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As an ingredient, sesame is very popular – it is in tahini and sushi; it is often mixed with granola, sprinkled on bagels or used as flavoring in a variety of dishes. But according to new research, this could be a problem for a large number of Americans.
While previous studies suggested that sesame allergies affected about 0.2% of American children and adults, a new study published this week by the JAMA Open estimates that the number of Americans allergic to sesame could reach 0.49% – about 1.6 million people.
The findings of the study come at a time when the FDA plans to add sesame to its list of key allergens to note on food packaging. Last October, the then Commissioner, Scott Gottlieb, launched a request for information on the "prevalence and severity" of sesame allergies in the United States in order to help him take a decision.
Fortunately, a team of researchers led by Dr. Ruchi Gupta, director of the research team on the science and consequences of allergy and asthma at Northwestern Medicine, and a physician at Lurie Children's Hospital, had already data. the food allergies they conducted between October 1, 2015 and September 31, 2016. As part of this study, researchers distributed diagnoses and symptoms of food allergy surveys to nearly 80 000 different people in more than 50 000 households. To respond to Gottlieb's request, all they had to do was extract their sesame data and consult them.
What they found: out of nearly 80,000 respondents, about 0.49% reported having a sesame allergy, an increase from previous estimates. Of these 49%, about two-thirds (0.34% of the US population) were diagnosed by their physician or had allergic reactions that were considered convincing. Nevertheless, the overall results suggest that sesame allergy is more prevalent than previously thought. Researchers say they are confident, according to their data, that more than a million people in the United States suffer from sesame allergies.
In addition, Christopher Warren, the Gupta epidemiologist, co-author of Gupta, about one in three people with convincing sesame allergies said to have been hospitalized, representing a relatively higher proportion than expected . And it was relatively unlikely that people with allergies to sesame would be diagnosed, compared to people with other food allergies.
"It can be harder to avoid sesame than other major allergens," he says, as it is often sprinkled on food, added to salad dressings or condiments in small amounts. This is not always clearly labeled.
Onyinye Iweala, an badistant professor of medicine at the Division of Rheumatology, Allergy and Immunology at the University of North Carolina and a member of the UNC's Food Allergy Initiative, qualifies this study as " very important ". She notes that her sample size distinguishes her from many previous studies on food allergies and increases her confidence in the results.
"Their definitions of food allergy were strict," she says, although these definitions have coexisted with the clbadic limitations of survey-based studies: the results depend on people reporting their food allergies, which may lead to: under-reporting or over-reporting. However, she baderts that the authors have correctly addressed the limitations of their study and that the conclusion is global.
The researchers' paper comes at a time when food allergies in general are on the rise in children in the United States, according to the Centers for Disease Control and Prevention. Between 1999 and 2011, the prevalence of food allergies increased from 3.4% to 5.1%.
Even compared to this rise, however, Iweala says that her peers in the food allergy world have witnessed a fairly large allergy to sesame in children. (She personally has not seen her clinic increase, which is mainly occupied by adults). She added that decision makers "should take note of these results, as they compare the prevalence of sesame allergy to that of certain nut allergies, such as cashews or pistachios". However, she notes that regulators will have to weigh other factors, such as logistics and the costs of implementing the new food allergy regulation.
Currently, the US FDA requires food manufacturers to list the top eight food allergens on packaging: milk, eggs, fish, seafood, seafood, nuts, peanuts, wheat, and soy. New discoveries on sesame allergy indicate that its prevalence could rival previous estimates for some of these top 8 allergens, including some nuts.
Thomas Casale, Chief Medical Advisor for the operations of FARE (Food Allergy Research & Education), a non-profit organization specializing in research on food allergies, and a professor at South Florida University in Tampa, agrees that the Study is important and recommends to decision makers to take note.
Sesame, he says, "should definitely become the 9th" listed allergy on food packaging, considering these results. The absence of sesame in the packaging could contribute to a level of dangerous allergic reactions higher than usual reported by the study: "If you do not have proper labeling, it becomes a lot more difficult for people to eat. "
On July 26, Illinois pbaded a law mandating the labeling of sesame on its food packaging. But as most packaged foods cross state borders, the impact of this law is not yet known, notes Gupta. This could be a problem, otherwise Illinois could push the major food manufacturers to go in the right direction.
"It's going to be difficult," says Gupta. "But I hope it's the first step to make it a national law."
Susie Neilson is an intern at NPR's Science Desk. Follow her on Twitter here: @susieneilson.
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