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Israel’s food allergy conundrum: why sensitivity to sesame but not peanuts?

Published Online: August 18, 2020

Worldwide food allergies are prevalent and on the rise. A previous cross-sectional study in Israel estimated the prevalence of food allergies in young children to be at 0.85%. Studies performed almost two decades ago showed that the prevalence of sesame allergies was high, while the prevalence of peanut allergies was low. It is not known if this trend continued, nor why the disparity was observed because both foods are common in the Israeli diet.   

A study recently published recently in The Journal of Allergy and Clinical Immunology: In Practice, reported the current food allergy prevalence in young Israeli children, explored the stability of the sesame-peanut disparity, and addressed possible explanations for the disparity.  The study was led by Professor Aharon Kessel from Bnai Zion Medical Center, a teaching hospital affiliated with the Technion School of Medicine in North Israel. He and his team screened families from a high attended/high volume government healthcare center. For some children, a telephone interview sufficed. In other cases, these were complemented by more thorough assessments, including skin prick tests and oral food challenges.

The study revealed a substantial increase in the prevalence of food allergies among young children, with prevalence rates rising over the intervening 18 years increasing from 0.85% to 2.8%. More specifically, of the 1932 cases examined (mean age of participants = 22.4 months [range 18–30 months]), 54 participants (56% of them males) exhibited at least one food allergic reaction (with a total of 75 food allergic reactions identified). As previously observed in 2002, the prevalence of sesame allergies was high (0.93%), while the prevalence of peanut allergies remained low (0.2%). The authors suggest that one possible explanation for this disparate sensitivity may be genetic vulnerabilities and protective factors. However, they also raise the possibility that the findings may stem from the widespread popularity and heavy consumption of a peanut snack (Bamba®) among young infants. In contrast, Israeli infants’ consumption of sesame-based products might begin later and be limited to smaller quantities.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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