Allergy Shmallergy

Simplifying life for families with food allergies.

Best (and Worst) Practices of Some of Our Favorite Restaurants June 12, 2017

Restaurants need to pay attention to food allergies.  Aside from the obvious risk of health complications, misunderstanding of such common and serious conditions comes off as uninformed, unsympathetic, and negligent.  Sometimes even the best restaurants aren’t well-informed or trained about handling food allergy requests.  But when a restaurant gets it right, it earns a customer’s loyalty forever.  Below are some of the best and worst practices among our experiences.  I’d love to hear some examples of BEST practices from YOUR dining experiences by commenting below.

 

To understand what’s happening behind the kitchen doors, read Allergic Living’s Special Report, What Restaurants Are Getting Right and Wrong on Food Allergies.  And if you work at a restaurant, please read Simple Strategies for Restaurants to Manage Food Allergies for easy ways to improve food allergy service.

 

 

Hops (Greensboro, NC)

Hops 2015-07-20 19.37.22

The reputation of this burger joint was impossible to ignore.  And, we knew from our first year eating here that it was well-deserved.  In fact, I had been impressed that they offered gluten-free beer and buns, despite the fact that we do not eat gluten-free.

However, one night, arriving with a large group of friends, we noticed that a vegetarian burger containing nuts was added to the menu.  This greatly increased the possibility of cross-contamination for our peanut and tree nut allergic son.  We asked the server if the restaurant could clean a small portion of the grill before making my son’s hamburger. No. Could they grill his burger in a pan?  No.  Would they consider grilling his burger on a piece of clean tin foil?  No.

 

So, we walked across the street and ate there instead.  Rather than thinking flexibly, the restaurant has lost our business – not just our family’s business, but that of our entire group.

 

Miyagi (McLean, VA)

This Japanese restaurant is always crowded.  Its sushi is consistently fresh and delicious.

 

When we explained that my son had a sesame seed allergy and could not have any sesame on his order, they seemed to understand.   But it was a different story when the plate arrived with sesame seeds covering the side dish.  And the replacement was sent back on the same plate with the side dish scraped off.

 

Firebirds Wood Fired Grill (Moorsetown, NJ)

Driving down the New Jersey Turnpike, we all grew hungry and needed a break from the car.  We decided to stop at Firebirds off exit 4 on a whim.  And, what a great choice!  The food was great and the servers were extra careful with our food allergy requests.  The chef himself came over to our table to answer each question we had.

“I like to visit each table with food allergies personally,” he said, “so that you know I understand your concerns and we can discuss a plan so you know you’re eating safely.”

The chef watched his best friend deal with celiac disease and food allergies at restaurants and wanted to change that experience for his own customers.  The effort was enormously appreciated!

 

Clare and Don’s Beach Shack (Falls Church, VA)

This local restaurant is an experience unto itself.  In addition to its fun and friendly indoor ambiance, it has generous outdoor seating with a fire pit for the cool months and live music for the warmer ones.  The owners always make everyone feel warm and welcome.  Their quick response to our questions (even when that requires contacting suppliers or figuring out how to make something safe on the fly) is part of their natural, good-natured customer service.  And, it’s something we’re incredibly grateful for.

In fact, they’ve become so accommodating with and accustomed to my son’s orders that when the ticket comes into the kitchen, his meals often return to the table with a greeting from one of the owners herself.

 

Burton’s Grill (Charlottesville, VA and elsewhere)

This restaurant gets kids’ menus right.  Rather than ordering and substituting everything as food allergy families usually do, this menu allows kids (and their parents) to customize each piece.  And for those of us with dietary restrictions, that means more options, less hassle.  We still had a few questions for our server (safety of hamburger buns and fry oil) and were pleased to see the seriousness with which they sought the answers.  Such a great experience, we made a repeat visit within the same weekend.

