Restaurant Food Allergy Awareness
By Michael Pistiner MD, MMSc
Restaurants serve more than just food. They serve an important role in our lifestyle and socialization. According to the National Restaurant Association (NRA), 44% of adults report that restaurants are an essential part of their lifestyle (NRA 2010 Restaurant Industry Pocket Factbook, www.restaurant.org) with 29% saying that purchasing take-out food is essential to the way they live (NRA Top Ten Facts in 2010, www.restaurant.org). Further, 78% of adults report that going to a restaurant with family or friends gives them an opportunity to socialize and makes better use of leisure time than cooking and cleaning up (NRA 2010 Restaurant Industry Pocket Factbook, www.restaurant.org).
People with food allergies have the same psychological and social needs as those without; but their dietary restrictions can make fulfilling some of these needs difficult In fact, a study performed by Cohen and colleagues demonstrated that in families with a child with food allergy, restaurant avoidance is a major reason for reduction in quality of life (Journal of Allergy and Clinical Immunology 2004;114: 1159-63.).
Communication is Key
Research demonstrates a need for improved communication and food allergy awareness in all types of eating establishments, from sit down to take out.
In Furlong, DeSimone, and Sicherer’s "Peanut and tree nut allergic reactions in restaurants study," of those with known peanut or tree nut allergy who had a reaction while ingesting a dish that they ordered, 55% did not notify the establishment of their allergy and in 78%, someone in the establishment knew that peanut or tree nut was an ingredient (Journal of Allergy and Clinical Immunology 2001;108:867-70.).
This drives home the importance of people with food allergies alerting the establishment prior to ordering. Another study, conducted by Ahuja and Sicherer highlights that many restaurant staff feel confident that they can safely serve those with food allergy, while they may not have the knowledge to do so. Annals of Allergy Asthma Immunology. 2007;98:344–348. This is a dangerous combination.
Food allergy advocates have been encouraging legislation directed at restaurant and other eating establishment for years. Yet, until recently there has been no requirement for food allergy education in the United States. That is changing. In February 2011, The Food Allergy Awareness Act will be put into play in over 14,000 Massachusetts eating establishments. They will be required to implement a new set of regulations designed to increase food allergy awareness in restaurants. The new regulations will require 1) menus to remind patrons to alert their server of their allergy, 2) food allergy awareness posters posted in clear view of all staff, and 3) at least one food protection manager to view a food allergy education video. By increasing basic awareness and encouraging effective communication, some reactions may be prevented and eating out will hopefully become less stressful for those with food allergies. For details on this legislation, visit www.mass.gov.
Safety is dependent on the partnership of the patron and the establishment. Continued effective communication (with a manager if possible), vigilance, and wise food and restaurant choices will continue to be necessary for those with food allergies.
If you or a family member have food allergies, check a restaurant’s menu online or call before visiting. Always alert your server or the manager about your allergy. Simple dishes made from scratch are safest. Remember to carry emergency medicine at all times, especially when dining out. And, if there is any question that an allergen-free meal cannot be safely served, then it is best to avoid the risk and politely leave.
Michael Pistiner MD, MMSc
Clinical Instructor, Children’s Hospital Boston, Harvard Medical School
Northeast Allergy Asthma & Immunology
This article was created for and edited by the American Academy of Allergy, Asthma, & Immunology. Used with permission.
You may view the Food Protection Program information on the Mass.gov website: www.mass.gov/dph/fpp
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