Avoiding Allergic Reactions While Eating Out on Vacation

My name is Mathew and I am allergic to all tree nuts and peanuts. I recently travelled to Cuba with my family and had a wonderful trip! The trip was a great opportunity to write a blog post as I encountered a buffet on a number of occasions and noticed many dangers that could occur for someone with food allergies when eating at a buffet. One interesting observation I made that I have noted throughout this post is that buffets are problematic, not only for people with allergies, but also for people who do not suffer from allergies.

cuba

This was my fourth time traveling to Cuba and I would most definitely consider myself a seasoned Cuba traveler. I know the ins and outs of staying safe and healthy while at a resort in the country. I often hear patrons complain about becoming ill, but I can proudly say I felt great from the moment I arrived until the moment I left as I played it safe with my food allergies. As I ate my safe meals, I couldn’t help but notice other customers visiting a buffet and noted some of the unique risks.

  1. Individual sets of tongs were used for different vessels containing different foods. These were then used to place food on a plate that already had food on it, and to push around various food items on patrons’ This poses a risk to allergy sufferers due to potential cross-contamination.
  1. Patrons used their hands to pick up food from vessels. Not only is this a serious health hazard, but the hands could have been in contact with an allergen prior to reaching into the container.
  1. Children laid both hands directly on top of plate piles and then reached for an entirely different plate. This is the same issue as in number 2.
  1. People would place food items that were on their plate back into vessels. This poses a risk of cross-contamination.
  1. People would use their plates multiple times rather than using a new plate for each new helping of food. This can be a health hazard and there is a risk of cross-contamination because the plate is potentially contaminated with allergens.

chinese food

There was no shortage of opportunity for me to be at risk of suffering from an allergic reaction.

For myself, I worked with the restaurant staff and felt comfortable with a few food stations and can share these tips:

  • I avoided all deserts. Nuts are commonly found in desserts and in the dessert section.
  • I avoided unidentifiable foods. If it is not clear what ingredients are in a dish than consuming it would be an unnecessary risk.
  • I selected food that was being cooked in front of me. If the food is cooked in front of me and it is a relatively simple dish such as grilled salmon, I consider it to be relatively safe. I can see what ingredients are included in the dish and how it is prepared. There is relatively less risk that patrons touched the food with either their hands or random tongs. I am weary of things that are cooked off site that do not have proper labelling.

At the end of the day, it’s important to ask yourself whether it’s worth trying to find safe food at a risky buffet, or whether choosing a more traditional restaurant is a better option for you.

For more information on observing at a restaurant to stay safe please refer to my post at https://whyriskit.wordpress.com/2013/04/09/asking-and-observing-when-dining-out/.

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The One Time I Did Not Ask About Nuts In a Restaurant

My name is Mathew and I am allergic to all tree nuts and peanuts. Recently I was hosting an event that I was planning on presenting at, but my time to speak was preceded by a trip to the emergency room.

I have never had an anaphylactic reaction but I do know my allergy to nuts is severe enough that ingesting small amounts of the allergen may trigger a life-threatening reaction. The event I hosted included a variety of food options that at first glance contained no nuts of any sort. On the tables there were vegetarian and non-vegetarian pizzas as well as meat and cheese trays.

Leading up to the presentation, I was somewhat nervous and wasvery focused on what I was going to say. I was somewhat hungry but I avoided food, not because of the risk of allergens, because I was very focused on my presentation. One of the people working with me handed me a slice of vegetarian pizza. I would normally ask a server, manager or owner about nuts but instead I quickly ate it and continued to work on the points I wanted to hit in my presentation. This may have been the first time I have ever forgot to ask about nuts because I was so focused on something else. Pizza, especially in a restaurant compared to a fast food chain, is a dish that one must always be careful with because of the potential for there to be nuts in pesto.

NewYorkSlice

Within a minute of finishing the pizza I felt tingling in the sides of my mouth, throat and lips. The feeling was very similar to what one would feel when they are getting their mouth frozen at the dentist. The cause quickly dawned on me. There must have been pesto on the pizza. I quickly told one of my fellow organizers that I was sure I was having a reaction and would likely have to leave for the hospital. I then found theowner to ask about nuts. The owner confirmed that therewere nuts in the pesto that was on the pizza I ate but a very minute amount. Although the reaction was not progressing very fast, I quickly had one of my co-workers drive me to the hospital emergency room because this is an experience that I have never had and did not want to take any chances.

Emergency

On my way I called my family to tell them where I was going and they said they would meet me there. Once I arrived at the hospital, I told the emergency staff of the situation and they assessed my status. I did not need immediate assistance but it was important that if I did, I was in a place that would be able to handle the reaction quickly. I had my auto-injector with me and I was ready to use it, but luckily it was not needed. The reaction did not progress any further than the minor swelling which eventually subsided after being given an antihistamine. I was grateful of my co-worker for getting me there quickly, as well as my family for coming to make sure that I was okay.

I learned a valuable lesson that day: it is critical to always ask the staff about the food you are eating at their restaurant. This is a priority above all else.

Lessons Learned from an Allergic Reaction

Emergency

I am Mathew and I am allergic to all nuts. This blog post is about a close friend of mine who recently suffered an anaphylactic reaction.

