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Dining out with food allergies

Ideally, a meal at a restaurant is a relaxing experience. You don't have to worry about grocery shopping, preparing the food or washing the dishes. All you need to do is order and enjoy.

But if you have a food allergy, restaurant dining may not be as pleasant for you as it is for others. In fact, it may be rather stressful.

"Safely eating in restaurants can prove to be quite tricky for a patron with food allergies," says Michael Pistiner, MD, MMSc, allergist and author of the children's book Everyday Cool With Food Allergies. "There, you don't have as much control over your food as you do when you're in your own home. And you are reliant on the food allergy management skills of others."

To avoid a reaction, you need to make good food and restaurant choices and communicate effectively.

"In order to safely eat at a restaurant you need to be competent and confident in your own food allergy management skills," says Dr. Pistiner.

Here's a look at some of the things you'll need to do to make sure your dining experience is a safe one.

Learn how to avoid trigger foods

One key to safely dining out when you have a food allergy is to learn to avoid the foods that cause you trouble. Here are some tips from Dr. Pistiner and the Food Allergy Research & Education (FARE):

  • Choose your restaurant wisely. Some restaurants may not be good choices for people with certain food allergies. For example, if you're allergic to shellfish, it's best to avoid a seafood restaurant. If peanuts or tree nuts cause a reaction, it's probably safest to bypass Asian restaurants and dessert shops, where nuts tend to be common ingredients. Buffets are best avoided by those with food allergies too, according to Dr. Pistiner.
  • Recognize hidden dangers. One important danger to be aware of is cross contact—when a food you aren't allergic to comes in contact with a substance you are allergic to during the cooking process. Popcorn shrimp, for example, might have been cooked in the same fryer as your chicken strips. Or deli workers could use the same slicer to cut roast beef that they use when slicing cheese. If you're allergic to milk protein, which is in cheese, a reaction is possible. Even pots cooking on the kitchen stove could splatter allergens onto your plate unnoticed. Making the staff aware of your allergy can help ensure that they are particularly careful to avoid cross contact when preparing your meal and help guide your choices when selecting items.
  • Keep your order simple. The best menu choices generally are simple foods made from scratch, Dr. Pistiner says. So, something like grilled chicken with a baked potato and steamed broccoli will likely be a better choice than pot pie, stew or soup. The latter foods could contain many ingredients that are difficult to identify.

Talk about your allergy

For your protection, others must know about your allergies.

"Many people don't want to be different from the other people in their party," Dr. Pistiner says. As a result, they keep their allergies hidden. This may prevent those with allergies from telling restaurant staff about their situation, as well. And these are the very people whose help is crucial in keeping someone with food allergies safe. Staying silent will limit others' ability to help an allergic person appropriately in an emergency, too.

"We're hoping to teach those with food allergies that they have nothing to be ashamed of and they really need to make their voices heard," Dr. Pistiner says.

At the restaurant it's essential to tell your server and, if possible, the manager and/or chef about your allergies—every time you eat there. This alerts them to be extra careful and strengthens your safety net.

For instance, they can tell you if they know a menu item contains your allergens. They can also be more mindful of cross contact and read labels on foods they might use when preparing your meal to be sure it won't cause you problems.

FARE offers a "chef card" that explains the steps restaurants should take to help keep you safe. You complete the card and pass it on to the chef when dining.

Watch for red flags

It's important that restaurants take you seriously. If there are language barriers, the restaurant seems especially hectic, or you don't feel your requests are being handled competently, it should raise red flags.

You might be able to address some issues by calling ahead or eating at less busy times. But it's better to be safe than sorry.

"Always ensure that there's communication and understanding," Dr. Pistiner says. "If there doesn't seem to be, then politely leave."

Prepare for a problem

Of course, even when you take precautions, an allergic reaction is possible. So you have to be prepared.

You and your doctor should discuss symptoms to watch for and what to do if they occur. If you've been prescribed self-injectable epinephrine, carry it with you at all times and don't hesitate to use it when needed. Then get emergency help.

"When you need epinephrine, you should call 911 and be taken to the hospital by ambulance," Dr. Pistiner says.

Even if you're feeling better, a second, more severe wave of symptoms can occur. The emergency department is best equipped to help you.

Let your doctor help

Talk to your allergist for more information. He or she is sure to dish up other helpful tips that will help you dine out happily and safely.

Reviewed 9/7/2023

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