A boiled sesame seed bagel may seem like a delicious breakfast to some, but a nightmare to those with a sesame allergy. While you may not have heard about a sesame seed allergy before, you might hear a lot more about this food allergy soon. In 2021, President Joe Biden signed The FASTER (Food Allergy Safety, Treatment, Education, and Research) Act in April 2021. Starting soon, any sesame in food will have to be called out on a label, like other top allergens that might be more familiar to people, like peanuts, or dairy. The new legislation is a win for individuals with sesame allergies, and their caregivers. Let’s learn more about this common food allergy and what the future holds for those with a sesame allergy.
A sesame allergy is the 9th most common food allergy, behind more common food allergies like a dairy allergy or peanut allergy. But a sesame allergy still affects a significant portion of the population, about .23% of children and adults. Some even estimate a sesame allergy to affect .5% of the population. This means millions of people live avoiding sesame products to avoid allergic reactions, and even anaphylaxis. Children with a history of both peanut allergy and tree nut allergy are more likely to have a sesame allergy. While sesame may only affect less than 1% of the general population, this seed can be a very big medical problem. In fact, Canada and European countries had already labeled sesame as a potentially dangerous top allergen before the US passed similar legislation.
Living with a sesame allergy
A sesame allergy is a difficult allergen to live with, as sesame is typically hidden in many foods. Sesame can often be found under the label of “spice” or “flavoring.” Anyone looking for sesame in a packaged food or restaurant meal has to play detective and ask all the right questions, down to what seasonings and oils are used in the preparation.
All parts of sesame can trigger an allergy. Something like a whole sesame seed can be found on a bagel or hamburger bun, or coating the rice on your sushi roll. Sesame oil is used in most Asian cuisines, and adds a nutty and roasted flavor to foods. But sesame oil isn't just for Asian food, it can be used in any cuisine - which makes it so difficult to uncover as a hidden allergen. Sesame can also be found in flour, although less frequently than seeds or oil. If you have a sesame allergy, you'll also need to avoid certain bath and body products that contain sesame and its derivatives.
Like any food allergy, sesame allergic reactions can vary from mild to severe, including anaphylaxis. Common food allergy symptoms can include:
- Itching or hives
- Difficulty breathing/feeling like your throat is tightening
- Nausea or vomiting
- Abdominal cramping/diarrhea
- Feeling faint/dizzy
- Feeling anxious/confused
You might not know how your body will react to ingesting sesame until you have an allergic reaction to it. Sesame allergy symptoms can include severe reactions. A recent study has shown that over half of people with a sesame allergy have received care in an emergency room for their food allergy. About a third of those with an allergic reaction to sesame treated the reaction with an EpiPen (or other epinephrine auto-injector). Most people with sesame allergies (80%) also have another food allergy. It's important to be aware of the first sign of food allergy symptoms, in case they advance to life-threatening severe reactions. In case of a severe food allergy reaction, please call 9-1-1 and seek immediate help.
Foods that may contain sesame
Some foods that contain sesame are easy to see, just by looking at it. But unless whole sesame seeds are being used on a product, it can be an ingredient guessing game. Like many allergens, sesame can easily hide in foods that you wouldn’t even think about, especially in the vague listing of “spices.”
However, these items should always be examined thoroughly for sesame ingredients:
- Asian or Middle Eastern-inspired dishes (ex. sesame chicken, stir-fry, kebabs)
- Sushi/Poke bowls
- Bagels or bagel chips
- Bread toppings (hamburger buns, challah, rolls)
- Granola, muesli or seed-based trail mixes
- Pita Chips/pitas
- Snack bars
- Cookies (ex. sesame seed cookies, also called Barazeks, and Italian sesame seed cookies)
- Dipping sauces (hummus, baba ganoush, tahini)
- Vegetarian or vegan burgers or meat substitutes
- Alternative milks
- Salad dressings and sauces
- Spices or seasoning packets
Common foods made with sesame
Outside of using the seed as a topping for breads, or the oil for cooking, there are a few items that are made with sesame with a different name altogether.
- Tahini is a popular paste made from sesame seeds that can be eaten alone, or added to hummus, baba ganoush, or halva.