 

Harvey Cedar’s Shellfish Co (Long Beach Island, NJ)

This is a perennial favorite for our family and friends.  A down-to-earth seafood restaurant with friendly staff is a no-brainer.  But nothing with food allergies is completely straight-forward.  As my son became more and more adventurous and we posed more and more questions about their menu, one server in particular took it upon himself to create an allergen menu with the help of the owner and chefs.  We were hugely impressed with this simple and easy to navigate menu.  It has encouraged my son to try even MORE menu items which has resulted in his love of swordfish, mussels, and lobster!

 

La Tela (Kiawah Island, SC)

We waited for 45 minutes to sit down at this popular wood-fired pizza and Italian restaurant just off Kiawah Island.  By the time we had been seated, it was late and the kids were STARVING.  We had a great time eating here a couple of years prior and were looking forward to a good meal.

When we told the waiter my son was allergic to peanuts, tree nuts, sesame seeds and sensitive to dairy (because of his EOE), a manager returned to discuss the menu with us.  She had thorough knowledge of kitchen preparations and ingredients.  As it turns out, because they use pine nuts in their pesto pizza (which contaminates the oven) only salad and plain pasta were safe for him – a HUGE disappointment.  But they were willing to prepare pasta for my son in a dedicated pot to ensure it was safe.  He was not thrilled, but we appreciated the extra step.

Unfortunately, the pasta arrived covered in sauce – something my son doesn’t like and specifically ordered against.  When we pointed this out to our server, he was clearly put out.  Annoyed and not hiding it, he said that although the kitchen could prepare another batch of pasta, it would take a very long time.  He suggested that my son just eat the meal in front of him.

The last thing you want to do is tell a food allergic child (or anyone with a medical condition) to just suck it up.  We left frustrated with our mixed experience.  While the restaurant itself was great, this visit emphasizes how much of your experience lies with the individual you are working with.  In our case: the server.

 

Sandbox (Long Beach Island, NJ)

Breakfast is tricky for those with dairy allergies.  So much of what kids want to order in the morning (pancakes, waffles, even scrambled eggs) is made with milk.  My son has become used to having fruit and bacon when we’re out at breakfast.  But on this one morning, he really wanted French Toast.  There were a lot of hurdles to overcome before we could safely order this: safety of the bread and preparation surface, can they coat it only in egg…?    Yes on all accounts.  This specially prepared French Toast – made in a separate pan – makes my son SO happy.  Sandbox’s flexible thinking makes him feel great and relaxed.

 

But, when we spoke with the owner, we experienced a funny lack of awareness.  While we complimented her restaurant at being so good at handling food allergies, she made a few insensitive comments.  We told her about my son’s many food allergies. Having been a former teacher, she said, “Oh!  I would have HATED to have you in my class!”  Later, my son asked, “What’s wrong?  Why wouldn’t she have wanted to teach me?”  Not the message you want your customers leaving with.  Also, you wouldn’t say that to someone in a wheelchair or with a serious illness.  Why say that to a child who similarly didn’t choose to have food allergies?

 

Rocco’s Tacos (throughout Florida)

Rocco’s Tacos is our Florida obsession.  My whole family loves eating at this festive and delicious restaurant.  It’s made even easier to love because across locations, Rocco’s takes food allergies seriously.  They seek out ingredients and are creative at work-arounds when necessary.  At our most recent visit in Boca Raton, the server approached us to let me know that his brother had food allergies, conveying that he understood our questions and concerns whole-heartedly.  That kind of information is so helpful when explaining what you (as the food allergy family) are looking for.

And, look!  They flag food allergy orders from the kitchen to table so that mistakes are avoided.  Love that system!

 

Sakura (Vienna, VA)

Japanese hibachi restaurants, as it turns out, can be a fantastic place to eat with food allergies.  Many do not use any dairy.  And their prep surface is diligently cleaned right in front of customers.

