The study's results, published in the peer-reviewed journal Pediatrics, were based on a survey administered to US households between 2015 and 2016, obtaining parent-proxy responses for 38,408 children.
Researchers noted a discrepancy between its findings that 7.6% of US children have a serious food allergy and the 11.4% figure reported by parents, which included non-convincing symptoms of food allergies.
"This discrepancy underscores the importance of improving patient access to physicians trained in the accurate diagnosis of food allergy to prevent placing families under the social, emotional, and economic burden of unnecessarily avoiding foods to which they are not truly allergic. Reactions to food may actually be intolerances or oral allergy syndrome, which are difficult for parents to decipher on their own," researchers noted.
The most common food allergies in the US included peanut (affecting about 1.6 million children), followed by allergy to milk (1.4 million), shellfish (1 million), tree nut (900,000), egg (600,000), fin fish (400,000), wheat (400,000) and soy (400,000). Sesame was the ninth most common food allergen affecting about 150,000 children.
The study revealed findings on food allergy severity: one in five of children needed treatment in the emergency department (ED) in the past year for a life-threatening reaction to food, while 42% reported at least one lifetime food allergy related ED visit. Of the children with food allergies, less than half (40%) had an prescription for an epinephrine auto-injector (EAI) used to immediately treat severe allergic reactions and 20% required a trip to the emergency room to treat.
"Knowing this, it is essential that these children are prepared with an action plan and an epinephrine auto-injector. Only 40% of these children had a current prescription for one," said lead author Ruchi Gupta, MD, MPH, and professor of pediatrics at Northwestern University Feinberg School of Medicine.
Speaking at the FoodNavigator-USA FOOD FOR KIDS summit in Chicago earlier this month, Dr Stephen Taylor from the University of Nebraska Lincoln said that the prevalence of food allergy in children has doubled over the past 10 years, while the severity of cases also seems to be increasing, along with the percentage of children with multiple food allergies.
"There are now two kids with food allergies in every elementary school classroom."
Severity of sesame allergy
While affecting just 0.2% of children, allergic reactions to sesame -- which is not currently one of the 'big eight' (milk, eggs, fish, crustacean shellfish, tree nuts, wheat, peanuts, soybeans) allergens required to be labeled on packaged foods -- were nearly as severe as peanut and tree nut allergies.
According to the study, among the children with a sesame allergy, 64.8% needed EAI prescription compared to 73% of children with peanut allergies and 70.4% with tree nut allergies.
"Our study found that sesame allergy prevalence and severity is comparable to that of other food allergens for which labeling is currently mandated, suggesting that sesame should be included under allergen labeling laws in the U.S., as is already the case in Canada, the European Union, Australia and Israel," said Dr Gupta.
In late October, the FDA issued a request for information (RFI) on the prevalence and severity of sesame allergies to inform possible required labeling for sesame as an allergen. "Unfortunately, we’re beginning to see evidence that sesame allergies may be a growing concern in the US," said FDA commissioner Dr Scott Gottlieb.
The FDA has received a citizen petition from the from the Center for Science in the Public Interest (CSPI), several medical professionals, and two consumer advocacy groups urging it to add sesame to the major allergens list based on the prevalence and severity of sesame allergies.
In the petition, Brian Heller, a parent of a child with a serious sesame allergy who started the petition in 2014, wrote: "It is estimated that about half a million people in the US have severe sesame allergies. If you include poppy seeds, sunflower seeds and other similar seeds (like we do with "tree nuts" as a category), the numbers are much higher. The US lags behind other countries which already require sesame disclosure on food labels, including Canada, and most countries in Europe, Israel, Australia, New Zealand, and many others."
In a statement, the FDA said it is looking to hear from epidemiologists, nutritionists, allergy researchers, and physicians about their clinical experiences and relevant findings.
"We’re also looking for feedback from the food industry and consumers to help us gain a more complete understanding of the risks and to learn more about the potential impact of any future regulatory action that could include new disclosure requirements for sesame," Gottlieb specified.
The comment period for the FDA RFI will close at the end of December before the agency decides on next steps. So far, there have been 785 comments submitted, many from parents of children with severe sesame allergies.