sesame seeds labeling: US specific (laws, loopholes)

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LinksEtc:
Severity:

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"Tourist dies of allergic reaction to tahini"
Apr. 1, 2014
http://www.haaretz.com/news/national/1.583210

--- Quote ---The woman, who was allergic to sesame, did not know that tahini (“tehina”) was made from sesame seeds and developed a severe allergic reaction shortly after her meal.
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"Allergy Led To Death Of Popular Teenager"
http://www.burnleyexpress.net/news/local/allergy-led-to-death-of-popular-teenager-1-1670926

--- Quote ---An inquest into the death of 16-year-old Paul Derrick Howard, of Thursfield Road, Fulledge, found that the keen footballer suffered from an allergy to sesame seeds, which had caused his death.
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"Sesame allergy: a growing food allergy of global proportions?"
Venu Gangur, DVM, MVS, PhD*†; Caleb Kelly, BS*; and Lalitha Navuluri, DVM*

Thanks to Dr. Gangur for giving me a copy of his paper years ago. :heart:

--- Quote ---A recent study on food allergy among Israeli children (n = 9,070) found food allergy prevalence to be 1.7%, with sesame the third most common food causing sensitization (0.18% prevalence), following egg (0.5%) and cow’s milk (0.3%) and more than that of peanut sensitization (0.04%).12 Furthermore, sesame was second only to cow’s milk as a leading cause of anaphylaxis.12,20
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Food Allergy: Is Sesame Seed the “Middle Eastern Peanut"?
http://allergynotes.blogspot.com/2011/05/food-allergy-is-sesame-seed-middle.html

--- Quote ---Although specific IgE to peanut were higher than for sesame, peanut-induced allergic reactions were mild, in contrary to sesame where anaphylaxis was the only clinical manifestation.
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Food Allergies For Dummies
Robert A. Wood, MD

Page 49

--- Quote ---While any food allergen can cause anaphylaxis, a few are particularly skilled at doing so. The most sinister of the bunch are peanuts, tree nuts, sesame, and shellfish.
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"Sesame allergy in Britain: a questionnaire survey of members of the Anaphylaxis Campaign."
http://www.ncbi.nlm.nih.gov/pubmed/15787876

--- Quote ---One in six (17%) had suffered potentially life-threatening symptoms, with 65% of severe reactions happening on first known exposure.
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"The Allergens to Watch – Sesame to Lentils and More"
http://allergicliving.com/2010/08/30/the-allergens-to-watch/

--- Quote ---So why did Health Canada choose to add a food like mustard seed to its list? According to Food Allergen Program Manager Michael Abbott, the government agency not only looks at which allergens are the most common, but which ones are mostly likely to produce the most severe reactions, because they especially need to be clearly labeled on food packaging.

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LinksEtc:
Prevalence:

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"Prevalence Of Food Allergy To Uncommon Foods Based On Oral Food Challenges"
Gita Ram, Christina Gustafson, Jonathan M. Spergel, MD PhD FAAAAI, Antonella Cianferoni, MD PhD
https://aaaai.confex.com/aaaai/2014/webprogram/Paper11869.html

CHOP

--- Quote ---Methods: Retrospective chart review of all children undergoing OFC to any food excluding milk, egg, peanut, wheat and soy from 2004-2012.
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--- Quote ---Patients aged 1-18 years (median 6) underwent 366 OFCs. Challenged foods included tree nuts (36.6%), meats (15.8%), seeds (11.7%), shellfish (9%), fish (6.8%), fruits and vegetables (6%), grains excluding wheat (5.7%), legumes excluding peanut (4.9%), and miscellaneous foods (3.2%). 90.7% of patients had other FA, 71.6% asthma, and 48.1% eczema. Overall, 81.1% of children passed OFC with similar pass rates within each food category.
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http://www.aaaai.org/global/latest-research-summaries/Current-JACI-Research/outpatient-open-oral-food-challenges-feasible-an.aspx

Mount Sinai

--- Quote ---The authors reported results of 701 challenges over the 22 month period. 18.8% of the challenges were positive, i.e. elicited a reaction. The challenged foods were common food allergens (in descending order of frequency: peanut, tree nuts, egg, milk, soy, fish, sesame, shellfish, wheat, and others).
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“Food Allergy in Kids Not Being Optimally Diagnosed” 11/14/2011
By Fran Lowry

--- Quote ---Ruchi Gupta, MD, from Northwestern University Children's Memorial Hospital in Chicago
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--- Quote ---Formal diagnoses were most frequently confirmed by oral food challenge for milk allergy (22.4%), soy (19.2%), peanut (16.1%), wheat (15.5%), shellfish (14.4%), tree nut (12.6%), egg (12.4%), sesame (11.2%), and fin fish (9.1%).
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http://www.webmd.com/allergies/news/20090316/sesame-allergies-on-the-rise-in-us

--- Quote ---“Sesame allergies have probably increased more than any other type of food allergy over the past 10 to 20 years,” says Robert Wood, MD, director of the division of pediatric allergy and immunology at Johns Hopkins University School of Medicine in Baltimore.