 

Sakura’s menu clearly states that they don’t use peanuts or peanut oil in any of its menu items.  They take time to understand the food allergies at our table and craft a careful plan to cook each meal in the proper order to ensure its safety.  When we eat with our extended family, as we often do, we need to avoid my son’s food allergies as well as my in-law’s – that means, no peanuts, tree nuts, sesame seeds, dairy, or shrimp.  They prepare everything with ease (and great skill!) right in front of us.

 

Panzone’s Pizza (Long Beach Island, NJ)

Panzone’s boasts some of the best pizza on the Jersey Shore.  But it was when we began ordering their other menu items that we realized how easy they made things for food allergic families like ours.  The owner pulled out a binder filled with ingredient lists for all menu items, including those from her suppliers.  Stock from suppliers is typically our biggest roadblock for information.  Restaurants often have no idea what is in a supplied item and cannot take the time to call to inquire.

 

Perusing Panzone’s ingredient binder allowed us to partake in items that are usually not safe elsewhere: like (cheeseless) cheesesteaks, amazing breaded wings, and fish tacos.

 

Simple Strategies for Restaurants to Manage Food Allergies June 6, 2017

food-1685942_1920

 

Dining out is stressful for those with food allergies.  Very stressful.  We carefully put our lives in the hands of wait staff, cooks and chefs in order to participate in the social aspects that surround food.  A well-educated waiter, manager or chef can create life-long patrons of a food allergic customer.  Negligent or ignorant staff could send that same customer to the hospital (or worse) and impugn their business’s reputation.

 

When dining out goes well, it’s the backdrop of a happy memory (and stomach!).  But when restaurants get it wrong, they don’t just lose a food allergic customer; they lose that person’s entire family and friends.

 

So many pitfalls surrounding food allergies at eating establishments could be easily avoided.

 

Food Allergy Training

It all starts with thorough training.

 

Food allergies and food preferences are NOT the same thing.  Understanding the consequences of ingestion in both cases is important.  Wait and kitchen staff also need to understand what each food allergy means.  I can’t tell you how many times we announce my son’s dairy allergy only to have the waiter return and assure us the meal we inquired about is, in fact,  “gluten-free” or doesn’t have any eggs in it.  This is both unhelpful and makes a customer feel as if the staff doesn’t understand food very well – not to mention food allergies.

 

 

In addition to reviewing how to handle a food allergy request in the kitchen, it’s important to relay some of these solutions to the waitstaff.  They should be able to help the customer think creatively and to reassure them that your restaurant understands their concerns and can prepare a safe meal for them.

 

At one restaurant with a large group of friends, we noticed that a vegetarian burger containing nuts was added to the menu.  This greatly increased the possibility of cross-contamination.  We asked if the restaurant could clean a small portion of the grill before making my son’s hamburger.  No. Could they grill his burger in a pan?  No.  Would they consider grilling his burger on a piece of clean tin foil?  No.  So, we walked across the street and ate there instead.  Instead of thinking flexibly, the restaurant has lost our business – our entire group will not eat there any longer.

 

Conversely, we’ve found a breakfast place that will make my son’s french toast both without milk and cook it in a separate pan to ensure it’s safe.  All done with a smile.

 

 

Prep Waitstaff to Handle Common Questions

In addition to giving waitstaff information about what can and cannot be accommodated in your restaurant’s kitchen, arm them with information about your dishes.

 

If there are only 3 dishes with tree nuts, highlight those items.  Perhaps the kitchen stocks (but does not advertise) gluten-free pasta.  Sorbet does not contain dairy – be sure to point that out!

 

Practice Answering the Customer/Understand their Perspective

 

Give waitstaff, cooks, chefs and managers time to practice responding to customer concerns.  Those with food allergies often feel as if they are imposing on others by asking a lot of questions and getting reassurances that they can eat safely.  In short, they sometimes feel as if their food allergy is an imposition.

