Welcome to the ‘holiday season’ – a temporary period of celebration in what has been a bleak year. Although it’s a time to relax and seek respite from the on-going stresses of 2020, news from the FDA hints at the need for continued vigilance. According to the agency, a new food-borne threat has been identified, one that has, until now, lurked in the shadows. It begs the questions: How much do you know about the threats posed by undeclared ingredients in your food? How confident are you about avoiding the ‘big eight’ food-borne allergens? And furthermore: Do you eschew foods with which you are less familiar – those typically consumed, for instance, only during the holiday season? The safety of your holiday plate is today’s focus, as the ‘big eight’ food allergens may – potentially – be joined by a tiny ninth. Read on to learn more…
There was a time, in what now seems like an alternative universe, when grabbing a coffee and a bagel with cream cheese on the way into the office was nothing special. Stop off at your favorite corner coffee shop, nod to the barista, and move on with the day, your usual order of caffeine and carbs in hand. The only ‘challenge’ was deciding on that day’s preference: sweet pops of blueberry or wake-up-the-tastebuds garlic? And if you just couldn’t decide, there was always the catch-all ‘everything bagel.’ But, despite universal protests, we are still in 2020 and bagel grabs are as far off the table as all-you-can-eat dinner buffets.
And maybe that’s not altogether a bad thing. Maybe giving up our boiled and baked morning treat will do more for our general health than just reduce our waistlines. Maybe it could save your life. How? Sesame seeds (and flavoring) are the new food allergy few people have heard of, but the problem is real. And being on the cusp of the holidays, with all of the food-centric activities they involve, we thought a discrete refresher on the 8 major food allergens might be timely. No, we’re not likely to be joining scores of our family and friends for celebratory meals this year, but if food gifts arrive from socially distant relatives, it’s best to know what’s in them that could harm you. So let’s review the List of Eight…
According to the federal Food and Drug Administration (FDA), the ‘big eight’ allergens are milk, eggs, fish, crustaceans, tree nuts, peanuts, wheat, and soybeans.
If a product includes any of these as an ingredient, the Food Allergen Labeling and Consumer Protection Act (FALCPA) mandates that it carries a warning label. A couple of these – peanuts and shellfish, for example – are broadly familiar (and indeed we have written about some of these in the past) and the others are largely unsurprising. But what might be a little more ‘head-scratching’ is the move to add a ninth item to the list: according to an article in Food Navigator, this newcomer to the allergen stage is the humble sesame seed.
In the genus Sesamum, S. indicum is a plant with purple blossoms resembling those of a foxglove. The ‘fruit’ is a green, grooved capsule reminiscent of okra, and houses seeds that spill out when the fruit splits open. But these seeds are small – typically only 2mm in width and 1mm in thickness – and the weight of around 100 seeds amounts only to approximately 0.2g. Yet, in spite of their diminutive size, sesame is prized as one of the oldest known oilseed crops. In wild form, sesame is native to sub-Saharan Africa but, as S. indicum, it is widely cultivated in India, its extensive root system making it a viable, drought-tolerant crop where others fail to thrive. And thrive it most certainly does. According to the Food and Agriculture Organization Corporate Statistical Database maintained by the United Nations, more than 6 million metric tons of seeds were produced globally from more than 11 million hectares of land in 2018.(1) (The FAOSTAT database is rather fun to query as it allows the specification of individual crop or aggregated crop type, production by country or region, year of production, and total yield, production quantity, and area harvested. From agave fibers to yautia (yes, we had to look that up too…), a wealth of crop cultivation facts are at your fingertips. Go ahead and check it out…you’re welcome!)
But why do we grow and harvest more than 6 million metric tonnes of such a tiny seed?
The answer, as always, resides in a powerful nutritional profile, with sesame offering not only an excellent source of dietary fiber, but also cholesterol-lowering lignans and phytosterols. Healthline data reveals sesame to be a good source of protein (5g per 30g serving), iron, copper, and vitamin B6 (beneficial in cell formation), and immuno-supports such as zinc and selenium. The bottom line: ‘Sesame seeds are a good source of healthy fats, protein, B vitamins, minerals, fiber, antioxidants, and other beneficial plant compounds [although only when] regularly eating substantial portions of these seeds – not just the occasional sprinkling on a burger bun.’(2) So nibbling the sesame from the top of your Big Mac bun is just not going to cut it…
Fortunately, they are so easy to add to a diet – in smoothies, baked goods, stir fries, cereals, or salads – that you just might not even notice their presence. And, of course, that’s also the downside: while relatively easy to avoid in whole seed form – grab the onion bagel not the ‘everything’ variety, for example – it is more commonly a hidden ingredient in foods, wellness products, and some pharmaceuticals. In addition to its obvious basis in the creation of tahini (ground sesame paste), it is often incorporated into breads, sauces, dressings, and garnishes especially in traditional Middle Eastern or Asian dishes.