“They’re now clearly one of the six or seven most common food allergens in the U.S.,” he tells WebMD.
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http://www.livingwithout.com/issues/4_8/sesame_seed_allergy-2025-1.html

--- Quote ---“It’s remarkably common to see sesame allergy and to see severe reactions to it,” says Robert Wood, MD, chief of pediatric allergy and immunology at the Johns Hopkins University School of Medicine in Baltimore. Wood estimates it’s the fourth or fifth most common allergy in his patient population of 4,000 kids with severe food allergies.
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LinksEtc:
"Sesame seed food allergy."
http://www.ncbi.nlm.nih.gov/pubmed/22610362

--- Quote ---Based on the available data, we estimate that SFA affects 0.1-0.2 % of the population, in areas where the food is available. Albeit this prevalence appears to be relatively low, it is approximately one-half of that of persistent cow's milk allergy. While only one fatality has been reported, the significant number of SFA patients presenting as anaphylaxis indicates the potential risk.
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US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. Published in the Journal of Allergy and Clinical Immunology, June 2010.
http://www.jacionline.org/article/S0091-6749(10)00575-0/abstract

--- Quote ---We sought to determine the US prevalence of self-reported peanut, TN, and sesame allergy in 2008
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--- Quote ---A total of 5,300 households (13,534 subjects) were surveyed (participation rate, 42% vs 52% in 2002 and 67% in 1997).
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--- Quote ---Sesame allergy was reported by 0.1% (95% CI, 0.0% to 0.2%).
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"Reported adverse food reactions overestimate true food allergy in the community."
http://www.ncbi.nlm.nih.gov/pubmed/11840177

--- Quote ---There was little agreement between self-reported perceived illness to food(s) known to contain the food allergen of interest, and positive SPT, suggesting that most reactions are not due to IgE mediated food allergy.
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"1 in 10 Americans report food allergies, but questions linger"
http://www.thedoctorschannel.com/view/1-in-10-americans-report-food-allergies-but-questions-linger/

--- Quote ---Nearly 1 in 10 American adults report food allergies, but many of them regularly eat what they say they are allergic to, according to data from the National Health and Nutrition Examination Survey (NHANES).
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--- Quote ---Dr. Keet concluded. “Hopefully in the future we can come up with combinations of questionnaires and laboratory measures that will give us a more accurate estimate of prevalence.”
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Just my opinion ... but my guess is that a lot of people think they have a peanut/nut allergy who don't, making sesame look less significant than it really is in the phone survey. Most people don't usually think "sesame" for reactions unless a doc is involved because this is not a well-known allergen among the general public ... so my guess would be that sesame is not as prone to overestimation in a phone survey as nuts/peanuts are.

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Quoting a friend who I think won't mind

--- Quote ---Yeah-- I'd go with the top allergists' honest appraisal of incidence within their own clinical practices over a phone survey. {sigh}
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LinksEtc:
"Hard to uncover sesame seeds for those with the growing allergy"
BY KATE SILVER
http://www.suntimes.com/lifestyles/23680924-423/hard-to-uncover-sesame-seeds-for-those-with-the-growing-allergy.html

--- Quote ---To further complicate matters, sesame can appear under a number of different names — benne, gingelly, sesamol, sesamolina, sesamum indicum, sim sim, tahini, til or simply “seeds” — so no matter how closely you read the a label, you may not be aware of its presence.
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What do companies tell you about their labeling practices for sesame?

--- Quote from: LinksEtc on April 09, 2012, 10:49:25 AM ---My dd is growing up being taught that we can only trust the labels of some companie s. She knows GM well :heart:

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I still like GM, but I'm taking away the heart

FDA-2012-N-0711-0053

--- Quote ---FARRP would assert that the FDA does not have compelling scientific data on the prevalence, severity and potency of other foods to consider any additions to the existing FALCPA list.
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FDA-2012-N-0711-0062 (GM)

--- Quote ---In addition to our direct comments, we fully endorse comments submitted by the Food Allergy Research and Resource Program.
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How nice it would be if, for once, companies didn't fight some additional regulations. It would be so nice if they said - you know, we support mandatory sesame labeling because we care about our customers and we are committed to their safety. No company likes complicated or excessive regulations, but requiring the labeling of sesame makes sense. Instead of fighting us, why not be true partners with us FA consumers?

2 Strikes.
General Mills now requires disputes to be resolved through binding arbitration

LinksEtc:
FDA-2011-N-0259-0001

--- Quote ---In accordance with Executive Order 13563, “Improving Regulation and Regulatory Review,” the Food and Drug Administration (FDA) is conducting a review of its existing regulations to determine, in part, whether they can be made more effective in light of current public health needs and to take advantage of and support advances in innovation. The goal of this review of existing regulations, as with our other reviews, is to help ensure that FDA's regulatory program is more effective and less burdensome in achieving its regulatory objectives. FDA is requesting comment and supporting data on which, if any, of its existing rules are outmoded, ineffective, insufficient, or excessively burdensome and thus may be good candidates to be modified, streamlined, expanded, or repealed. As part of this review, FDA also invites comment to help us review our framework for periodically analyzing existing rules.
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ID: FDA-2011-N-0259-0046

--- Quote ---As a consumer, I do not find FDA’s existing regulations easy to understand and my experience is that there is not much help for consumers when they have a need for assistance in understanding those regulations.

As part of the transparency initiative, when communicating with industry,
“FDA will also aim to respond to general questions about an existing policy,
regulation, or the regulatory process that are submitted via email, whenever
practicable, within 5 business days or acknowledge receipt of the inquiry and
provide an estimated time for response.”
http://www.fda.gov/downloads/AboutFDA/Transparency/TransparencytoRegulatedIndust%20ry/PhaseIIITransparencyReport/UCM239088.pdf
(page 4)

That is good, but consumers with serious questions have no such guarantee that I am aware of.
I have many very detailed examples of regulatory questions that I have had, but I’ll just go over one here. When trying to figure out if sesame could be labeled as “spice” on the food label, I could not get a straight answer. One FDA representative told me no, one FDA representative said it could be labeled as spice in certain forms (ex – crushed), I have heard of some companies that do label sesame as spice, whereas another company told me that FDA regulations prohibit the labeling of sesame as spice. This was not an academic question for me. I had a very real need to know in order to keep my daughter safe. I have given up trying to figure it out and only rely on the labels of companies like General Mills which voluntarily treat sesame as an allergen
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