 

Restaurants can and should respond with patience and kindness – reducing the stress of dining out and increasing a customer’s positive experience.  But sometimes, they don’t:

 

At one Italian restaurant, there was only ONE item on the menu that would up being safe for my son.  When we mentioned to the waiter that we had asked for it without sauce, he responded poorly.  After making it seem like a huge hassle to redo, he basically suggested my son just suck it up.  Wrong message.

 

You’ll read many more examples in Shmallergy’s upcoming post, Best (and Worst) Practices of Some of Our Favorite Restaurants.

 

Supplier Lists/Binder of Ingredients

Keep a binder (be in digital or paper form) that contains the ingredients of each item used in the kitchen as well as supplier information.  Remember to keep it up-to-date as suppliers and dishes often change.  This makes both checking ingredients as well as seeking answers to food safety questions much simpler.  We’ve flipped through many a supplier/ingredient book which has added a great amount of reassurance to our dining.

 

Another option is to create an allergen menu which allows waitstaff and/or diners to easily reference to allergens.  One restaurant we eat at regularly created one after my son began asking his own food allergy questions.  It doesn’t have to be fancy; just reliable.

 

 

These simple strategies to understand and accommodate food allergies will forge lasting relationships with customers and will enhance your restaurant’s reputation for service.

 

6 Tips for Traveling with Food Allergies March 7, 2017

pool-690034_1920 via pixabay

 

Spring break is on the horizon!  Can you smell the fresh air already?  Are you mentally packing your bags? (I am!)

 

Here are a few tips when traveling with food allergies:

locking-knob-883059_1920 via pixabay

  1.  Call your airline and inquire about their food allergy policy in advance.  Ask specifically about early boarding and in-flight announcements.
  2. Most airlines will allow passengers to board the plane early in order to wipe down surfaces (this includes seat backs, seat belts, tray tables and knobs, armrests). Be sure to bring enough baby wipes or antibacterial wipes (such as Wet Ones) to cover all the legs of your travel.  Again, ask about pre-boarding at the gate.
  3. Carry your epinephrine auto-injectors and antihistamines ON BOARD.  Do not pack these away in your luggage.  [*ALLERGY SHMALLERGY TIP*: Zyrtec makes dissolvable tablets which eliminate the worry over bringing liquids through security as well as anything spilling in your bags.]
  4. If you’re traveling to a warm weather destination, you’ll need to remember to keep your epinephrine auto-injectors at room temperature – even while enjoying the beach or pool.  Pack a cool pack (like this one) and an insulated bag (like this cute lunch bag).  Store the cool packs in your hotel’s mini-fridge (who needs a $15 bag of M&Ms anyway!?) or plan on ordering a to-go cup of ice to keep the medicine cool poolside.
  5. A hotel or resort’s food services manager can usually help you navigate menus.  On our last vacation, the food services manager had food allergies himself and was invaluable in hunting down ingredients and safe alternatives for our family.  Befriend this fantastic person!
  6. If you’re planning on visiting an amusement park, taking a hike or being similarly active, consider packing a backpack into your luggage (or use one as your carry-on!).  You’ll need to bring your epinephrine auto-injectors wherever you go – especially on vacation when you’re away from home cooking, familiar restaurants and local knowledge of hospitals and doctors.  Backpacks can make carrying it easier depending on the activity – simply slip the insulated bag into your backpack and go!

 

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Two more notes:

  • Airline travelers should bring their own snacks/meals on board flights to ensure their safety.
  • Refrain from using airplane blankets and pillows as allergen residue may reside there.
  • Bring a baby or antibacterial wipe to the bathroom to wipe down door  and knob handles.

 

 

 

The Future of Food Allergies: Recommendations from the Experts December 8, 2016

Last week, the National Academies of Sciences put out a report outlining the gaps in global food allergy management.  Titled, “Finding a Path to Safety in Food Allergy Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy,” the authors made recommendations that would lead to significant change in the quality of life of patients and families living with food allergies.

