8 Essential tips for dining out with an allergy

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Food allergies can sometimes turn eating out from a treat into a task.

Choosing from a narrow list of restaurants, then selecting from an even narrower list of appropriate dishes, sending the wait staff back and forth to the chef to check what sauce is made of what, and then relying on these requirements to be observed as food is prepared in the kitchen; in past years, eating out has been quite the trepid adventure for some with a food allergy.

But thankfully situations like the one described above are in a steep trend of decline. Restaurants and eateries are on the whole becoming more accommodating to those with allergies, and more willing to make adjustments to their dishes.

It’s a welcome and liberating development for those with food allergies. But it’s worth noting that making menus accessible to allergic customers stands to benefit restaurants too.

In 2013, the World Allergy Organisation reported that the number of people living with a food allergy worldwide could be somewhere between 240 million and 550 million. On a planet of roughly 7.1 billion, that’s between 3 and 8 percent of the population.

This isn’t a segment that restaurants can afford to neglect, so while catering to those with allergies makes sense from a PR perspective, it makes sense from a business perspective too.

While the restaurant and grocery trade is now undoubtedly more mindful of food allergies and intolerances, it is still important to be vigilant, and aware of the risks of eating in an environment where an allergen may be present.

Continuing our ongoing allergy coverage in support of Allergy Awareness Week, we thought it might be interesting to take a look at what measures those with food allergies can take to reduce their likelihood of exposure to an allergy when eating out, and make their dining experience a stress-free and enjoyable one:

1. Let the staff know about your requirements

The people are responsible for preparing your food need to be informed about your allergies in any case. Even if the dish you’re ordering doesn’t contain the food you’re allergic to, the kitchen and servers need to know so that they can do whatever is necessary to limit the risk of cross-contamination.

Ideally, this should start not with your server, but with the very first member of staff, you speak to when entering the establishment. In some restaurants bread or complementary sides may be brought over before you order; so it’s important to make the staff aware of any wheat, seed, or nut allergies prior to these items arriving, just to be on the safe side.

2. Don’t make any unnecessarily risky choices

The restaurant trade may no longer be a no-go area for people with food allergies, but this doesn’t mean those with sensitivities to certain types of food can afford to fly in the face of caution.

It might seem like stating the blindingly obvious, but those allergic to shellfish for example should remember that seafood restaurants present a significant risk. It doesn’t matter if you’re only intending to go as a one-off for a friend’s birthday meal and order the chicken; for those with a fish allergy, a seafood restaurant still going to be an allergen-laced environment, and likely worth avoiding.

Those with allergies to fish or sesame should also tread incredibly carefully in sushi restaurants, or again steer clear altogether.

Similarly, if you’re allergic to nuts, try to stay away from street stalls and vendors who sell open containers of these alongside other items, as the likelihood of cross-contamination is particularly high.

This also applies to ice cream stalls usually found at the shopping center or the cinema. Between customers, servers may only rinse scoops in water as opposed to thoroughly cleaning them, which is again something for those with nut allergies to consider.

If there aren’t cross-contamination control measures in place and you can’t be sure you’re going to avoid your allergen, don’t risk it.

3. Beware of buffets

There are a number of potential hurdles someone with a food allergy faces when visiting a buffet. Among these are:

food being incorrectly labeled or not labeled at all
items being kept close to one another, with accidental spillages leading to cross-contamination
serving tongs and spoons being mixed up, again leading to cross-contamination
ingredients of food items not being listed on the menu

Some buffet restaurants are more vigilant at policing their spreads and preventing cross-contamination than others, but the fact remains that this type of dining suits those without allergies better than those with them, due to its nature of unpredictability.

Ordering from the menu affords the allergic diner more control, and this is certainly something for those with severe or life-threatening anaphylactic allergies to consider instead of the buffet.

The Pick n’ Mix section at the cinema also gets a mention here; as again, the self-service nature of it makes it a high cross-contamination risk.

4. Don’t be afraid to choose a chain when on holiday

We’re not suggesting that independent restaurants aren’t able to cater to those with specific dietary requirements; many in the UK do and some may even specialize in serving up free-from foods, and catering specifically to those with certain allergies or food intolerances.

But when traveling abroad, chain restaurants are often a less risky option for those with allergies. They’re more likely to have an operational framework in place to deal with certain allergies than smaller independent eateries. Furthermore, staff will be required to prepare dishes to designated specifications, and less inclined to experiment with new ingredients or improvise.

So however much you may want to support local or family-run businesses, it’s important to keep your well-being in mind. It might feel like a copout heading into a well-known chain when on holiday, but if it’s the safest-looking option available, stick to what you know.

5. Keep your medication with you at all times

Those with anaphylactic allergies will typically be advised to carry an EpiPen on their person when they go about their daily routine. This is just as essential when going out to eat, as the likelihood of encountering or ingesting an allergen is increased.

It’s vital to let the wait staff know if you have an anaphylactic allergy, not only so that they can take the appropriate measures to limit cross-contamination with an allergen during food preparation, but also (particularly if you’re dining alone) so that the nominated first-aider can be ready to administer your EpiPen in the event that anaphylaxis occurs and you’re unable to administer it on your own.

6. Avoid the deep-fat fryer

There might be no mention of seafood in the description of your deep-fried chicken dish on the menu. But those with allergies should be aware that many kitchens may only have one or two compartments in their fryer. In some cases, those serving deep-fried seafood items will fry them in the same oil as their meat (and potentially even their vegetables too, if only one compartment is present).

If there’s a deep-fried dish you like the look of, check with your server whether any fish products are fried in the same oil before ordering it. Alternatively, you might think about choosing something non-deep-fried, just to play it safe (and save yourself a few calories into the bargain).

Grills can often be another hazardous area, particularly if the restaurant serves a selection of barbecued seafood items. Again, it’s better to ask questions first than risk it, and if you aren’t sure, go for something else.

7. Remember that the simplest choices are the safest

It’s common now for restaurants to offer their signature dishes with small modifications made in order to cater to those allergic to specific ingredients or items used in the cooking process.

But keep in mind that the more changes that need to be made to a dish to make it safe, the more room for error there is. Particularly in severe allergy cases or where several alterations need to be made to a dish, keeping things simple and selecting a more suitable something else is often a safer option.

8. Pick your time carefully

Once again it may seem like stating the obvious, but the busier your restaurant is, the more likely the staff are to be rushed and prone to making mistakes. For the diner with an allergy, this makes contact with potentially harmful foods more likely.

Going at a quieter time will allow you to have a conversation about your requirements with your server, and mean that the line of communication between staff is less susceptible to errors.

Which hours are the busiest in any given restaurant is obviously subject to the locality, type of food, and several other factors, but in most cases, the hours of 12-2 pm and 7-9 pm are peak times, and evenings will be particularly busy at weekends. The late afternoon and early evening hours during the week are usually much quieter periods.

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Tom Perry, M.D., attended Tulane University and graduated Magna Cum Laude with a B.S. degree in Parasitology. He received his M.D. degree in 1983 from the University of Virginia School of Medicine, where he gained extensive research experience, including studies conducted through the National Institutes of Health.