Sesame - An Emerging Food Allergen | Premier Allergy & Asthma

What you need to know:

Sesame was officially identified as a major food allergen in the United States with the passage of the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act in 2021, which requires sesame to be labeled as a food allergen beginning this year (2023).

What is Sesame?:

Scientific Name: Sesamum indicum

Other names: Ajonjoli, Benne, Gingelly, Sesamol/Sesamolina, Sim-sim, Tahina/Tahini, Teel/Til

Dishes containing sesame: hummus, baba ghanoush, dim sum, siuggiuleni, goma-dofu, gomasho, halvah, khao phan, milagi podi, til pitha, tilor laru, wangila

Foods that can contain sesame: baked goods, breakfast cereals/bars, candy, crackers, marinades, noodles, snacks, salad dressings, sauces, soups, vegetable oils, vegetarian burgers

Cosmetics with sesame: body oils, eye products, lip balms, moisturizing creams, ointments, soaps

Description: Sesame seed is a seed from the sesame plant that is one of the first oil crops used by humans (other major oil crops are soybean, peanut, and rapeseed). Chinese people have used sesame seeds for more than 5000 years, and currently China, India, Myanmar, Sudan, and Tanzania are major producers. Sesame has an aromatic odor and mellow flavor, and is used to make a variety of food products such as sesame oil and sesame paste, as well as for decoration of foods like baked goods and snacks.

Sesame Allergy Details:

Prevalence in the United States is estimated 0.1-0.2%.
Clinical presentation of sesame allergy includes anaphylaxis (systemic allergic reaction with multiple organ systems involved) and urticaria (hives). Gastrointestinal symptoms can also occur but are less common than rash/hives.
Contact Dermatitis from sesame oil has been reported particularly when used as an ingredient in cosmetics.

Natural History:

Allergic reactions to sesame can be present in childhood particularly in the Middle East and North Africa where sesame is quite common in introductory foods. Studies range from 1 out of 10 to 1 out of 3 patients naturally outgrowing sesame allergy.

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Diagnosis:

Sesame allergy skin testing and blood IgE testing can be performed, though results of such testing may not always correlate to clinical reactivity, therefore an in-office Oral Food Challenge to sesame is considered the gold standard for diagnosing or ruling out a sesame allergy.

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Treatment:

Avoid foods known to contain sesame (sesame will start to be added to allergen food labeling in 2023)
Carry an epinephrine auto injector and be trained in its use, in case of anaphylactic reaction.
Some studies suggest Oral Immunotherapy (OIT) can be a promising treatment option.

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References:

https://www.fda.gov/food/food-labeling-nutrition/food-allergies

Weiss, S, and Smith, D. Open sesame: Shedding light on an emerging global allergen. Ann Allergy Asthma Immunol. 2023 Jan;130(1):40-45. doi: 10.1016/j.anai.2022.08.002.
Wei et al. Sesame ( Sesamum indicum L.): A Comprehensive Review of Nutritional Value, Phytochemical Composition, Health Benefits, Development of Food, and Industrial Applications. Nutrients. 2022 Sep 30;14(19):4079. doi: 10.3390/nu14194079.