 

This was an important and informative report which helps prioritize ways in which we may see adjustments to food allergy diagnosis, information and policy in the future.  I listened to the live presentation while furiously taking notes, but you can read the report for yourself at:

nationalacademies.org/FoodAllergy

#foodallergies #peanutallergy medical doctor government law

 

In case you missed it, here are the highlights and some reflections:

 

Prevalence of Food Allergies:

The committee noted that although no formal studies have been able to corroborate the information, doctors across the country have confidently noted the increased prevalence of food allergies.  Studies of this sort are difficult to conduct and expensive, Dr. Hugh Sampson of the Icahn School of Medicine at Mount Sinai in New York noted.  However, the true prevalence of food allergies would help lawmakers and other health-related institutions prioritize food allergies as the “major health problem” it is in this country.  It is currently estimated that between 12 and 15 millions American are living with food allergies.

Recommendation: The CDC or other organization conduct a food allergy prevalence test that will help inform us of current food allergy levels and serve as a baseline for future assessments.

 

Standardized Diagnosis:

 

This is no one, standard way to diagnose food allergies.  Some doctors use skin tests (otherwise known as “scratch tests”) and some use IgE blood tests.  Still others consider the use of IgG testing to detect food intolerances.  Each test varies in conclusiveness and none can accurately predict the reaction a person will have to an allergen.  Only an oral challenge can determine the type and severity of an allergic reaction.

 

[More on this testing in a separate post.]

 

Recommendation: Doctors follow a standardized set of tests and protocols to inform them of a patient’s allergy and future medical action.

 

Prevention:

While there has been much in the news about best strategies to prevent food allergies from developing, advice on the ground from doctors and within parenting circles is lagging.

 

Recommendation: Clear, concise and solid advice about the early introduction of food and its benefits would greatly help parents and patients alike.

 

Education and Training

Misconceptions still abound.  Some dangerous.  Timely, proper management of food allergies saves lives.

 

Recommendation:  The launch of an educational campaign to align doctors, patients and general public regarding the diagnosis, prevention and management of food allergies.  This is especially important in organizations that provide emergency services as well as in medical schools and other healthcare institutions.

 

Policies and Practices

 

The list of major allergens identified in each country has not been updated since they were established in 1999.  And, labeling laws (particularly those known as Precautionary Allergen Labels, PALs – “may contain” and “made on equipment with” are two examples) aren’t currently effective at helping consumers assess risk.

 

Recommendation:  Reassess the priority list of major allergens to better identify regional allergens. Develop a new, risk-based system for labeling – specifically to address issues related to PALs – and outline guidelines for the labeling of prepackaged food such as those distributed at schools, on airlines, and in other public venues. Additionally, the committee recommended that federal agencies re-imagine and standardize food allergy and anaphylaxis response training for employees who work at public venues (schools, airlines, etc).

 


 

I was encouraged to listen to the guidance from the committee in each area.  There is certainly a long way to go in getting federal and state-level attention for the growing epidemic that is food allergies.  But by identifying current gaps and taking action to improve communication of standardized, evidence-based information and advice, I am confident we can help improve the lives of those living with food allergies in the near future.

 

No-Brainer: Support a Bill to Place Stock Epinephrine on Airlines November 6, 2015

No Nut Traveler

My food allergy colleague and the brains behind No Nut Traveler, Lianne Mandelbaum, has helped introduce a bill to place stock epinephrine on airlines and train airline personnel on the symptoms on anaphylaxis and how to administer autoinjectors.

This is a safety measure that just makes sense.

