Sesame joins the major food allergens list, FDA says

(CNN) — Sesame has joined the list of major food allergens defined by law, according to the US Food and Drug Administration.

The change, which went into effect on January 1, comes as a result of the Food Allergy Safety, Treatment, Education and Research Act, or FASTER Act, which was signed into law in April 2021.

The FDA has been reviewing whether to put sesame seeds on the major food allergens list — which also includes milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans — for several years. Adding sesame to the major food allergens list means foods containing sesame will be subject to specific food allergen regulatory requirements, including those regarding labeling and manufacturing.

Sesame allergies affect people of all ages and can appear as coughing, itchy throat, vomiting, diarrhea, mouth rash, shortness of breath, wheezing and drops in blood pressure, Dr. Robert Eitches, an allergist, immunologist and attending physician at Cedars-Sinai Medical Center in Los Angeles, told CNN in 2020.

The FDA conducts inspections and sampling of food products to check that major food allergens are properly labeled on products and to determine whether food facilities are preventing allergen cross-contact, according to the agency’s website.

"What it means is, for the 1.6 million Americans with life-threatening sesame allergy, that life gets better starting January 1, 2023," said Jason Linde, senior vice president of government and community affairs at Food Allergy Research & Education, a large private funder of food allergy research. The organization helped work to pass the FASTER Act.

Sesame "is in dozens and dozens of ingredients," Linde said, but it wasn’t always listed by name.

"For years, (people) with a life-threatening sesame allergy would have to look at the back of the label, call the manufacturer and try to figure it out," he said. "If it was included, it was just included as a natural spice or flavor."

The new law "is a huge victory for the food allergy community," Linde said.

The road to inclusion

Before the FASTER Act, the FDA recommended food manufacturers voluntarily list sesame as an ingredient on food labels in November 2020. The guidance wasn’t a requirement and was intended to help people with sesame allergies identify foods that may contain the seed.

Under regulations before the 2020 recommendation, sesame had to be declared on a label if whole seeds were used as an ingredient. But labeling wasn’t required when sesame was used as a flavor or in a spice blend. It also wasn’t required for a product such as tahini, which is made from ground sesame paste. Some people aren’t aware that tahini is made from sesame seeds.

While such guidance was appreciated, "voluntary guidance is just that — it’s voluntary," Linde said. "Companies don’t have to follow it, and many did not."

"The way an allergen is identified by the FDA as one that must be labeled is due to the quantity of people who are allergic," Lisa Gable, former chief executive officer of FARE, previously told CNN. "Take sesame, for example: What’s happened is you’ve had an increase in the number of people who are having anaphylaxis due to sesame. There are various opinions as to why that is, but one reason might be the fact that it is now more of an underlying ingredient within a lot of dietary trends."

As plant-based and vegan foods have become more popular, the wide use of nuts and seeds has been an issue that has come up more often, Eitches said.

Safety tips

"We remind consumers that foods already in interstate commerce before 2023, including those on retail shelves, do not need to be removed from the marketplace or relabeled to declare sesame as an allergen," the FDA said in a December 15 statement. "Depending on shelf life, some food products may not have allergen labeling for sesame on the effective date. Consumers should check with the manufacturer if they are not sure whether a food product contains sesame."

Many companies have already started the process of labeling their products, but it could take three to six months for foods currently on shelves to get sold or removed, Linde said. Some foods, such as soups, have even longer shelf lives.

People with sesame allergies can stay safe by being "very careful" about eating certain foods, especially in restaurants, Eitches said.

Middle Eastern, vegan and Japanese restaurants are more likely to include different forms of sesame seeds in their dishes, he added.

Those who suspect they are sensitive or allergic to sesame should see a specialist who can answer their questions and provide medications or devices for emergency situations, Eitches said.

Adrenaline and epinephrine are more effective than diphenhydramine, he added. If an allergic reaction happens, be prepared with any medications or devices and seek medical help.

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