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Bakeries and the 'Sesame Loophole'

Op-Med is a collection of original articles contributed by Doximity members.

Imagine learning that your favorite bakery was adding cyanide to the breads and rolls you love. Outrageous, of course. But now imagine that you have a food allergy, in this case, to sesame, and that your favorite bakery is intentionally adding sesame to its baked goods. Outrageous, yes, but that is exactly what is currently happening

As of January 1, 2023, the FASTER ACT took effect, mandating the labeling of sesame in products. Sesame allergy affects more than 1.6 million adults and children in the U.S., and reactions often include life-threatening anaphylaxis. Affected families celebrated this legislation, knowing now that such reactions may be avoided by checking ingredients. The law protected children, adults, and those who love and care for them. 

Media outlets are now reporting that certain bakeries are actually adding sesame flour to their products. Suppliers to restaurants such as Olive Garden, Wendy’s, and Chick-fil-A admit to this practice. Why would a company intentionally add a potentially lethal substance to its goods? Apparently, the answer is money, plain and simple. Bakeries claim that it is cheaper to just add sesame flour than to clean their manufacturing lines. Yet, other countries with similar legislation, such as Canada, have had no issues with compliance. In the U.S., our bakeries are putting cost over lives. This is bad faith and ultimately bad business. 

Even if companies claim they will be labeling their products as containing sesame, it is clearly unethical to intentionally add a harmful substance. Apparently, corporate leaders have learned nothing from the opioid crisis, where profits came before public health. In the short term, such unethical practices will be profitable, but not long term. Eventually, public trust erodes, and the companies will suffer — financially, and perhaps even legally.

As an emergency physician, I have treated countless patients — mostly children — presenting with serious food allergy reactions. Food allergy accounts for about 200,000 ED visits each year. The addition of sesame to seemingly “innocent” products, such as a Chick-fil-A  sandwich bun, will likely add to these potentially life-threatening episodes. Our children and my patients deserve better from companies that serve an unsuspecting public. As clinicians, it’s imperative that we educate ourselves as well as our patients about this new health risk. 

This so-called “sesame loophole” must be addressed. Patient advocacy groups are already trying to notify Congress and the FDA to address this problem. Physicians must add our voices and our clinical expertise to these efforts. There are personal and public ways to urgently fight this loophole. Patients and families first need to be informed about these new sources of sesame allergy. Public efforts include notifying your members of Congress to act on our patients’ behalf. Pressure can also be put on the companies and organizations, such as the American Bakers Association, that condone these practices — whether it be through email or social media. Physicians cannot be silent and permit risk of an avoidable hazard to over a million Americans. History has shown that public pressure can change corporate policy. For the sake of our patients with sesame allergies, it’s time to stop intentionally adding this allergen.

How will you lend your voice to the sesame allergy fight? Share in the comments.

Bonnie Salomon is an emergency physician with Northwestern Medicine. Her writings, both creative and non-fiction, have appeared in medical journals, newspapers, and book anthologies.

Image by Galiyah Assan / Getty Images

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