The U.S. Food and Drug Administration has issued a draft guidance that will outline the agency’s approach to evaluating the public health importance of food allergens that are not one of the major nine food allergens identified by law in the United States.

The agency is accepting public comments about “Evaluating the Public Health Importance of Food Allergens Other Than the Major Food Allergens Listed in the Federal Food, Drug, and Cosmetic Act” before it begins work on the final guidance. Comments can be submitted at with the Docket ID: FDA-2021-N-0553 within 120 days of publication of the draft guidance in the  Federal Register.

Currently, the major food allergens recognized by the FDA are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans. However, more than 160 foods are known to cause allergic reactions. Among them are sesame, which is scheduled to become the ninth major food allergen identified in U.S. law, effective Jan. 1, 2023.

The “major” allergens must be identified separately on food labels, not just listed in the ingredient declarations.

“The nine major food allergens don’t currently represent all foods nationwide that people are allergic to or that cause food hypersensitivities,” said Susan Mayne, director for the Center for Food Safety and Applied Nutrition. 

“This draft guidance is part of the FDA’s efforts to evaluate emerging evidence about other non-listed food allergens that can cause serious reactions in a consistent and transparent manner, which can inform potential future actions to better help protect the health of consumers.”

Food allergies and other types of food hypersensitivities affect millions of people in the U.S. and occur when the body’s immune system reacts to certain proteins in food. Food allergic reactions vary in severity from mild symptoms, involving localized hives and lip swelling, to severe, life-threatening symptoms, called anaphylaxis, which may involve fatal respiratory problems and shock. Reactions to some non-listed food allergens have relatively low prevalence rates, with some as low as single cases.

The draft guidance focuses on immunoglobulin E antibody (IgE)-mediated food allergies, which are capable of triggering anaphylaxis and are considered the most severe and immediately life-threatening food allergies, according to a statement from the FDA. 

Food allergic reactions caused by the nine major food allergens are all IgE-mediated. The draft guidance describes the approach the FDA generally intends to take when evaluating the public health importance of a non-listed food allergen. It includes a discussion of the evidence that establishes the food as a cause of IgE-mediated food allergy and key scientific factors, such as prevalence, severity and allergenic potency, that the FDA intends to consider in its evaluations. The draft guidance also provides the FDA’s recommendations for identifying and evaluating the relevant body of evidence to determine the public health importance of a non-listed food allergen.

In August 2004, the Food Allergen Labeling and Consumer Protection Act (FALCPA) was signed into law. At that time, eight major food allergens were responsible for 90 percent of IgE-mediated food allergies and were the most common causes of severe food reactions in the U.S. On April 23, 2021, the Food Allergy Safety, Treatment, Education, and Research (FASTER) Act was signed into law, declaring sesame as the ninth major food allergen recognized by the United States.

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