|
|
Eating Out and About with Food Allergies
Compiled and written by A.
with input from FAST members
Edited by Melissa Taylor
Note
This article is intended to help food allergy sufferers make important decisions when
ordering food in restaurants, through takeout, and from any other source away from home. It is
risky in any situation where someone else prepares your food. It is important to
remember that most cases of deaths from food allergies are caused by commercially
prepared foods.
The details in this article have been gathered from the wealth of
information from personal experiences of FAST members. While the information contained
here is mostly from personal experiences, it in no way is an indicator or guarantee
that all food is safe in all locations. Be sure to read labels whenever possible, and
diligently check with your server or chef at any eating establishment--each and
every visit.
Before We Begin
Most food allergy deaths in a recent study occured as a result of dining out in
restaurants. You can read the abstract of
"Fatalities due to anaphylactic reactions to foods" at
http://www.foodallergy.org/Research/publishedresearch.html, a bit
here: http://allergies.about.com/cs/anaphylaxis/a/aa012201a.htm,
or look for the entire article at your local library. Here is the full citation:
Fatalities due to anaphylactic reactions to foods
Bock SA, Muñoz-Furlong A, Sampson HA
Department of Pediatrics, National Jewish Medical and Research Center and University
of Colorado Health Sciences Center, Denver CO
Journal of Allergy and Clinical Immunology 2001; 107(1):191-3.
This article mentions that only five of the fatalities studied
occurred in the home--the rest were from eating food prepared by
others.
Good Experiences
While the stories of loss can strike us all as horrifying, individuals with food
allergies have also had wonderful experiences when dining out.
Participant Miriam Breslauer shares one: "My husband and I traveled to San Diego and
stayed at a hotel with a restaurant. The waitress quickly discovered that I had food
allergies. She made sure she had a complete list of my food allergies and took it to
the cook. Nothing on the menu was safe. So the cook created new fancy recipes on the
fly just for me. I really wish I had asked for copies of those recipes. One involved
steak, portobello mushrooms, and a few other ingredients."
Rowan says, "There is a Mexican restaurant I was at with a
friend who is allergic to pork and dairy, and gluten intolerant. We hadn't eaten in
many hours. The waiter, who was apparently the owner, went out of his way to answer
questions and point out that most of their dishes contained ground peanuts. It turned
out that the only thing I could eat was boiled pinto beans, but I really appreciated
his helpfulness."
Which Restaurants?
Some FAST members have discovered specific restaurants where they can eat. Some are ethnic
food restaurants with non-traditional ingredients, while some are names we all know, with
standard dishes. Because we all have different allergies and are in different
locations, it is very important to double-check with your local server or chef about
the ingredients in each and every food. Many chain restaurants use different
ingredients in different location or on different days!
Here are some ideas, provided by members.
Miriam Breslauer finds ethnic restaurants to be helpful for her in avoiding her specific
allergens, which she feels are more prevalant in American cuisine. "I also try to
avoid restaurants that aren't clear on ingredients, are known for creating random
marinades, or cook foods that have a high percentage of my food allergens. I do
believe that most restaurants are not food allergy safe, but I have found a few safe
types that I can depend on when I am desperate. It usually costs more. I order items
on the menu with the fewest ingredients." Miriam is also careful about the way things
are prepared. "Grilled, baked, and steamed are usually the safe words for me. I
always ask the staff about marinades, butter, and oils that might be used."
Traci Thomas also asks about preparation; she orders, specifically "steamed veggies,
baked potatoes, grilled chicken."
Unlike Miriam, another participant, who wished to remain anonymous, does not eat out
in ethnic restaurants. However, there is an exception in the case of "kosher ones,
because my serious allergen is not kosher, so anything kosher is safe for me."
Rowan says, "I try not to eat out unless it's unavoidable; no matter how careful you
try to be, it's always a bit of a crapshoot. There are basically only
three items in restaurants that are fairly consistently safe for me:
plain salad (no dressing or croutons), pinto beans (the boiled ones, not the refried
ones) in Mexican restaurants, and hamburger patties,
depending on the specific restaurant, though these can be risky."
