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Dr. Scott Sicherer

Why isn’t Sesame a Top Allergen in the U.S.?

Q: My 11-year-old has sesame allergy and I keep hearing about more and more sesame-allergic children. Why isn’t sesame on the top allergens list and labeled on foods as an allergen?

Dr. Sicherer: Sesame is not regulated in U.S. labeling laws, although it is included in these laws in many other countries, including Canada.

The U.S. laws focus on “major allergens” accounting for most food allergies: milk, egg, peanut, tree nuts, fish, crustacean shellfish, wheat and soy. A recent U.S. study found that approximately 1 in 1,000 people self-reported a sesame allergy, which matches a recent Canadian study.

The U.S. law does not provide guidance about what may warrant adding more foods to the list. Sesame allergy can be a severe and it certainly could be argued that it should be regulated. We should continue to advocate for improvements in the laws.

Avoiding sesame is tricky. As part of the U.S. National Institute of Allergy and Infectious Diseases-sponsored Consortium of Food Allergy Research (COFAR), we developed educational materials for food allergy.These are available free of charge at www.cofargroup.org.

There you will find an informational sheet that provides tips for successfully avoiding sesame. (For example, did you know that “tahini” is sesame paste, or that sesame is also known on product packaging as “benne”, “til” or “teel”?)

I strongly suggest speaking with your allergist about the sesame allergy. If an allergic reaction to sesame is not part of the history, and avoidance is based only on testing, more evaluation may be warranted. Several studies have shown that most people who test positive to sesame are not actually allergic when evaluated by a physician-supervised feeding test.

Dr. Scott Sicherer is Chief of the Division of Allergy and Immunology of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York. Together with Dr. Hemant Sharma, Associate Chief of the Division of Allergy and Immunology at Children’s National Medical Center in Washington, he writes “The Food Allergy Experts” column in the American Edition of Allergic Living magazine. Questions submitted below will be considered for answer in the magazine.

Send your question to Dr. Scott Sicherer by e-mail.
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Allergic Living acknowledges the assistance of the OMDC Magazine Fund, an initative of the Ontario Media Development Cooperation.