Sesame allergy has gained popularity in the Western diet, it is mainly consumed as intact sesame seeds in baked products. Sesame allergy has a prevalence in the U.S. of about 0.2% and in Israel where it is more widely consumed of 0.93%. In Israel, sesame is a major cause of IgE-mediated food allergy.
Sesame allergy was recently given the label of the “9th” food allergen, and food products must list it as an ingredient now.
Sesame is in many food products worldwide and there is an increased risk of unintended sesame ingestion.
A recent study published in The Journal of Allergy and Clinical Immunology: In Practice, investigated whether sesame-allergic patients can tolerate oral food challenges with a small quantity of intact sesame seeds.
A total of 51 children were enrolled in the study who had been diagnosed with sesame allergy. Oral food challenges were performed, 41 patients (80.4%) were able to consume an average of approximately 60 sesame seeds. 10 of the children (19.6%) reacted during the challenge with GI symptoms, mild rash or runny nose. 4 patients required antihistamines and none required epinephrine.
The patients who passed the challenge were advised to continue eating sesame seeds 3-4 weeks, none of them reported any allergic reactions to sesame.
Preliminary evidence shows that 80% of sesame-allergic patients can tolerate a small quantity of intact sesame seeds. All children who failed the oral food challenge had only mild reactions.
Complete sesame avoidance is the current standard recommendation, but based on this study, most patients with sesame allergy can tolerate a small amount of sesame seeds. The authors hypothesized that when compared with concentrated sesame forms (such as tahini), the diminished allergenicity of intact sesame seeds, as well as the low protein concentration of whole seeds, led to a high pass rate on the oral food challenge.
Allowing children with sesame allergy to consume a small quantity of intact sesame seeds and foods that may contain sesame, may positively impact their quality of life. Less strict measures would allow for expansion of food choices and decreased anxiety. The inclusion of small amounts of sesame seeds may also promote eventual resolution of sesame allergy.
This study was done under the supervision of allergy doctors. Parents who have children that are diagnosed with sesame allergy, should not try this at home. Speak to your allergist whether an oral food challenge with intact sesame seeds is right for you.