An anonymous participant shares about finding safe restaurants: "I also try to find
'safety' restaurants where I know I can always
go, and where the food is inexpensive so I can go any time. For me, one
place is a small barbecue joint, because they don't serve shellfish, and
the other was an Italian place that served shellfish but always gave
me a safe order and a large enough portion that I had dinner the next
night too, and the food was good."
Questions to Ask
After looking at a restaurant menu, you may feel that you have some choices to
pick from, but there are a few things you need to know before ordering. Sometimes it
is difficult to ask questions. How do you ask? Here some tips from FAST members.
Take along an understanding friend, or friends, who knows about your allergies
and will back up your requests, as well as remind you when you are not being cautious
enough. This is especially important in case of a surprise allergic reaction.
Talk to the waiter or waitress first. Miriam Breslauer recommends saying the
following to him or her: "I would love to eat _____, but I have the following food
allergy concerns. Could I please talk to the chef to find out if these ingredients are
not in the dish? Thank you for this extra effort." Miriam says, "Be polite and
friendly. Smile. Be apologetic. It really is a pain for them to look up all this
information (even if it is part of their job description)."
Miriam Breslauer recommends talking to the chef as well. "That is how I find out
how few dishes at any restaurant are likely to be safe for me."
An anonymous participant also adds that you be sure to "ask about the preparation
areas. Do they have separate grills? How close
are the sauté pans to each other (since oils and fat can 'jump' from
pan to pan in high heat)? I've found that if I explain carefully what I need, and
explain that I'm not doubting their competence but that I would rather be overcautious
because of how sensitive and severe the allergy is, chefs and managers are very
willing to spend an extra few minutes with me. They answer my questions and provide me
with additional information and assurances. I've been to two restaurants where the
managers were very honest and said, 'You know, the way our kitchen is designed, I can
really only guarantee a salad will be safe. I'm sorry but I wouldn't want you to have
a reaction.' It's always disappointing, but I'd much rather have that honest response
than a reaction."
Traci Thomas has found that restaurants may even let you into their kitchen area.
She checks kitchens in order "to assure there will be no cross-contamination. I have found
that most--and I say most because we have come across those that do not understand the
severity of food allergies--people are more than willing to accommodate us."
Another member, who didn't want to be mentioned by name, recommends speaking to
the manager. "I've found I have fewer reactions
when I do so. The way I approach this is that when the waiter takes
our drink orders and says, 'I'll be back to take your orders,' I say,
'Actually, I have a food allergy and I'd prefer to order with the
manager,' with a smile on my face. They never say no." One member has noticed that "I
have fewer reactions when I order with the manager. Waiters and waitresses just take
orders and attempt to explain what I have to the chef. Manangers know more about the
food and kitchen, and they may have had some training about food allergies and
understand what you're talking about."
Other Tips
Carry an allergy card with you; member One member has found this to be very beneficial.
"I modeled it after one I found for free
on the Mayo Clinic Web site. It lists what I'm allergic to, including all the strange
names for the foods. On the other side it explains how to prepare safe foods for me by
using clean pans, clean utensils, etc. I
laminated the cards and keep several in my wallet, because sometimes they don't get
returned to me. I give the card to the manager as well."
An anonymous member recommends keeping a log of where you eat. She lists "what I
ate, when I ate, where I ate, whether or not I had a reaction, and--if so--how severe,
and any other notes. I'm hoping that after a longer period of time, I'll be able to
pick up a pattern or two that
will help me be even more reaction-free."
Even if you find out something sounds safe, remember that food in restaurants may
contain "natural flavorings." According to Melissa, "restaurant workers don't
know what the natural flavors
are (that's one reason not to trust wait staff about what ingredients are in a food."
Rowan also says that "it's rare for the
staff to know what's in the food, and often they can't really find out."
