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In the Know

Be Informed and Healthy

By Susan Vallee

For millions of families (one in thirteen, to be exact) deciding on where to go out for dinner is a minefield. Instead of choosing between kung pao chicken and deep-dish pizza, families with a member who has a food allergy worry about cross-contamination in the kitchen and servers who don’t take their orders seriously.

While it’s easy to say these people should avoid eating out, it’s not logical. Children attend school, where they eat in the cafeteria alongside other students. And there are celebrations, holidays, and busy weeknights when dining out is the best solution for everyone.

The need for worry is not imagined. According to the Centers for Disease Control and Prevention, the incidence of food allergies among children increased by 50 percent between 1997 and 2011—that’s a lot of kids with food restrictions, to say nothing of the numbers of adults who already have food allergies or will develop them. As food allergy rates continue to increase, so does the need for informed kitchen staff, no matter where you dine.

The Mayo Clinic defines the top eight food allergens as cow’s milk, eggs, fish, shellfish, soy, wheat, peanuts, and tree nuts. There is no cure for food allergies; the only way to avoid reactions and to prevent anaphylaxis is strict avoidance of the food.

The Mayo Clinic defines the top eight food allergens as cow’s milk, eggs, fish, shellfish, soy, wheat, peanuts, and tree nuts.

Icons of top eight food allergens icon illustration food allergy awarenessResearchers have yet to pinpoint a definitive cause for the spike in food allergies, but high-fat diets, an increased number of C-sections, a rise in formula feeding, and the overuse of antibiotics have been identified as potential culprits by Cathryn Nagler, PhD, a professor at Bunning Food Allergy Institute at the University of Chicago. Her research studied how probiotic strains could prevent and treat food allergies.

Dr. David Berger, a board-certified pediatrician with Wholistic Pediatrics and Family Care in Tampa, Florida, has seen this approach work in his practice.

“I look at food allergies as a symptom, not a disease,” he explains. “What is the underlying cause? I find often this is related to low vitamin D, low zinc, high antibiotic use with secondary loss of bacterial flora, and/or the growth of intestinal pathogens like candida and clostridia, the lack of good bacterial flora with C-sections, and the lack of ‘seeding’ that occurs during passage through the birth canal.”

He advises mothers to check these key nutrient levels during pregnancy or lactation. He also suggests giving probiotics and vitamin D to babies, especially if the baby was born via C-section or was exposed to antibiotics.

This is all done in the hope of preventing an anaphylactic reaction to a food allergen. In most cases of severe food allergies, epinephrine (adrenaline) is given via an EpiPen as quickly as possible after exposure, but the shot is not always a guarantee, and the more time that passes before an injection is given, the worse the odds are for recovery. It’s scary stuff, but for millions of people, it is their reality.

So, what can chefs do to help? They can listen to their clientele.

The food industry has taken notice of the increase in food allergies. Large, tourism-based destinations are also taking the issue seriously. Walt Disney World Resort, for example, offers a wealth of allergy-free menu items and snacks, even on board its fleet of cruise ships. Guests can contact the resort before arriving to see sample menus and discuss allergy-safe options. In the on-property restaurants, the chefs take the time to meet face-to-face with diners to discuss dietary needs and options.

A restaurant in Montreal, Canada, recently made headlines for a vigorous crowdfunding effort by its customers. The restaurant, ZERO8, does not serve any of the top eight allergenic foods. Its chef-owner, Dominique Dion, also vets his food suppliers thoroughly to ensure that no cross-contamination of ingredients occurs. When rent increased on Dion’s restaurant space in 2013, making it impossible for him to stay in business, his loyal clientele encouraged him to launch a fund-raising effort online. He did and was able to reopen in a new location in the city.

Families dealing with food allergies should also take a look at the Amy’s Kitchen brand of frozen foods. The company’s revenue last year totaled close to $480 million, according to research company IRI. In what some considered a bold move, Amy’s Kitchen opened Amy’s Drive Thru in Rohnert Park, California, in 2015. The fast-food restaurant, whose tagline is “American Fast Food in a New American Style,” sells vegetarian and organic breakfast, lunch, and dinner items. In its first year, Amy’s Drive Thru sold a half million veggie burgers. Paul Schiefer, director of restaurant operations, said the concept has exceeded expectations and has hinted at a second location that will be opening soon.

The allergen-free (or at the very least allergen-conscious) dining industry certainly offers room to grow, given the shocking increase in food allergy rates. Families and people living with food allergies don’t expect every restaurant to offer safe dining options, but it does help. No one can go through life in a bubble. As restaurants and resorts rise to meet these challenges head-on, it seems the customers will seek them out.

Living with Food Allergies: Don’t Forget

  • Auto-injectors such as EpiPens expire after a year. Not only will you need a new auto-injector, but the dosage may also need to be increased if your child has gained weight in that time.
  • Buy an allergy ID bracelet or necklace for your child.
  • Talk with your child’s school about the location of EpiPens and auto-injectors. Experts are now recommending that auto-injectors be stored in the cafeteria and school hallways with other emergency items (similar to the way fire extinguishers are stored).


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