When you eat sushi or a crusty loaf of bread, you may not even notice that you're eating sesame seeds with each bite. While these tiny beige seeds may look and taste fairly harmless—they add a delicate, nutty crunch to foods—for many Americans, they, and any form of sesame, can cause an allergic reaction ranging from hives, upset stomach, itching, and swelling, to life-threatening anaphylaxis requiring an epinephrine auto-injector such as EpiPen.
And a large new study from Northwestern Medicine, published in JAMA Network Open, found that sesame allergy may be more common than you think. In fact, the study is the first to quantify the current public health burden of sesame—basically, how many people are really affected by this allergy. Here’s what you need to know about allergy to sesame, which comes from a flowering plant called Sesamum indicum.
Labels Don't Warn of Sesame Allergies
The Northwestern study authors report that overall, more than 1.5 million people—or 0.49% of the U.S. population—has reported a current sesame allergy, thanks to their survey of more than 50,000 households in 2015 and 2016, which resulted in a nationally representative sample of approximately 80,000 children and adults. And four out of five patients allergic to sesame also have at least one other food allergy.
The problem is, say the study's authors, there's not currently a requirement for sesame labeling in the United States like there is for the other eight main allergens: peanut, milk, shellfish, tree nuts, egg, wheat, soy, and fin fish, along with proteins derived from them.
Unlike the United States, the European Union, Australia, New Zealand, and Canada do require the labeling of products containing sesame, says the Journal of Asthma and Allergy.
Coming Soon to Sesame Products Near You
Thankfully, things may be about to change. The U.S. Food and Drug Administration (FDA) is currently considering adding sesame to that list of allergens that are required on product warning labels. In late October 2018, FDA Commissioner Scott Gottlieb said in a news release that there's enough evidence that sesame allergies may be a growing concern in the U.S, and that the prevalence of sesame allergies here is on par with allergies to soy and fish.
As of April 2018, only 14 of 22 major food manufacturing companies declare the presence of sesame, according to the nonprofit Center for Science and the Public Interest. The other companies may hide sesame as a "spice" or "natural flavoring,” which could potentially endanger consumers with sesame allergy.
And the number of people allergic to sesame really has risen in the past 20 years, according to Food Allergy Research & Education (FARE). The thing is, you may not even know you're eating sesame, which can also be consumed in these forms:
- Benne, benne seed, benniseed
- Gingelly, gingelly oil
- Gomasio (sesame salt)
- Sesame flour
- Sesame oil
- Sesame paste
- Sesame salt
- Sesame seed
- Sesamum indicum
- Sim sim
- Tahini, tahina, tehina
Do Your Sesame Due Diligence
For a person with any food allergy, reading Nutrition Facts labels is an absolute must—it can be a lifesaver. Be on the lookout for sesame in Asian cuisine, baked goods, breads, rolls, cereals such as granola and muesli, chips, crackers, dressings and gravies, hummus, and much more.
Check out FARE’s complete list of potential sesame-containing foods—it may be worth printing out and sticking on your fridge if someone in your family has a known sesame allergy. And if you know you are allergic to sesame, call the manufacturer and ask whether that new food you're craving contains any sesame—it's always better to be safe than sorry.