- Halva is a popular toasted sesame seed dessert/candy.
These two items are popular in Western Asian and Middle Eastern cuisine, but eaten across the world.
Labeling sesame: the FASTER act
Thanks to the FASTER act, those living with a sesame allergy can soon live an easier, and safer, life. Starting January 1st 2023, all sesame-derived ingredients must be labeled on packaged food, the same way that other top allergens would be labeled.
This is the first time the FALCPA (Food Allergen Labeling and Consumer Protection Act) has added a new food allergy, since FALCPA became law in 2004. Those with sesame allergies, and those advocating for better allergen labeling laws, have been pushing to label sesame for years. In 2018, the FDA launched a formal request for information. This allowed the general public to submit their comments to the government in hopes for a better future for those with food allergies to sesame.
Along with the sesame allergen labeling mandate, the act also will include a report delivered in 2022 with recommendations towards a framework to label any new allergens.
Finding sesame on a food label
All packaged food products under control of the FDA have an information panel. Things like fresh meat and alcohol, which are regulated by other agencies, do not. When you pick up a frozen chicken in the store's freezer, it's easy to see that it's just chicken inside. But a box of crackers is a mystery. This product's information panel will include the product's nutrition facts panel and a list of ingredients. These ingredients will be listed in order of weight found in the product.
It's not always easy to find sesame on food labels, and it probably won't be until 2023 when the FASTER act is official. Between now and 2023, you might see food manufacturers adding sesame in a product's allergen statement in preparation. It can take months for new packaging with revised information to roll through production and manufacturing, and onto store shelves.
For those with a sesame allergy, look for the phrase "contains: sesame" in a product's food label. The "contains" statement is typically at the end of the product's ingredient list. Sometimes, a product will use bold font to alert the consumer to an allergic ingredient in the ingredient list. Other times, the allergen is simply listed in the ingredients. This is part of why scrutinizing a food label is so important for someone with a sesame allergy, or other food allergies.
You will also want to look for alternative names for sesame. According to Allergic Living, the following are alternative names for sesame or sesame-derived ingredients:
- Benne, benne seed, benniseed
- Gingelly, gingelly oil
- Gomasio (also known as sesame salt)
- Sesamum indicum
- Sim sim
- Tahini (also called Tahina or Tehina)
If you don't know a specific ingredient on the label, you can call the manufacturer and ask about the ingredient and if it is made from sesame. If you don't feel comfortable eating a product, don't! It's better to avoid potential allergic reactions than eat something you're not sure is safe. Thankfully, all flavors, colors, and incidental additives are subject to labeling of food allergens. For those with a sesame allergy, reading ingredients will soon become easier - but you should never let your guard down!
Getting tested for a sesame allergy
If you are concerned about having a sensitivity to sesame ingredients, it’s important to be tested for a sesame allergy. There are several testing options to help diagnose a sesame allergy. Food allergy testing can include IgE food allergy testing using your blood, or skin prick testing using specific food allergens that provoke a skin reaction. Both tests can aid in a potential diagnosis for food allergies. Skin prick testing, however, must be done without the use of antihistamines. This means stopping your over-the-counter allergy treatments several days before the test.
An IgE food allergy test can help diagnose a sesame allergy, or other food allergies. An IgE allergy test results measure your Immunoglobulin E (IgE) which is an antibody that's produced by the body’s immune system in response to a perceived threat. When looking for a sesame allergy, make sure that your IgE food allergy panel includes a screening for sesame.
To prepare for any allergist appointment, to prepare a recent food diary that outlines detailed descriptions of anything you eat, and any physical reactions you may experience afterwards. This can help your allergist better understand your reactions to food, which may or may not contain sesame. You'll also want to prepare a history of any past allergic reactions to foods or medications.
Your food allergy diagnosis journey may also include oral food challenges. Oral food challenges consist of eating rationed amounts of an allergen to see if your body produces a reaction to the allergen. Oral food challenges should always be done in a controlled setting with a physician in case of serious allergic reactions. Your allergist can discuss if a food challenge is part of your personal diagnostic process.
Working with a qualified allergy specialist, alongside proven science-based food allergy testing, can help identify the culprit, and then eliminate it from your diet.