Eating out with food allergies

by Nick Rose, M.S., PCC Nutrition Educator

This article was originally published in March 2013

At least 12 million Americans have a food allergy, most commonly to milk, eggs, fish, tree nuts, peanuts, wheat, shellfish or soy. An even larger number of Americans have a non-allergic food intolerance, such as lactose or gluten intolerance.

Too often, the terms “allergy” and “intolerance” are used interchangeably when they are very distinct conditions and are managed differently. Many with a true food allergy carry an epinephrine needle in case they accidentally consume their deadly allergen. Those allergic to shellfish, for example, are advised to completely avoid seafood restaurants, where even a green salad could be cross-contaminated in kitchens that produce so many seafood-based dishes. Even a minor trace of an allergen can be enough to trigger an immune response and send someone to the hospital.

Those with a food intolerance may suffer digestive upset, migraines, flare ups of rheumatoid arthritis and other reactions should they accidentally consume lactose, wheat or other triggers. But generally, they do not need to be as cautious when dining out or sharing food because their bodies do not react as strongly to trace ingredients. The exception to this rule is celiac disease, a severe form of gluten intolerance. Even small traces of gluten that arise from sharing processing equipment can be dangerous for an individual with celiac and can contribute to long-term consequences. That risk of cross-contamination is why, out of an abundance of caution, the PCC Deli will describe a dish as “wheat-free by recipe” rather than just “wheat-free.”

Eating out with a food allergy or intolerance can be challenging, but many restaurants are able to help if you just ask. Food allergy support groups (such as the Gluten Intolerance Group, Food Allergy Initiative, and the Food Allergy & Anaphylaxis Network) provide restaurant cards that you can hand to your server, stating which food(s) you are allergic to and a list of ingredients you must avoid. These can help you communicate your dietary needs clearly, especially when traveling to places where English is not the first language.


How careful do I need to be?

Sharing condiments?

Squeeze bottles for mayo, ketchup and more prevent cross-contact, rather than everyone dipping a knife into a common jar.


Keep a portion of the grill space available for allergen-free grilling, using foil or a grill-safe skillet.

Got enough spoons?

Prevent cross-contamination by providing a unique serving spoon for each dish, rather than using the same utensil for multiple dishes.


Provide notecards for everyone to write out the full list of ingredients in their dish.

If YOU have a food allergy bring something hearty to the party, in case you don’t feel comfortable eating dishes from unknown kitchens.

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