A sesame allergy law has made it harder to avoid the seed. Here's why

For years, people with sesame seed allergies have been vulnerable to allergic reactions from accidental exposures, in part, because sesame wasn't always listed on ingredient labels. For example, sesame may have been included in a spice blend, and labeled only as "spice."

"Sesame was hidden in words like 'spices' or 'tahini'," which is sesame paste, says Priscilla Hernandez, whose son Zacky, 11, has a sesame allergy.

A law that took effect in January, known as the FASTER Act, was intended to help the roughly 1.6 million people in the U.S. who have a sesame allergy. The law designated sesame as the 9th official allergen, and ushered in strict labeling requirements. Manufacturers are subject to recalls if traces of sesame are found in products that don't list the allergen.

People with allergies were thrilled by the passage of the law, but ironically, many say the law has made it more difficult to avoid sesame.

This is due to an unintended consequence that neither regulators nor people with a sesame allergy saw coming: Big commercial bakers began adding sesame, often in the form of sesame flour, to products that had never contained it before.

"This has been pretty disappointing," Hernandez says.

At a time when sesame allergies have been rising, many now say it's harder to find breads and baked goods that don't contain it. "This has unbelievably narrowed down our list of what is safe," she says.

Turns out, it has been easier for some of the biggest commercial bakeries to comply with the law by blending sesame into their products, rather than taking on the expense of establishing separate, sesame-free production lines.

"This is a quick and dirty approach to avoiding investments in food safety, and it's putting consumers at risk," says Sarah Sorscher, director of regulatory affairs at the Center for Science in the Public Interest.

Hernandez says in addition to finding fewer sesame-free products in big grocery stores, it can be a big challenge to eat out. Their favorite bagel shop began adding sesame flour to her son's favorite egg bagel, and she didn't realize the chain had changed the recipe until she checked the company's website.

"The way they're putting sesame flour in, it's not even a seed," Hernandez says. So you can't see it or smell it.

"You wouldn't know it's in your bread until maybe it's too late," she says. Now she says she must double and triple-check labels and websites. She fears a repeat of an emergency room visit for an allergic reaction, which happened after Zacky accidentally ate a breadstick with sesame at school.

"That was a very scary situation," she says. (They advocated for a new state law in California, the Zacky bill, aimed at protecting kids with allergies at school.)

Chains such as Chick-fil-A, and the maker of Dave's Killer Bread and Nature's Own breads have notifications on their websites to alert customers to the changes, though "consumers may not see the label changes," says Sorscher.

The Center for Science in the Public Interest petitioned the Food and Drug Administration with the aim of preventing manufacturers from intentionally adding sesame to foods when they identify cross-contact risks. "What we asked the FDA to do is to clarify that this can't be done under food safety rules," Sorscher says.

The FDA denied the petition last month, though FDA Commissioner Robert Califf has made it clear that the agency does not support the practice of intentionally adding sesame to products. "This keeps manufacturers in compliance with our law for disclosing the presence of a major food allergen, but limits options for consumers who are allergic to sesame," Califf wrote in an update. Califf points out that some bakers have dedicated sesame-free spaces in their facilities, but he also acknowledged the ongoing practice of adding sesame.

Meanwhile, commercial bakeries have told Congress that it's hard to eliminate the risk of cross-contact of sesame seeds, given the use of shared equipment in many facilities."

Sesame's physical characteristics make it particularly difficult to control," wrote Eric Dell, the President and CEO of the American Bakers Association in a letter to lawmakers. The seeds are small and light, Dell says. "They can easily and unintentionally get into crevasses and hard-to-access areas," wrote Dell.

He said the FDA typically expects recalls for products containing traces of allergens, even when there's a "may contain" warning on the label, so some bakers determined that intentionally adding sesame was the only way to comply with the FASTER Act. He says it's not feasible for all bakeries to establish separate facilities to produce sesame-free products.

The American Bakers Association has proposed one potential solution. The group has asked Congress to call on the FDA to establish a sesame allergen threshold, which would allow a trace amount of sesame to be present in foods, an amount too small to cause an adverse reaction in most people. This would help eliminate the current incentive to add sesame to foods.

"Addition of sesame would likely not be needed if [the] FDA would establish allergen thresholds," Dell says.

It's a strategy the allergy community may support as they continue to follow the issue and talk to regulators and bakers.

"For the FDA to embrace thresholds is one option that could eliminate the bakers' intentional addition of sesame flour to its baked products," says Robert Earl of Food Allergy Research & Education, known as FARE, a non-profit group that advocates on behalf of the allergy community.

In Australia, the food industry has a population threshold approach which is predicated on understanding the smallest amount of an allergen that can prompt a reaction. To set a threshold for an individual person, an allergist will expose the person to increasing doses of the allergenic food during a "food challenge" test. This can help set a maximum tolerated dose. Setting a threshold for a population depends on understanding the tolerance of many individuals. Scientists at the University of Nebraska explain "the most sensitive individuals dictate the low end of the range for the population threshold."

Meanwhile, Robert Earl says his group was "exquisitely disappointed that FDA could not act to prevent the intentional addition of sesame," but says the allergy community continues to engage with regulators to work towards the common goal of protecting people with allergies. [Copyright 2023 NPR]