An in-flight food allergy reaction is frightening and can be deadly.  It’s a situation that our family has experienced first hand.  My father-in-law DISCOVERED he was anaphylactic to shrimp (at age 40) on a transcontinental flight midway over the Atlantic Ocean.  Amazingly, there WAS an epinephrine auto-injector on the flight but the flight attendants wouldn’t deliver the injection, stating they needed a doctor to administer it.  When he flashed his medical credentials (he’s a surgeon), the attendants told him (as he ballooned and his condition became serious) that they required ANOTHER doctor to administer the life-saving medication.  Luckily, flight attendants and passengers assembled a hefty dose of Benadryl that helped ease the reaction until the plane landed several hours later.  Imagine having your first anaphylactic reaction as an adult to a food that you’ve loved and eaten safely for years? It could happen to anyone…

Lianne has helped inform Sen. Mark Kirk (R – IL) and Sen. Jeanne Shaheen (D – NH) who introduced bill S.1972, the Airline Access to Emergency Epinephrine Act of 2015, to Congress.  Current co-sponsors include Senators Ben Cardin (D-MD) and Mark Warner (D-VA).

I encourage you to read more about this bill and the efforts behind it at No Nut Traveler.  And, please reach out to your local representatives and ask them to support S.1972.  What an easy way to make air travel much safer!

 

Play Ball! April 1, 2014

The Washington Nationals have announced their peanut-free days this year and so have many of the MLB and minor-league teams!  Mark your calendars, grab your tickets and bring your glove.  You never know if you’ll catch a fly ball, but you can rest assured knowing that you’ll enjoy the game without worry!

 

Here’s the Nats schedule:

 
PEANUT FREE SEATS
Date Opponent Time
Sat, Apr 26
Nationals vs San Diego Padres

San Diego Padres

1:05 pm
Sun, May 18
Nationals vs New York Mets

New York Mets

1:35 pm
Sat, Jun 21
Nationals vs Atlanta Braves

Atlanta Braves

7:15 pm
Sat, Jul 19
Nationals vs Milwaukee Brewers

Milwaukee Brewers

7:05 pm
Sun, Aug 17
Nationals vs Pittsburgh Pirates

Pittsburgh Pirates

5:05 pm
 
 

Check your local team’s website for more information.

 

Hosting Guests with Food Allergies for the Holidays? No Problem! December 11, 2013

As if there isn’t enough to do to get ready for the holidays, preparing your house for visitors can be stressful.  And, treading into the unfamiliar territory of food allergies can completely overwhelm hosts.

 

Well, never fear!  Allergy Shmallergy is here to help and get you started to safely hosting a guest with food allergies.

 

1.  Speak with the food allergic guest or parent (if a child has food allergies) and understand the scope of his/her food allergies.

 

2.  Ask for a list of a few foods that would be helpful for the guest to have on hand.  For example, my parents always make sure there is soy milk in the fridge and safe cereal for my dairy and nut-allergic son.

 

3.  You may wish to consider keeping a basket or clearing out a small drawer to keep safe snacks and food for your guest.  This is especially helpful if your food allergic guest is a child. By knowing where to find safe food, this may reduce the chances that he/she will accidentally reach for something that could cause a reaction.

 

4.  As for the kitchen, if you regularly cook with your guest’s allergen, you’ll want to thoroughly wash the cutlery, cutting boards, counters, pots and pans that you plan on using to prepare food.  A run through the dishwasher should sanitize them, but a good scrub in the sink will work as well.

 

5.  Discuss your menu with your food allergic guest.  In a perfect world, everything would be safe for him/her, but try to ensure that he/she can make a meal out of what is on the table .  Check here for easy substitutions:

Baking Substitutions from the Pros

And, there are many options for dairy-free margarine and butter in the average supermarket.  Look for Smart Balance Organic and Earth’s Balance brands to name a few.

prod-spread-original

 

6.  Finally, be sure to learn how to use your guest’s emergency medications.  You probably won’t need to use them, but you’ll feel much more confident just knowing how.

  

For more tips on hosting a guest with food allergies, read here:

 

A Host’s Guide to Allergies

The Host’s Guide: Part II

The Host’s Guide: Part III