Peanut Allergy, Nut Allergy and Summer Travel Tips!

For me, the most stressful part of traveling with my nut-allergic daughter is restaurants. When you're away from home and staying at a hotel, restaurants are your main source of food. As someone who watches "Ramsay's Kitchen Nightmares" on BBC America, that is a pretty scary reality for me. The bottom line is that you just never know what is going on in a restaurant kitchen and who is doing the cooking. As we know, restaurant workers vary widely in their knowledge and understanding of food allergies. So the pressure is on us to communicate and navigate menus and establishments on our own. Yes, some restaurants do a stellar job, but you always have to do your research prior to eating.

Less is more. When evaluating a restaurant for allergic folks, seek our restaurants with small, simple menus. Why? Well, big menus that feature everything under the sun usually contain several off-limits items and cross-contact risk becomes greater. Also, the bigger the menu, the more likely that several chefs are cooking at once and again, cross-contact is an issue.

Find out what kind of oil they use for frying. This is especially important if a fried dish is one of a resto's specialities. When we travel, we call restaurants with lots of fried items and ask if they use peanut oil. If they do, we skip it. I've heard a lot about the "cold-pressed" vs "refined" peanut oil debate and some people insist that peanut oil is safe. The thing is, people have reacted to peanut oil -- some fatally -- and I would also argue that if you tell restaurant staff that you can have peanut oil with a peanut allergy, you're sending them a mixed message that may result in other kitchen mishaps. Plus, no peanut oil is 100% free of peanut protein, so for me, that's dancing too close to the mouth of the volcano. Many times, restaurants tell us that they use canola oil, and we have staff confirm this from the kitchen. These are the restos we feel good visiting. If you want to be absolutely safe, peanut oil is out and canola is in. Minimize your risk ahead of time and you'll have a better experience.

Get the menu in advance. Most places have their menu displayed outside the restaurant and in many cases you can get menus online. This is hugely helpful--don't skip this step! Knowledge of the menu helps you to avoid places that emphasize items that your allergic family members need to avoid.

Pay attention to salads. Salads are one of my daughter's favorite meals, especially Greek salads (no doubt a heritage thing since my husband is Greek.) However, salads can be high risk so before you let your child order one, examine what other salads are on offer. Do any of the salads contain nuts or nut oils in the dressings? If so, don't order a salad. The reason? Sometimes chefs untrained in food allergy simply pick the nuts off of a prepared salad and serve it--this makes for a potential reaction because the salad is then contaminated. Dressings look alike and can be mistaken for each other. Side note: my daughter knows to do this already. When she ordered a Greek salad, I opened my mouth to say--let's look at the other salads first--and she already had read the menu. None of them contained nuts. One more reason to involve your kids in the menu-reading process, even when they are young. It's great when they take responsibility for their own allergies.

Take the pressure off with some non-restaurant meals. We made sure to get a room with a refrigerator, enabling us to give our kids some cereal for breakfast or simple snacks. We also had a picnic dinner and lunch during our vacation using items we purchased from the local grocery store. Our kids really enjoyed picking out foods for our picnics and our allergic daughter felt more in control and more relaxed. Our picnics were some of our best times while on our trip--and it was the one time I wasn't on alert for allergic reaction. I needed a break--and so will you. Adding a few non-restaurant meals to your trip is not only stress-saving, it's money-saving as well.

AllerDine and Allergy Eats. These two food allergy restaurant guides help you decide where to eat by offering a database of U.S. restaurants that are rated according to your specific allergen. If you travel and find a good place to eat (or a bad place) don't forget to share your experience on these helpful web sites! www.allerdine.com and www.allergyeats.com

Food Allergies in The New Yorker: What Restaurants Don't Know Can Kill You

I received my latest New Yorker magazine dated February 7 (with a caricature of Mayor Bloomberg on the cover) and it contains an article that is causing a lot of buzz around the food allergy community. "The Peanut Puzzle" explores theories on what may be causing food allergies and some of the research that is being done to desensitize allergic kids. (You cannot read the entire article online unless you are registered; you can find it at your local library or magazine stand, though.)

After a careful review of this article, I'm very mixed about it, mainly because it ends with a supposedly successful desensitization to milk and it gives the impression (if you don't know all of the research and details) that food allergies are pretty simple to cure. The article never explains that desensitization is not an actual cure, that is, removing the allergy. All that desensitization will do is raise a person's threshold.

The article does not reveal any brand new research: the "hygiene hypothesis" is mentioned, as is the low rate of peanut allergy in Israeli babies, the theory being that this is due to an infant food containing peanuts. Both of these theories have been out there for awhile. Leading allergists Hugh Sampson, M.D. and Scott Sicherer, M.D. are both quoted in the article. One striking thing that they both mention is that they don't know, and that no allergist really knows what is causing food allergies.

One thing this New Yorker article accomplishes, however, is that it brings home some startling facts about public perception of food allergies, especially with regard to restaurants. In a study that Dr. Sicherer conducted using 100 restaurant workers (managers, chefs, waiters) in the NYC and Long Island regions, whopping percentages of those surveyed had potentially deadly misinformation about food allergies. More than a third surveyed thought that food allergens can be "killed" by frying a food at high temperatures and a fourth believed that small amounts of food allergens aren't harmful. A fourth also were misinformed about cross-contact; they believed that simply removing allergenic foods from a finished dish (taking walnuts out of a salad and then serving the salad, for example) would not be harmful to an allergic person.

Despite being wrong on these accounts, 75% of the workers surveyed believed that they knew how to serve an allergic diner a safe meal. Wowsa. That scares me to the core, especially because incidents in restaurants account for about half of all fatal food allergy reactions.

Is it any wonder that I get more than a little antsy in restaurants? I share this information because many of you reading this right now are brand-new to food allergies. Because food allergies get so much media attention lately, you may wrongly believe that restaurants understand how to keep your allergic family member safe. Many don't. You need to be really cautious. For example, my family avoids restaurants where a lot of dishes serving nuts are on the menu. We won't allow our daughter to eat a salad if other salads on the menu contain nuts or nut dressings (the stats I list above back us up on this one.)

That's not to say that you can never eat in a restaurant. But don't shoot the messenger here, if you care for an allergic child or have allergies yourself, your carefree restaurant days of breezing in and out of establishments are over. Do your homework, read menus, make phone calls. If it doesn't feel right, don't do it. Learn to cook--it's safer.

I may not agree with everything in this article, but one thing I do agree with. The author states that "People with food allergies live under a constant threat in a society that is still poorly informed about the condition."

For information on handling food allergies in restaurants, please check out some of my former blog posts:

Check online menus before you eat

A great restaurant experience

A bad restaurant experience

Please also visit Allerdine and Allergy Eats for more helpful dining out info!

Are Food Allergies Getting Easier to Manage?

I was interviewed for the current issue of Special Parent magazine, a spin-off of Chicago Parent magazine. The story focused on Chicago-area businesses and restaurants that accommodate various food allergies and intolerances. The story also discussed the difficulties that parents have in managing food allergies with their children and how the new crop of businesses are beginning to make it easier.

Now, it's your turn. Can we have your input on allergy-friendly stores, restaurants or other establishments in your area?

Every little step does make it easier, especially when dining out with food allergies. I am encouraged by the article and am hopeful that more establishments will crop up to address our needs. We are definitely loyal customers once we trust a place, so the success of allergy-friendly establishments should be assured.

OK, let us hear from you!