Take note of the time you decide to eat out. According to one member,
going to "a popular restaurant in the heart of the city at 8 PM on a Friday or
Saturday night is a terrible idea. The staff and kitchen are too busy to give an
allergen-free meal the time and attention it needs to stay uncontaminated. If I do
expect to be there at a busy time, I always speak to the manager on the phone ahead of
time and check to see if I can be accommodated at that time."
Special Events/Catered Events
It never fails: happy events, occasions, and holidays are always celebrated with food.
How do you party without worry? Do you bring your own food? Get a "special" meal? Stay
home?
At some parties and events in restaurants you can bring things to supplement
the main dishes. Have you ever been to a catered event where the desserts are all
homemade? Try bringing along your own safe dessert. Parties in private halls often
have food that is both homemade and catered or brought in. Check with the host and be
sure to bring enough to share, perhaps posting a little sign that lists the
ingredients. For all you know, other people may have diet restrictions for a variety
of reasons, too. I bring guacamole. Who can resist homemade dips and a bowl of chips?
Then you can join the munchers, too. Salads work great at potlucks, as
well.
Rowen has noticed this trend! "Lately, when I go to parties, I’ve had to
start bringing enough to share with everyone, because the people I know have fallen in
love with my cooking! Most of them don't even guess that it's not normal food. I often
take deviled eggs, made from a recipe I've adapted for myself. It's gotten to the
point that people have started demanding deviled eggs now! On Christmas Eve I went to
a party where I brought smoked salmon and trout, rice crackers, fruit and vegetable
trays, and some chocolate to share with all my friends. For
Christmas day there was a potluck, and I brought roast lamb with garlic and herbs (so
yummy!), salad with homemade dressing, and more deviled eggs."
Miriam Breslauer takes along trays of sandwiches to the parties she attends.
There is always the supplement trick. Order something safe and add a few things, such
as homemade croutons, crackers, or safe bread. When my friends order from the good
deli, I get a quarter pound of my favorite cold cuts or cheese, lettuce, and tomato on
the side, and make a sandwich. Rowan says, "If there's an event at a restaurant, I
will often order a green salad with no dressing or croutons (a bowl of lettuce,
basically), as that seems to be the only thing on most menus that is likely to be safe
for me. I bring my own dressing
and some stuff to add to the salad so I get a whole meal out of it. Meats, poultry,
beans, and such can just be marinated in the container of salad dressing to make a
full meal."
At catered events it can be difficult to get a meal specially prepared for you. Here
is what some FAST members do:
"I ended up not eating anything at one large catered event. In the
future I'm going to try calling ahead to make sure they save
some fridge space for me. I'll bring my own food and let them hold it
in the kitchen so I can then eat with everyone else," says one member.
An anonymous member says that, "For catered events that are not really big, I
talk to whoever's hosting the event, get the name of the caterer ahead of
time, and call. I recently went to a conference, and the chefs
at each restaurant/hotel had a meal set aside for me that was prepared
separately."
An anonymous participant recommends avoiding buffet-style catered food. "Other
people mix things. Plus, with multiple large dishes there are too many cooks working
on
them for them to all know how to keep mine safe."
Anna Marie opted to just take her own food to a wedding reception she attended.
Be sure to ask ahead of time if you plan on bringing along your own food to
restaurants and events. Some companies, restaurants, and local guidelines may not
allow it.
If You Can't Eat Out
Due to multiple or severe allergies, eating out is not a safe or viable option for
everyone. Nevertheless, you can still "eat out" and have fun doing so--no matter how
you do it! Following is what a couple members say about not eating out the more
"traditional" way.
Anna Marie doesn't eat out. Instead, she says, "I picnic wherever I
go--no matter what the weather."
Melissa Taylor has a similar experience. "A lot of people on FAST had recommended
getting a fun lunch bag. That sounded kind of silly to me at first, but now I have
three--and they were right! Each one is a different style and size, with a
different animal motif (can you tell I like animals?).
