Eating out with allergies

Having a food allergy can make eating out seem impossible – but it doesn't have to be! Nutritionist Jane Dostine has easy tips which will help minimise your risk.

For most people, eating out is a treat. But if you suffer from an allergy, or coeliac disease, the risks associated with eating commercially-prepared food – not to mention the hassles that come with having to plan ahead – can sometimes outweigh the benefits of a night out.

Unfortunately, there is no way to guarantee that food prepared by someone else will be free from allergens. But, with a few easy steps, you can enjoy a night away from your kitchen. Just make sure you take your medication with you and let your family and friends know where you keep it.

Step 1: First things first

Allergic reactions can be serious – even fatal. So, before you make a restaurant reservation, it’s essential that you have an Action Plan in place (provided by your allergy specialist). An Action Plan is an easy-to-understand set of instructions for your friends and family to follow in case you have an allergic reaction (to find Action Plan templates, go towww.allergy.org.au/content/view/10/3/).

If you are in doubt, you may wish to take ‘safe’ food with you to the restaurant. If you plan to do this, ask the restaurant management beforehand – even if it’s just a café – if this is okay. Eateries will almost always say yes – it is not asking permission that’s rude and could get their backs up.

If you have a child with allergies, take the same steps as for adults.

Step 2: Choose the right cuisine

Allergens can be found anywhere but choosing a restaurant that serves ‘lower-risk’ cuisine can make eating out easier.

• Peanut or tree nut allergy: Steakhouses may be your best bet but they still serve high-risk foods such as marinades, sauces, gravies, pastries and desserts, so be mindful of this when you order. Avoid Asian, Indian and African cuisines, and vegetarian dishes, as they are all likely to use nuts in their cooking.
• Fish or shellfish allergy: Even the cooking of seafood can spray protein into the air which can trigger a reaction, so avoid seafood restaurants and Asian cuisines. Vegetarian, and reputable restaurants with seafood-free options are better choices.
• Sesame allergy: Your best bet is European-style cuisines (French, German, Italian etc) as these traditionally don’t use sesame products. But always check salads, breads and oils. Avoid Lebanese and Middle Eastern-style cuisine.
• Dairy allergy: Asian-style cooking is probably lowest-risk. Avoid European-style cuisines (French, German, Italian etc) as these regularly feature cheese and dairy.
• Egg allergy: Eggs are found in almost everything but vegan restaurants will be egg-free. ‘Modern’ café-style meals such as grilled seafood and meat and three veg are generally safe when served in reputable restaurants – but steer clear of creamy sauces and breading or crumbing.
• Soy allergy: As per egg allergies, café-style meals may be a better choice. Asian cuisines generally need to be avoided as well as many vegetarian meals which use soy beans and tofu. Stay away from bread (most contain soy flour), avoid re-formed seafood and skip Asian sauces.
• No matter what kind of allergy you have, it is best to avoid buffets:The risk of contamination is very high as serving utensils can be shared and foods can be accidently mixed.

Step 3: Select the right restaurant

Selecting the right restaurant can be half the battle. A few simple tricks can go a long way!

• Google restaurants. Customer reviews can give you an indication of how attentive the wait-staff are – which may mean the difference between a safe meal and a contaminated one. Good service also goes hand-in-hand with staff who know the menu in detail, making ordering easier.
• If a restaurant won’t accept bookings, they may have a high customer turnover – which can lower your chances of receiving attentive service. Select a restaurant where you can book ahead, and hopefully, this will increase your chances of having an allergen-free meal.
• It’s also a good idea to book a reservation outside of the lunch or dinner rush.
• Cost can count. More expensive restaurants tend to have better informed (and more accommodating) wait-staff and chefs. This doesn’t mean you should only choose fine dining restaurants – but as with most things in life, you get what you pay for. It is worth paying a few extra dollars to safeguard your health.
• Check out a restaurant’s website. The most suitable eateries will have a good reputation and having a website can be an indication of how well-established a restaurant is.
• If a restaurant doesn’t have a current menu posted on their site, call and ask for a copy. This will reveal if they have any allergy-friendly options and, if not, how easy it will be to order an allergen-free meal. Most large restaurant chains have complete nutrition information available, too.

