Food-Allergy Awareness (Restaurants USA, January 2002)

January 2002 issue

Food-Allergy Awareness

Restaurants USA magazine's final issue was published in September 2002 but these archived articles remain available for our readers' convenience.

Restaurants USA, January 2002

Food allergies are a potential problem that every restaurant employee should take seriously. Some food-allergy sufferers are at risk for fatal or near-fatal reactions because of food-induced anaphylaxis, an abnormal reaction in which the immune system overreacts to what is-for most people-a harmless substance. This program provides valuable information on how to minimize food-allergy problems in your restaurant.
By NRA staff

Section 1: Serving Customers With Allergies
Section 2: Food Preparation
Section 3: Emergency Procedures

Section 1: Serving Customers With Allergies

People with food allergies must avoid allergenic foods completely, because even one bite could lead to serious illness or even death. That's why it's so important that restaurants work to ensure that a customer with an allergy is not served an item that he or she is allergic to.

• Advise staff to pay close attention when a guest says he or she has a food allergy. Most allergy suffers are very knowledgeable about the foods they cannot eat. If you're not certain what food items an allergy encompasses, ask. For example, if a person asks whether an egg roll was fried in peanut oil, staff members should ask if the diner is allergic to all peanut products. In one incident at a Miami restaurant, a server assured the customer that the egg rolls were not fried in peanut oil, but failed to mention that peanut butter was used to seal the dough. The customer died from an allergic reaction.

• Servers should be able to describe a menu item and its ingredients upon request. Staff members should know what ingredients are in an item or where to find the information. In some cases, it may be helpful to show guests product labels so that they can assess the situation for themselves.

• If a server does not know whether a menu item is free of a potentially offending food substance, he or she should say so and refer the guest to a manager who has been designated to answer such questions.

• Ideally, there should be a designated point person on staff during each shift who is prepared to answer questions about ingredients; however, if no one knows for certain whether an allergen is in an item, admit that and recommend ordering another item.

Section 2: Food Preparation

• Train staff about potential allergens. Common allergens include eggs, fish, milk, peanuts, shellfish, tree nuts (including almonds, Brazil nuts, cashews, chestnuts, hazelnuts, hickory nuts, macadamia nuts, pecans, pine nuts, pistachios and walnuts) and wheat.

• Avoid cross-contaminating foods with potentially allergenic foods. Food for allergy sufferers should be prepared and served without any contact with allergens. Train kitchen staff to use a prep table that has not been exposed to the allergen if at all possible and to clean their cooking utensils after working with potentially allergenic foods.

• Train chefs so that they can prepare allergen-free versions of items upon request.

• Never include a possible allergenic food as a "mystery ingredient." A customer, cognizant of her allergy to peanuts, ordered chili in a Providence, Rhode Island, restaurant. She never even suspected that the secret ingredient used to thicken the dish was peanut butter. She died minutes later of anaphylactic shock.

• The trend toward "creative cookery" and the use of nontraditional ingredients--such as nuts in cheesecake--can increase the chance that customers will ingest offending foods. To avoid these problems, try to include such ingredients in the menu item's name or description.

• Don't make casual product substitutions. For example, don't substitute peanut oil for canola oil. A regular customer with a food allergy will not think to ask whether a dish he or she has been enjoying for years has suddenly been altered.

• Read labels carefully. It's not good enough to guess what ingredients are in a product. For example, a barbecue sauce may contain nuts, but many people might not think to check the label for this. Just because a product was safe last month or last year doesn't mean that it's safe today. Food manufacturers sometimes change ingredients.

• Complex foods such as sauces, dressings and garnishes may cause an allergic reaction. Serve these items on the side to allergy sufferers.

• Be aware that even a minuscule amount of food can set off a severe allergic reaction. For example, if a customer specifies that he or she is allergic to walnuts, it's not enough to simply scrape the nuts off the top of a piece of cake you are serving.

Section 3: Emergency Procedures

People with a food allergy or food hypersensitivity experience an abnormal reaction in which the immune system overreacts to what is for most of people a harmless food substance. Chemicals are released in the body that cause affected skin areas to become red, itchy and swollen, blood vessels to widen, and internal muscles to contract.

• Restaurant staff should know how to recognize the symptoms of an allergic reaction. Symptoms can include:
--itching in and around the mouth
--a tightening of the throat (airway blockage)
--wheezing and hoarseness
--shortness of breath
--appearance of hives
--swelling of the eyelids, lips, hands or feet
--nausea
--cramping or vomiting
--a sense of impending doom
--a drop in blood pressure
--a loss of consciousness

• Symptoms may appear as soon as 1 to 15 minutes after consuming the food, but can also develop over a period of hours.

• Most cases of allergic reactions to food are relatively mild, but a small percentage of individuals with food allergies have severe reactions that can be life-threatening.

• Train staff members to call for emergency aid if they see a customer in distress.
Have emergency numbers posted at all telephones for emergency service. Also post the name, street address and telephone number of your restaurant beside each telephone to ensure rapid response by the emergency squad.

For more information about food allergies, contact the National Restaurant Association at (800) 482-9122 or see our Welcoming Guests with Food Allergies, developed by the Food Allergy & Anaphylaxis Network in coordination with the National Restaurant Association.

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NRA staff