One of my lunch bags holds enough for two people; I used to use it as
a mentor, taking food along to the park with my 'little sister.' It
was a lot of fun, and gave me a sense of normalcy. Instead of
going through a drive-through when out, I have a bag full of goodies!
I really like having a few lunch bags to choose from. Sometimes for
me, making the food--or what it's held in--just a bit different
helps so that it doesn't become mundane."
Bad Experiences
Sometimes it is just not easy getting your point across. Or sometimes, no matter what
the staff says, reactions happen. In fact, one kind visitor to the website shared an
experience about losing her sister to a fatal reaction with FAST. You can read it at
https://www.angelfire.com/mi/FAST/fatality.html.
Here is what some members say about their less serious--but still
dangerous--experiences. Perhaps their experiences will help you to be safe when
choosing--or not choosing--a particular restaurant.
Sadly, no matter how hard you try, the wrong order may arrive. Sometimes kitchens
are
busy, servers are lax, and the dish is obviously prepared with ingredients you asked
the staff to leave out of it. If the order is wrong, an anonymous member suggests
that you "Keep the dish that's wrong at your table instead of sending it back,
and say that you need a new one prepared correctly, and you'd like to
keep that one in front of you until they bring the new one. That way
you know they didn't just scrape something off." Be very careful; Melissa says, for
example, that someone she knew asked for peanuts to be
left out of a food, due to a peanut allergy. When he was served the food, it arrived
with peanuts. Rather than return it, he went ahead and ate it after picking out the
peanuts. This sends a bad message to the restaurant and may make eating there in the
future more dangerous for you--or even for others with allergies, especially those
with more severe reactions. Be aware of the message you send to the waitstaff in the
way you handle a wrong order. Be firm that you need it replaced with new food and
cannot eat something that has even been "touched" by an allergen.
During the day, Sue attends drop-in centers. "While they’re not actually restaurants,
I have asked what is the food policy. Unfortunately, I have been treated like I have
some sort of problem. I have not asked that people do not bring in their homemade
food, but rather that there be a specific snack area. The fact that this is
life-threatening should be taken into consideration. The teachers have reacted like
I'm overreacting, and say they have asked people to stop letting their children walk
around with food, but there is nothing they can
do about it. Needless to say, I have to watch my daughter like a hawk.
In contrast to Miriam's positive experience, another member says, "my allergist told me to avoid ethnic restaurants." If there is a language barrier, it may be difficult to explain your allergies sufficiently. The member goes on to say, "It's often
difficult to communicate what you need to
restaurant staff; in this area many of them speak very limited English, and I'm not fluent enough
to explain my allergies in another language." Ethnic restaurants may or may not be a good choice; they may work for some, but not others. Take into consideration the ingredients, preparation, staff, and size of the restaurant before
making a choice. Foods from different
cultures sometimes contain
nontraditional ingredients that may work for some people, but are nevertheless not guaranteed to be safe unless
you prepare them yourself.
Rowan feels that, "bad experiences are unfortunately the norm. Very few places
actually manage to get
a special order right. I've had to send things back two or three
times. Sometimes I could see that they'd merely scooped off the part of
the food that had been covered with cheese, and they acted like I was
being unreasonable for saying I still couldn't have it. This happened so
often that I pretty much gave up on eating out."
"I was at an upscale restaurant," one anonymous member begins the story, "because
a family friend was in town on
business and wanted to take me out to dinner to a place I wouldn't
treat myself to. I ordered with the manager, and as I was explaining
my needs he was like, 'Oh? Really? Um, OK, sure we can do that.' I got
the impression that he had no idea what a food allergy was, but I
thought with his emphasis--as well as the card I carry to be given to
the chef--I'd be okay. The friend I was with ordered an appetizer
for himself. Ten minutes after he finished and they took it away, a
server brought him another one. This was a red flag, because the kitchen didn't know
what they were doing! At this point, I was thinking this might not turn
out well, but the order was in and I wasn't sure what to do about it.