Step 4: Explain your allergen

Once you’ve selected a restaurant, it’s a good idea to phone ahead to explain your needs. But keep in mind that you will probably need to explain them again to the person serving you.

• Don’t just request that your dish be prepared free of your allergen – explain your reason for allergen avoidance and stress the seriousness of a potential allergic reaction. Wearing a Medic Alert bracelet will help emphasise your point!

Step 5: Peruse the menu

• Take plenty of time to read through the menu. Don’t be afraid to ask for help with complicated or foreign cooking terms.
• Before you order, find out which dishes can be made ‘free from’, so you know your options.
• Ask your waiter (or the chef) to describe how the meal is prepared – just in case. A meal may be free of nuts, for example, but it’s possible that it’s made using peanut oil.
• Don’t assume a ‘safe’ dish in one restaurant is the same in another – always check the preparation method.
• Become familiar with alternative names and ingredients of your allergens, such as arachis (peanut), edamame (soy), and bulgar (wheat).

Step 6: Place your order

• The safest dishes tend to be basic – grilled or roast meat (served without marinades or sauces), steamed vegetables and potato, and fresh fruit for dessert.
• Ask to have barbecued meat wrapped in foil, before cooking, to separate it from other food.
• If you order wine, ask to check the bottle’s label. Winemakers use a clarification process called ‘fining’ to remove sediments from their wine and may use egg whites or casein (a milk protein) as their fining ingredient. By law, these must be declared on the label.
• Instead of having to explain the intricacies of your allergy every time you eat out, become a regular at a local dining venue. (Always double-check your choice is allergen-free, though – the recipe or chef can always change!)

Step 7: Taste test your meal

Don’t sit down to a meal absolutely ravenous and rush into it – proceed cautiously. A good idea is to try the ‘sniff, lick and wait’ test:

• First, smell your food. The aroma of a dish can indicate if an allergen (like fish) is present and is an important warning sign not to eat it.
• Second, have a small taste and allow your tongue to come in contact with your food. Don’t take a big bite – a ‘lick’ is all that is required.
• Third, wait five minutes to see if you experience any kind of allergic reaction, usually indicated by a tongue tingling sensation.
• Finally, all being well, enjoy the meal! But remember, always have an Action Plan in place and always carry your medication. We can’t stress that enough!

What if you do have a reaction? Advice from Allergy New Zealand

By following these steps when eating out you are reducing your risk of having an allergic reaction. But you can never eliminate risk so if you do have an allergic reaction, follow your Action Plan.

• Once you have recovered, report the reaction. By reporting a reaction, you are helping create better allergen management and labelling processes in the food manufacturing and food service industry and making the world a safer place for yourself and others like you.
• Take note of the food you ate just prior to the reaction. Re-check with the restaurant staff and go back over the preparation. If you suspect the reaction was caused by an undeclared allergen in the food or by cross contamination, keep any remaining food including packaging with the labels so that it can be tested if required. Raw and cooked food should be sealed in a container and refrigerated but make sure there is no chance you can be in contact with it inadvertently; contact the New Zealand Food Safety Authority (NZFSA) on 0800 693 721 (0800 NZFSA1), or by email:info@nzfsa.govt.nz. Or contact your local Food Act Officer through the website: www.foodsafety.govt.nz/food-complaint/public-health-units.htm
• Contact Allergy New Zealand. Let us know what happened and what is happening in respect to the report to the NZFSA. Or ring us to talk through what happened to help decide what to do next – for example make a report (or not) or contact the restaurant. We need to know what is happening so we can assess whether regulations, monitoring and industry practice are being followed.