Institute and professor of pediatrics at the Icahn School of Medicine at Mount Sinai, said patients have had to make assumptions about whether a product includes sesame or even go as far as to call a manufacturer to find out the exact ingredients of a product. "My patients now, they're concerned since sesame is not part of the labeling laws, if they're buying something that has natural flavoring, maybe that has sesame in it.
"I think there's enough evidence to suggest that sesame allergy is as common as a lot of the other foods that are already included in the labeling law, if not more common," Sicherer said. "Including it as part of our US labeling laws makes perfect sense to me."
A new study published Monday in the journal Pediatrics also supports the notion that sesame labeling could be warranted. The results of a survey of US households got allergy-related responses for 38,408 children.
The researchers found that there was an estimated 0.2% prevalence of sesame allergies and that they affect about 150,000 children.
It was the ninth most common allergen in the study after peanuts (affecting around 1.6 million children), followed by milk (1.4 million), shellfish (1 million), tree nuts (900,000), eggs (900,000), "fin fish" (400,000), wheat (400,000) and soy (400,000). More than half of those with a sesame allergy had to carry an Epipen.
The FDA is asking for information, specifically from epidemiologists, nutritionists, allergy researchers and physicians, "so we can learn more about the prevalence and severity of sesame allergies in the US, as well as the prevalence of sesame-containing foods sold in this country. These include foods that, under current regulations, may not be required to disclose sesame as an ingredient."
The agency also wants to hear from medical professionals, researchers, consumers and the food industry to get a more complete understanding of the risks and impacts of changing laws around sesame disclosure. Information on how to comment can be found here.