The food arrived, and it was delicious, but before I even finished eating it
my neck got itchy and my tongue started swelling. The restaurant
comped both our meals, but I would rather not have had a reaction
and enjoyed the evening! What upset me was that the
manager said it could be taken care of."
Miriam Breslauer shares another story of a bad experience. "Chain restaurants with
typical American food tend to cause me problems. I got pressured into going to
one, even though I said it wasn't safe for me. I tried to eat the safest thing on the
menu for me, but it was marinated, bun grilled, and it seemed like something else was
'off.' I didn't refuse to eat it, because it had been over six hours since I last ate
(including three hours of waiting to eat at the restaurant). I was going to pass out
due to not eating
and was in bad shape from a few other things. Anyway, I ate guaranteed trouble.
Sure enough, 15 minutes later I had a bad allergic reaction. I then spent the rest
of the day in the house.
I didn't prepare in advance to actually bring safe food for me to eat. I treated this
bad experience as a reminder to not count on others having allergen-free food
available."
Whatever you do, don’t challenge your allergens (per allergist recommendation)
with foods that you haven't prepared yourself. Tricky ingredients like natural
flavorings may confuse you and your body. Melissa
reacted to restaurant French fries when she "tested" potatoes. The restaurant in
question later admitted that both dairy and wheat products are present in their fries.
Convenience Food/Desk Drawer Stuff
Sometimes our desire to eat out is because we don't have convenient food readily
available. As some members have discovered, owning a lunch bag or other picnicking
supplies can be very beneficial to those with allergies. However, you can also stash
away supplies for when all else fails and you forget to pack a lunch! Keep an
emergency stash at work, in your car, or other places you might be when the munchies
hit. Here are some suggestions; adapt them as needed to fit in with your own
allergies. Especially look for any products that have a long, extended shelf life.
Breads
Baby food
Canned fruit
Cheese snacks
Corn chips
Crackers
Granola bars
Oatmeal
Potato chips
Rice Chips
Members have found this type of stashing away to be very beneficial. An anonymous
participant carries around granola bars, finding "the right brand can be filling
enough
to hold me over till I can get more food." Rowan says, "I'll have rice crackers, or
jars of baby food meat (there's one brand that doesn't have cornstarch in it), oranges
or grapefruit." Miriam Breslauer recommends canned fruit, which she says "stays good
in your work drawer for a long time. I have done this for years." Anna Marie's
husband keeps heatable cups of soup "in his desk at work. Maybe you can find
some that doesn’t have your allergens. There are also a lot of canned
soups that don't require having any water added and are one serving."
Resources
If you can check menus online you will know ahead of time what you can order--or be
prepared with questions (be aware that not all ingredient listings are complete, and
may only be geared toward those with the eight most common allergens). Always
double-check with your server or chef to find out if the ingredients differ from what
is posted at restaurant websites.
One member says, "I always search the Internet ahead of time for ingredient listings.
Sometimes I can tell by
looking at the prevalence of my allergen on the menu that it's too
risky to go. Online menus are a great gauge for me. For places that don't list
ingredients,
I've been known to ask to look at a menu before being seated, just to
make sure I'm comfortable staying there."
Before beginning your online search, there are some things you may wish to know:
The new labeling guidelines in the United States are only for packaged foods, and
restaurants do not need to comply. Ingredients may be in the food without your being
informed, such as in the case of natural flavorings or cross-contamination. You can
never be 100% sure in a restaurant that your allergens are not in a food you eat.
The Gluten-Free Restaurant Awareness Program (GFRAP), developed by the
Westchester Celiac Sprue Support Group (WCSSG), is a great resource. Participating
restaurants will be able to prepare gluten-free meals in addition to their regular
meals. To access a database of restaurants participating in the program, visit:
http://www.glutenfreerestaurants.org/.
In Canada, restaurants are encouraged to list their ingredients. Here is a
newsflash article about it at Allergic Living website: http://www.allergicliving.com/newsflash.asp?nf=5 (Contributed by Anna
Marie).
News about pending legislation and new laws in the United states regarding
restaurants and food allegies can be found at:
http://www.foodallergy.org/Advocacy/restaurants.html.
