Poor sesame labeling on food products causes high rate of allergic reactions, anaphylaxis
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Food packaging often does not consistently label allergens such as sesame, putting many people at risk for adverse reactions, according to a study published in Annals of Allergy, Asthma & Immunology.
“Sesame is the ninth-most common childhood food allergy in the U.S., yet many people don’t recognize it on food labels, or it’s missing entirely,” study co-author Katie L. Kennedy, MD, attending physician with the division of allergy and immunology at Children’s Hospital of Philadelphia, said in a press release.
Kennedy and colleagues found that more than 56% of products that included sesame and were involved in self-reported allergic reactions did not declare sesame among their ingredients on their labels.
The Food Allergy, Safety, Treatment, Education & Research Act, signed into law earlier this year, requires food labels to identify sesame and other allergens by 2023.
“What we discovered in our study was that amongst those who reported events related to accidental ingestion of sesame, many reported they didn’t know that words such as ‘tahini’ meant sesame. Because the word ‘sesame’ is often not used on labels, accidents happen at a greater rate,” said Kennedy, who also is a member of American College of Allergy, Asthma and Immunology.
The researchers developed a questionnaire that they disseminated to online sesame allergy communities. The analysis included 379 self-reported events related to sesame involving 327 individuals (45.6% male; age 1-5 years, 41%; 60% white) with distinct adverse clinical reactions. Nineteen events involved a sesame labeling issue but did not result in a clinical reaction. Also, 85.6% of the reports were from parents providing information on events involving their children.
Anaphylaxis occurred in 68.9% of the reactions, and epinephrine was administered in 36.4% of cases.
“About 48% of the allergic reactions required hospitalizations or an emergency room visit,” study co-author Kim Nguyen, MD, a fellow in the division of allergy and immunology at Children’s Hospital of Philadelphia, said in the press release.
“Most of the events (63%) occurred at home. About 11% of events occurred at a restaurant, 5% at a friend’s house and 4% of events occurred at school. The most common reason for reporting an event was the occurrence of an allergic reaction following ingestion (99%) as opposed to contact-only exposure,” said Nguyen, who also is a member of ACAAI.
The products that caused the reaction were primarily purchased at a grocery store (37.7%), followed by at a restaurant (9%).
Also, 67.5% of adverse reactions involved a packaged food product with a label, but only 43.8% of these packages used the word “sesame.” Further, an alternate name was used in 46% of the products that did not include “sesame” on their labels, most of which was “tahini.”
“Some of the reports were due to products declared as containing ‘spices’ or ‘natural flavors’ and required consumers to call the company or manufacturer to clarify the ingredients,” Kennedy said.
In one of the reported events, a child with a known sesame allergy ate meatloaf made with breadcrumbs. The parents later learned that the “spices” labeled on the breadcrumbs included sesame.
“Clear and specific” product labeling for sesame is crucial for preventing adverse reactions and anaphylaxis among people with food allergies, the researchers concluded.
“Given that it took nearly a decade to secure mandatory sesame labeling through legislation, we strongly recommend the implementation of a new swifter process that would allow the FDA to more easily make future updates to the list of major allergens based on prevalence and severity data pertaining to food allergy,” they added. “We suggest that there remains significant potential for improvement in systemic and standardized monitoring of adverse events related to food exposure that would be useful both in broadening our understanding of accidental food reactions and the potential impact of inadequate labeling.”