How to Dine Out Safely with Food Allergies

This story is part of The New Rules of Dining Out. Read the resthere.

The first time I piped up about myfood intolerances, my voice shook. I'd been diagnosed with a gut condition I won't bore you with (thus explaining the gnarly way my body felt after a few bites of certain foods) and for months, I retreated to the dull safety of a mostlyPaleo dietat home. That's a major bummer for someone who writes about food for a living, so after consulting with my healthcare pros and industry pals, I ventured out for a meal with my script scrolling across the back of my eyes like a news ticker.

After the specials spiel, the server slipped into the rote text she'd likely recited tens of thousands of times,"Does anyone have any allergies, restrictions?"and for once I had a refrain."Um,"I wobbled,"I have a few…"She raised pen to pad."I'm sorry."She lowered her hands and looked into my eyes.“你不用道歉。这是你的老板dy. And it's my job to keep you safe."

RELATED:How Chefs with Food Allergies Are Raising the Food Safety Bar

As I've come to learn in the years since, yes, plenty of the responsibility for diners' wellbeing falls on the waitstaff, but we also have to play an active role. That starts with clear, honest, and early communication with a restaurant if there are allergies involved.

Chef and restaurateurMing Tsaibecame anational spokespersonfor theFood Allergy and Anaphylaxis Networkwhen his son was diagnosed with a life-threatening peanut allergy, so he's intimately acquainted with the stakes from both sides of the pass. Tsai has written an "allergy bible" for his own restaurant Blue Dragon and provides templates on his website (ming.com) for other restaurants to create their own, but the man likes to dine out with his family, too, and shares a few guidelines for diners.

RELATED:Ming Tsai talks about food allergies, CBD, and why having fun matters.

Communication is imperative, says Tsai, and it includes a call to the restaurant manager, even if (and you definitely should) you've made notes in a reservation app. This gives you an initial read of how the restaurant is going to treat the restriction. "Are they rolling their eyes on the other side of that phone? Like 'Oh, not another food allergy person', or are they really sincere,'Not a problem, our fryer is shellfish-free?'" Their reaction should determine if you're going to go there or not.

On a party's arrival at his restaurant, Tsai has his front-of-house team welcome them with an assurance that they're aware of specific allergies. If that's not part of the protocol where you're dining, he says it's absolutely fine—even necessary—to bring it up with your server repeatedly as you order, and when the food arrives at the table. "Look in the eyes of that waiter, and ask, 'Are you sure this is peanut, tree nut, and dairy free?' You're not being a pain in the ass," Tsai says."You're protecting your life or the life of your child."

RELATED:Do You Really Have a Food Allergy?

It's also a good idea to, like him, have cards printed to give directly to the chef, in multiple languages even, so there is no gap in communication or doubt about what's at stake. And if the allergy is life-threatening, don't sugarcoat it. "When you use the word 'death' or another that's really severe, people will take notice," says Tsai. "If it is life threatening, say it, and it will get attention."

No restaurant in the world wants to make you sick, but there are vastly different protocols for how a kitchen deals with various scenarios. Both Tsai and 2014 F&W Best New ChefMike Gulottaof Maypop andMoPhoin New Orleans urge diners to be honest.

When someone has an aversion, restriction, or intolerance, many dishes can be adapted on the fly with the substitution or omission of a garnish, sauce, or another component. "We go through training with our cooks, because we have specific dishes set up for people with dietary restrictions: This person can have this dish, since we know we can easily remove the gluten or dairy. We have our servers steer people toward certain dishes that we know we can do quickly and efficiently," says Gulotta.

"If you're at a restaurant that's really trying to please you, you can crash the kitchen because we want to make you happy. I will burn a whole cook to make you a specific dish." But if he walks out into the dining room and sees the allegedly allergic person nabbing forkfuls of someone else's, say, dairy-laden dish, he, his team, and other diners are the ones who get burned because it erodes trust, and may make things harder down the line for people with real issues.

Tsai isn't afraid to politely confront a fibbing guest who took time and resources away from other diners who might actually have serious allergies. "Nothing pisses a chef off more than when we bend over backwards, change our cutting boards, tongs, and gloves, because this person says they have a dairy allergy, and then we see them eating an (expletive) ice cream dessert. Do not lie and say it's a life-threatening food allergy when it's just an intolerance, or you're on a diet," he says. "Just say 'I'd rather not eat dairy...then,we don't have to do backflips."

Allergy vs Intolerance

Physical reactions to food are common, but may call for different protocol from the staff. An allergy means a food triggers an immune system response from multiple organs, with reactions that range from mild to severe or even fatal. An intolerance may be quite unpleasant (digestive issues, headaches, and joint pain, for example) and should be respected, but the stakes are different.

Anaphylaxis

These sometimes life-threatening reactions may happen minutes after the offending food is eaten—or in a biphasic case, hours or even days—and often impair breathing or blood circulation. Many people who have been diagnosed with allergies will carry an epinephrine auto-injector (often called an EpiPen) to reverse the effects in case of emergency.

Aversion

There's something about this ingredient that you just don't like. Might be the smell, flavor, texture, sight, or the fact that it reminds you of your ex or your childhood bully. That's totally valid! But it's not an allergy.

Restriction

Might be ethical, moral, religious, health-based, diet-based, or nobody's dang business. Your boundaries should absolutely be respected. (But it's still not an allergy.)

Food Allergy Research & Education (FARE)—a nonprofit organization dedicated to education, research, and advocacy—reports that85 million Americansare impacted by food allergies, and that32 millionof them deal with potentially life-threatening conditions. The group also estimates thatevery three minutes, a food-related reaction sends someone to the ER.Many foods can cause an allergic reaction, but thesenine allergensare responsible for about90% of cases: milk, peanuts, tree nuts, eggs, soy, wheat, shellfish, fish, and sesame.