Menus and Ingredients Online
Please note that, because URLs change, I have listed the homepages of restaurants. You
may have to search for the ingredient information--but these are restaurants that
do disclose at least a bit of ingredient information online. Also, in the case
of regions, be sure to check that you are reading lists from your area, as ingredients
differ--especially in different countries (the below are basically US websites). Inclusion does not imply an
endorsement or recommendation.
BD's Mongolian Barbecue - http://www.bdsmongolianbarbeque.com/
Biaggi's - http://www.biaggis.com/
BJ's - http://www.bjsbrewhouse.com/
Burger King - http://www.bk.com/
Carrabba's Italian Grill - http://www.carrabbas.com/
Chick-fil-A - http://www.chickfila.com/
Cold Stone Creamery - http://www.coldstonecreamery.com/
Famous Dave's -
http://www.famousdaves.com/
International Dairy Queen, Inc. - http://www.idq.com/
In-N-Out Burger - http://www.in-n-out.com/
Jamba Juice - http://www.jambajuice.com/
Long John Silver's - http://www.longjohnsilvers.com/
McDonald's - http://www.mcdonalds.com/
McGrath's Fish House - http://www.mcgrathsfishhouse.com/
Mimi's Cafe -
http://www.mimiscafe.com/
Outback Steakhouse -
http://www.outbacksteakhouse.com/
Pei Wei - http://www.peiwei.com/
P.F. Chang's China Bistro -
http://www.pfchangs.com/
Rockfish Seafood Grill Restaurant - http://www.rockfishseafood.com/
Ruby Tuesday - http://www.rubytuesday.com/
Subway -
http://www.subway.com/
Taco Delmar -
http://www.tacodelmar.com/
TCBY - http://www.tcby.com/
Texas Roadhouse -
http://www.texasroadhouse.com/
Thaifoon -
http://www.thaifoon.com/
Wendy's - http://www.wendys.com/
Ztejas -
http://www.ztejas.com/
A Final Note
The FAST website's official stance on eating out is that it is not
safe, especially for individuals with multiple allergies, severe and/or
life-threatening reactions, and those newly diagnosed who are still unfamiliar with
labeling practices in their country. Why is it not safe?
* A study (as mentioned elsewhere in the article) showed that most food allergy deaths
occur as a result
from "eating out" (in restaurants or other food service). Like you, most of these
individuals also likely thought they were being careful.
* Even if you feel 100% positive that food is allergen-free, it may still contain
allergens, even potentially life-threatening allergens.
* Vague ingredients like "natural flavorings" and "secret sauces" are unknown by the
food staff, and they will not necessarily--unlike you--realize that all
ingredients--no matter how minute--need to be disclosed to an allergic person.
* Think back to before you knew anything about food allergies. Would you have
trusted yourself to prepare food for someone with food allergies?
* Even basic/"plain" foods that you would not believe would contain anything other
than the obvious (like fries, a baked potato, beans, or rice) commonly contain
allergens, such as dairy, wheat, soy, and nut products. One can never assume that
there is any "basic"/bare bones food in a restaurant.
* A well-known restaurant admitted in 2006 that its ingredients
in a food product contained highly allergenic substances--this product was originally
declared to be free of these allergens. The ramifications of
this are quite obvious. No matter what a restaurant says--even in its printed
materials--the food you eat may still contain your allergens.
One member of FAST says, "it amazes me that people with food allergies do eat in restaurants." The FAST founder also--though begrudgingly, and with a real sense of loss--gave up eating in restaurants about 10 years ago, and noticed a big change in her frequency of reactions as a result.
Choosing not to eat out is a difficult decision to make, but is nevertheless one many
individuals with food allergies have made, with their health and safety in mind. FAST
advocates that you thoroughly discuss this issue with your allergist, and weigh the
risks with great care.
FAST, the author of this article, and its
participants are not responsible for any decisions
you make or experiences you have if you decide to eat out.
|
