TOPLINE

Allergies to sesame, non-sesame seed, and herbs/spices often present in childhood, occur at higher rates in certain racial and economic groups, and can lead to severe reactions that require epinephrine.

METHODOLOGY

• To better understand the clinical burden and effect of certain rare and understudied food allergen groups, researchers analyzed data from 2601 participants with sesame, non-sesame seed, and/or herb/spice allergies between August 2017 and July 2025, from a US-based registry of such allergies.
• Participants completed surveys on demographics, history of food allergy, including tree nuts, non-sesame seeds, and herbs or spices, food allergic reactions, and quality of life.
• Researchers assessed demographic patterns; diagnostic characteristics; reaction severity, including severe reactions requiring epinephrine use; and effects on quality of life across the sesame, non-sesame seed, and herb/spice allergy groups.

TAKEAWAY

• Most participants (75.3%) reported allergies confined to a single allergy category. The most commonly reported non-sesame seed allergens were sunflower seeds, mustard seeds, and flaxseed (reported by 28%, 19%, and 14% of participants, respectively).
• Participants with sesame allergy alone were more likely to identify as White than those with herb/spice allergy alone and to report a higher family income (P < .0001).
• Healthcare providers made most food allergy diagnoses — 89% for sesame, 81% for non-sesame seeds, and 78% for herbs/spices. Diagnosis before 1 year of age was more common in participants with sesame allergy (18%) than in those with non-sesame seed allergy (7%) or herb/spice allergy (2%; P < .0001 for both).
• Epinephrine was reported to have been administered in 42% of participants with only sesame allergy, 40% with only non-sesame seed allergy, and 29% with only herb/spice allergy (P = .05).

IN PRACTICE

“Our findings underscore the need for greater clinician awareness of seed and spice allergies and for proactive patient and family counseling to prevent, recognize, and manage reactions to these allergens,” the authors wrote.

SOURCE

Carolyn H. Baloh, MD, with Brigham and Women’s Hospital, Boston, was the corresponding author of the study, which was published online on July 7 in The Journal of Allergy and Clinical Immunology: In Practice.

LIMITATIONS

The registry was based on participant-reported data, which may introduce bias and recall errors. Not all reported allergies were verified by an allergist.

DISCLOSURES

The study received support from the National Institutes of Health and the Immune Tolerance Network. One author reported serving on scientific advisory boards for multiple pharmaceutical companies and receiving research funding from one of these companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.