Accredited Practising Dietitian, Rachael Bradford, shares her tips to help patients with food allergies and intolerances to enjoy dining out.


Most of us enjoy the social experience of dining out. From exotic dishes inspired by far-flung corners of the world, to that favourite comfort food done with a twist, eating away from home enables us to transcend the everyday.

However, for people with food allergies or intolerances, dining out can be quite stressful. Even a trace amount of an allergen can cause a severe reaction. For individuals with allergies, food consumed outside the home (e.g., at restaurants, other people’s homes, parties, takeaway outlets or food courts) poses a much higher risk.

Yet – with careful planning and consideration – people with food allergies can still dine out and enjoy the social experiences that we all share.

 

What’s the difference between a food allergy and intolerance?

Food allergy and food intolerance are commonly confused, particularly when the symptomology of the two are quite similar.

Food allergies are immune reactions to specific protein components within a food. The eight foods that account for 90% of food allergy reactions are peanuts, tree nuts (e.g., almonds and cashews), eggs, milk, fish, shellfish (e.g., prawns and lobster) sesame and soy.  A reaction to these foods will usually occur quite rapidly (within minutes and up to two hours), and manifests as a rash, hives, swelling, vomiting, breathing difficulties and anaphylaxis.

Food intolerances do not involve the immune system, and likely occurs due to an individual’s tolerance threshold of naturally occurring food chemicals.  These common food chemicals include salicylates, amines, glutamates and fodmaps, and reactions to these foods may take hours to days to present themselves.

 

Help your patients with food allergies and intolerances to enjoy dining out by sharing these tips:

Choose a restaurant

  • Select a restaurant or cuisine that best suits your allergy; Google “allergy-friendly restaurants” in your city and peruse their menus online.
  • Avoid high-risk restaurants for your allergy (e.g., for tree nut or peanut, avoid Asian, African, vegetarian and Indian; egg or milk allergic, avoid crumbed, battered foods and European restaurants; soy, avoid all Asian restaurants and some vegetarian restaurants; sesame, avoid Lebanese style dishes and many patisseries; shellfish, avoid all seafood restaurants and some Asian).
  • Avoid buffet-style restaurants or MYO outlets, due to shared utensils used.
  • Call ahead to let staff know of your food restrictions, and to check whether they can cater for you.
  • Always check the restaurant each time you go, even if you have eaten there previously. The dishes, ingredients or chef may have changed from your past experience.

Place your order

  • Inform wait staff/owner/chef of your food allergy or intolerance, and seriousness of it (e.g., chef card, medic alert bracelet or allergy wrist band).
  • Be aware of, and inform, kitchen staff of the potential for cross-contamination – serving utensils, shared grill plates, BBQs and deep fryers, cutting boards and knives.
  • Check the oil that is being used in the cooking (e.g., peanut oil).
  • Keep it simple – choose foods that are less processed (e.g., steak and vegetables; fish and salad; grilled chicken and salad, plain rice, fresh fruit) and hold off on sauces, gravies and marinades.

Have an action plan

  • As a patient with food allergies, you should have an action plan; ASCIA action plans are downloadable here.
  • Carry allergen and chef cards that you can present to any person providing food outside of your home. These are also downloadable here.
  • Double-check your meal when it is served to ensure that is free from the allergen. Smell first, have a taste and wait five minutes to ensure no reaction (often tingling of lips) — and then enjoy your meal.
  • Ensure you carry your medication and/or adrenaline auto-injector (EPIPEN™) with you at all times.
  • If in doubt that your meal is allergen free and/or don’t have your medication with you …. do not eat the meal – it is not worth taking the risk.

 

Great links for patient resources:

About: Rachael Bradford is an Accredited Nutritionist (AN) and Accredited Practising Dietitian (APD) at Eat and Enjoy Nutrition, and a member of Dietitian Connection.

This article was originally published on RACGP and has been adapted for dietitians