What's allergenic in hummus?
In recent years, hummus has not only become fashionable, but also available in almost every shop. As a result, it has started to feature more and more on our plates. It is included in the diet of children from the age of one year old – not only in the Middle East, but also in Europe.
This popular dip is a mixture of cooked chickpeas, tahini sesame paste, olive oil and lemon juice enriched with the flavour of oriental spices [1].
Hummus can be bought (or prepared yourself) in various flavours. In addition to herbs and spices, you can add, in a variety of flavours, e.g. olives, sun-dried tomatoes, peppers, beetroot. It is also available in a sweet variant – with honey, dates or peanut butter. Such hummus can be eaten not only – as it is usually the case in Middle Eastern countries – with falafel (i.e. fried chickpea balls). It also goes very well with pancakes, cakes and other dessert dishes [1].
It is a very nutritious addition to bread (traditional and crisp), as well as to sliced vegetables (carrots, peppers, cucumber) and even to pasta [1].
It has been shown that people who eat hummus – compared to those who do not – have a diet richer in numerous nutrients. These primarily include dietary fibre, polyunsaturated fatty acids, folic acid, magnesium, iron, potassium and vitamins (A, E, C) [2].
Regular consumption of hummus can play an important role in weight control and blood glucose regulation, as well as reducing the risk of cardiovascular disease [2].
Hummus and the risk of allergies and anaphylaxis
However, people with food allergies should be very careful with this delicacy – mainly due to the sesame and chickpea content. The spices can also turn out to be insidious.
Sesame
The results of a study among paediatric patients in Canada say a lot about this. Researchers showed that hummus was the main trigger of anaphylactic reactions in children allergic to sesame [3]. Between 2011 and 2021, sesame contributed to 4% of all food-induced anaphylaxis in the study group. Almost 60% of these occurred after hummus containing sesame paste [3]. This potent allergen in an allergic person can cause symptoms even when a minimal amount is present in the product [10]. This is why accidental exposure to sesame is so dangerous.
Chickpeas
Also chickpeas, the main ingredient in hummus, are among the food allergens. It is even one of the most significant allergens in the Indian subcontinent [5]. It is the staple legume in the diet of the average Indian. In addition, allergy to chickpeas (and lentils) is relatively common in Mediterranean countries and Central Asia. The area of incidence of allergy to the closely related soya bean, which belongs to the so-called big eight food allergens, is slightly different [6].
Legumes can cause immediate hypersensitivity reactions. Interestingly, chickpeas cause virtually no gastrointestinal symptoms. Screening studies from India have shown that respiratory (shortness of breath, wheezing, coughing) and skin symptoms (urticaria, angioedema) predominate in people with chickpea allergy. Anaphylactic reactions were observed in 3.3% of subjects [5]. It was also found that even inhaling the fumes from cooking chickpeas was sufficient to trigger severe asthma attacks [5].
Spices
Hummus owes its original flavour to spices such as black pepper, allspice, cloves, cinnamon, ginger, nutmeg, cumin and cherry seeds. It is also seasoned with garlic and coriander [7]. Unfortunately, in sensitive people, rich spice blends can cause allergy symptoms. Some are associated with the mugwort-selery-spice allergic syndrome. This syndrome affects herbaceous plants of the Apiaceae family such as celery, parsnip, carrot, but also cumin, coriander, fennel [11].
Cross-reactions
It is important to note that a cross-reaction to the chickpeas contained in hummus can occur in people who are allergic to soya, lentils, peas and even hazelnuts [8]. It also cross-reacts to sesame – with a variety of nuts: peanut, hazelnut, walnut [9]. 13-25% of people who react to peanuts also have symptoms after eating sesame [9].
Post-exertional anaphylaxis
Furthermore, episodes of post-exercise anaphylaxis (FDEIA) have been linked to hummus. For example, a case has been described of a 17-year-old girl who ran on a treadmill about 10 minutes after eating hummus crackers. Over the next 10 minutes, she developed swelling of her lips. This was followed by periorbital swelling, urticaria, abdominal pain and generalised pruritus. The girl rushed to the emergency department. She had eaten hummus many times before and had not experienced any reaction from it. She had also never experienced an anaphylactic reaction [4]. Hence, we conclude that the causative factor, and in fact the relevant cofactor, here was exercise.
Aleksandra Lipiec
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translation: Julia Majsiak
