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FARE Blog January 15, 2021

FARE Patient Registry Data Sheds Light on Prevention and Management of Food Allergy Reactions in Restaurants

Reactions in restaurants are common. Restaurant training and patient education are needed to reduce the risk.

A recent research paper based on data from the FARE Patient Registry reveals that food allergy reactions in restaurants are common and that restaurant training and patient education are needed to reduce the odds of a reaction while dining out and improve preparedness to treat reactions. Published in the Journal of Clinical Immunology: In Practice, the study examined survey responses from 1248 adults with food allergy (mostly women) and from the parents of 1579 food-allergic children in the U.S.

Here are some of the key findings:

  • For both adults and children, restaurants are the second most common location for food allergy reactions. Homes are the only location where more reactions take place. Notably, the fraction of food allergy reactions that take place in restaurants is much higher for adults (31 percent) than children (13 percent).
  • Cafes, fast food establishments, Asian restaurants, ice cream parlors and bars are the types of restaurants where most reactions were reported.
  • Peanut, tree nuts and milk were the foods most commonly blamed by patients and parents for triggering allergic reactions in restaurants. Egg was another common allergen for children, while shellfish was a common allergen for adults.
  • Only about half of the customers who had a reaction (53.9 percent) informed restaurant staff beforehand about the allergy.
  • In roughly one-quarter of the reactions (26.2 percent), restaurant menus informed patrons beforehand by listing ingredients or allergens or by including precautionary language, suggesting that greater transparency in menus is even more effective than informing restaurant staff in helping customers to avoid their problem foods.
  • Only 13.7 percent of reactions took place under circumstances in which customers informed restaurant staff about their allergies and menu language informed customers about allergens. While reaction risk was not eliminated by both steps, the danger was clearly diminished by two-way communication between the customer and the restaurant.
  • Nearly three in ten reactions (28 percent) were treated with epinephrine. Two doses of epinephrine were required in 6.2 percent of reactions, highlighting the importance of carrying two epinephrine auto-injectors at all time.
  • The study shows that food allergy reactions can cause serious acute illness. Reactions in restaurants resulted in hospitalization for 6.2 percent of patients, of which nearly one in three was admitted to intensive care.
  • These results likely underestimate the number of reactions associated with restaurant food, as the study includes only those reactions that resulted from dining out. Reactions that result from eating take-out or delivery foods from restaurants are not included.

The paper recommends that allergists should discuss these findings with their patients and that all restaurant staff would benefit from mandatory, regular food allergy training. These insights were made possible by the FARE Patient Registry’s participants, who generously and anonymously share their stories with the research community.

To access the study, click here.

To learn more about FARECheck, FARE’s certified training program for food service staff, click here.

To explore FARE’s educational resources about dining out while managing food allergy, click here.

To help advance research by joining the FARE Patient Registry, click here.

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