And what is to be expected in cases of exposure to sesame?
In an allergen primer from Healthline, symptoms are typical of the immune system reacting to the perceived ‘threat’ of certain food proteins: nausea, headache, vomiting, flushing of the face, hives, itchiness (especially in the mouth), coughing and/or difficulty breathing, and abdominal pain. And as with the more commonly recognized allergen, the peanut, these reactions can be precursors to anaphylaxis, a potentially fatal multiple organ system reaction that requires quick access to epinephrine (adrenaline) to control. And, of course, a frustration here is that, as the FDA acknowledges ‘[o]ther countries have recognized foods other than the major food allergens, e.g. sesame, as priority allergens of public health importance for which specific product labeling of food source is required.’(3)
Following the announcement of the FDA’s voluntary guidance on sesame, the article quotes Lisa Gable, CEO of Food Allergy Research & Education (FARE) as concerned that the announcement does not go far enough: ‘On behalf of the 32 million Americans who suffer from life-threatening food allergies, and the 1.5 million Americans allergic to sesame, FARE is disappointed in the FDA’s proposed guidance to industry regarding the ‘Voluntary Disclosure of Sesame as an Allergen’ issued on November 10. While the guidance is a step in the right direction, sesame needs to be be recognized as the ninth top allergen and it must be labeled.’(4) Taking a glance at the material, it is hard not to share Gable’s disappointment given that the document is headed as ‘Nonbinding Recommendations Draft-Not for Implementation.’(5) Fortunately, FARE’s argument has proved somewhat persuasive with the FDA which, while noting the ‘a gap in national prevalence data,’ did signal a willingness to review additional information.(6)
And that’s probably a wise course of action. According to a news release by the American Academy of Allergy, Asthma, and Immunology (AAAAI), sesame ‘appears increasingly common among United States children and adults, with new research establishing it as the ninth most common type of food allergy.’(7) In fact, as of 2019, it is estimated that ‘at least 0.2% of children and adults in the United States are allergic to sesame, which approaches the prevalence rates of a number of well-known allergens such as soy and pistachio […] Data collected from the survey also found that over half of individuals with a sesame allergy have received care in an emergency department for food allergy in their lifetime. Another 38% report at least one severe allergic reaction to sesame, with one in three reporting a sesame-allergic reaction that was previously treated with an epinephrine auto-injector. Approximately four in five sesame-allergic patients have additional food allergies.’(8)
Of course it almost goes without saying that, in the current situation where the resources in many hospitals, ICUs, and emergency rooms are drastically over-stretched, it is incumbent upon us all to avoid exposure to anything requiring medical intervention. And most consumers are cognizant of that. But while we all do our due diligence in reading labels and understanding the ingredients in our foods and cosmetic products, we have to trust that the manufacturers do their part too. Taking a cursory glance at the FDA’s updates on product recalls is sobering at any time but in the midst of a pandemic, seeing recalls of products tainted with undeclared allergens or contaminated with pathogens is deeply concerning. For those without a soy allergy, ‘healthy’ foods such as edamame beans should be an easy addition to the lighter meals such as salads that we are encouraged to enjoy in mitigation of our seasonal excesses. But the benefits are negated, in the case of packages retailed at Trader Joe’s stores, when contaminated by the potentially fatal Listeria monocytogenes.(9) And for those of us intent on enjoying the festivities as best we can this year, even the small joys of the season should perhaps be eyed with a degree of suspicion. This week, for example, O&H Danish Bakery, Inc. issued an alert for its Almond Kringle which is also sold at Trader Joe’s. Why? The presence of undeclared pecans resulting from ‘a temporary breakdown in the company’s baking and icing processes.’(10)
A temporary breakdown? Where were the cGMPs, HACCP, and other industry standard safety protocols that serve to prevent this type of error?
It really is a head-scratcher trying to understand how the normal guardrails failed in this situation, and we can only hope that the mislabeling does not result in sickness and that O&H Danish Bakery, Inc. learns a salutary lesson. In the final analysis, although imperfect in many ways, our national system of food safety is robust. Clearly improvements can be made but, as we’ve said many times before, the effort is well worth it. After all, the next time a potentially dangerous food product slips through the safety net, it could end up on your plate. Food for thought indeed.
Food allergens – do they concern you? Do you agree that the regulations regarding ingredient listings should be expanded to include items like sesame? Are you personally affected by food-borne allergens? We’d love to hear your story!