Seeds, Spices-Not Always So Nice: A Report on the Food Allergy Research & Education Patient Registry

An estimated 33 million Americans have food allergy. Allergists are seeing an increasing number of patients for allergies to foods once thought to be rare causes of the disease.

This study sought to characterize patient-reported allergies to sesame, other seeds, and herbs and spices in a nationwide patient registry.

Survey data from the Food Allergy Research & Education Patient Registry were obtained for food allergy diagnosis, demographics, and reactions for participants who reported an allergy to sesame, other seeds, and/or herbs and spices.

The dataset included 2,601 participants who reported a sesame (n = 1,195), other seed (n = 968), and/or herb and spice allergy (n = 616). Participants were 51% male and 56% White. Reporting a family income of less than $25,000 and non-White race were significantly more common among those reporting an herb and spice allergy (P < .0001 for both). The top three non-sesame seed allergens were sunflower, mustard, and flaxseed. The top five herb and spice allergens were garlic, black pepper, cinnamon, ginger, and curry. These diagnoses were made at less than age 18 years for about 80% of participants. Diagnosis at age 1 year or earlier was significantly more common among those reporting a sesame allergy (P < .0001). Epinephrine was administered for approximately one third of reported reactions regardless of the causative allergen.

This study presents a large cohort to date of patient-reported non-sesame seed, and herb and spice allergies. The practicing allergist should be aware that allergies to these foods most commonly present in childhood, occur at higher rates in certain racial and economic groups, and can result in anaphylaxis requiring epinephrine.