On September 17, my friend left class to grab lunch. She ordered a chicken gyro from a new Greek restaurant on campus. She took the meal to go and got on a bus to commute home. When she was half way through her meal, she started experiencing symptoms of an anaphylactic reaction. Her face was swelling, her throat was itchy and she was experiencing chest and stomach pain. She did not have an auto-injector with her because she left it in her gym bag and forgot to put it in her school bag. She decided to get off the bus to find a cab. The cab driver took her to the hospital. Once she got into the emergency room, the hospital staff quickly identified that she was experiencing anaphylaxis and gave her a shot of epinephrine. She was placed in a hospital bed, hooked up to intravenous and was monitored for 8 hours before being released from the hospital. It took two days for the effects of the reaction to leave her system.

Although the story is very simple, there are three valuable lessons to be learned from this person’s experience:

1. Always ask about allergens when ordering food. As you may have noticed, she did not ask the restaurant about how they do, or do not accommodate allergies. Although what caused the reaction is not clear, it is highly likely that cross-contamination may have occurred. One can only speculate as to how the allergen got into the food but it is possible that the cross-contamination issues could have been identified if she had asked about the food before ordering it.

2. Always carry an auto-injector. As I stated above, she did not have her auto-injector with her. One must always have it with them because you never know when a reaction will occur. Kudos to her for taking it to the gym because 57% of people do not carry their auto-injector with them at the gym(1). She could have treated herself on the bus if she had the auto-injector with her.

3. Always call 911 if experiencing a reaction. It’s important you do not try to drive yourself to a hospital during a reaction. An ambulance stocks life-saving medicine and can provide timely treatment on the way to a hospital.

(1) Sampson MA, Muñoz-Furlong A, Sicherer SH: Risk-taking and coping strategies of adolescents and young adults with food allergy. Journal of Allergy and Clinical Immunology 2006, 117:1440-1445.

Asking and Observing when Dining Out

LIVE_ Dining OutMy name is Mathew and I have allergies to all nuts and some fish.  I recently wrote a post about the reasons why I think allergy sufferers tend to undertake risky behaviour in regards to their allergies.  In this post I hope to provide helpful information about what I do when I eat at a restaurant.  I ask questions and more importantly, I make observations.

Asking restaurant staff about their food allergy policy is always necessary when eating at a restaurant.  Sometimes the restaurant will state their policy on the menu or where patrons place their orders.  Although asking is important, it is subject to human error and therefore making your own observations and using common sense is important too.  Some things that I look out for include:

  • Other menu items that have allergens in them.  An example would be if you are ordering pasta with tomato sauce and the restaurant serves a pasta dish with nuts.  There is a chance that there could be cross-contamination.

  • Menu items that have “hidden” allergens.  An example is pesto sauce on pizza.  Pesto may be put on a pizza and may not be visually obvious.  Pesto may or may not have nuts in it (but usually does as it’s commonly made with pine nuts).

  • Set-up of the kitchen.  If I can glance into the kitchen on the way into the restaurant I will observe the set-up of the kitchen.  I look for any potential cross-contamination issues.  One time I was at a restaurant for breakfast and the waitress assured me that I was safe eating there as they had no nuts on the menu.  I was able to sneak a look at the grill and noticed that on “special order” (which means that it was not on the menu) the chefs were using peanut butter in the pancakes (on the grill).

The problem is that not everybody is educated in food allergy safety and relying on their assurances is not always sufficient.  This is why it is so important to not only speak with the wait staff, but also with a manager and the chef if possible. When I do make inquiries, I am careful as to how I frame my question.  I often notice that people ask, “does the pizza have allergen X in it?  I am allergic”.  That question warrants a basic yes or no answer and implies that if there are no allergens directly on the pizza you ordered then you will be okay.  A better question is, “I am allergic to X, what is the restaurant’s policy in regards to allergens”.  This question sounds more serious and will often result in the wait staff inquiring with the chefs or management.

The next time you dine out, be sure to ask the right questions, observe, and never take a chance with a food you don’t feel 100% safe with.

Reasons for Food Allergy Risk-Taking

Screen Shot 2013-03-09 at 7.57.55 PM

My name is Mathew and I am allergic to all nuts and some fish.  For many years I have observed; and I have not been surprised by the fact, that people who do not suffer from severe allergies often misunderstand the risks associated with severe allergies.  Recently I have noticed; and was surprised by the fact, that some allergy sufferers themselves downplay their allergies by taking risks.  I believe that the most prevalent reasons for the risk taking behaviour of allergy sufferers are carelessness, a lack of understanding and embarrassment.

CarelessnessHotel restaurant table

From my experience, allergy sufferers can be careless when making decisions that are impacted by their allergies.  I have observed allergy sufferers who have claimed to have mild to moderate allergies, eating foods knowing that the food contained an allergen that would adversely affect them.  I asked them about their actions and the response was a very simple, “I’ll be fine”, followed by a shrug.  Although they thought their allergy was not severe, they still had a significant allergic reaction to the allergen.  Their actions may be evidence of their carelessness.  When I am with people who suffer from a known severe food allergy, I’ve noticed that they rarely ask the server about the restaurant’s policy in regards to food allergens.  I have questioned them on why they did not inquire and have received responses such as, “its fine, whatever”.  The responses may be confirmation that the individuals are careless but they may be evidence of the individual’s lack of knowledge about the risks that they are taking.

Lack of Understanding

I think the most common and dangerous reason why individuals take risks when it comes to their allergies is a lack of understanding of the risks that they are taking.  I know of people that will eat products that are labeled with, “may contain allergen X”.  I have questioned their actions and I often receive responses such as, “most of these warnings are there for legal reasons”.  Although there are laws regarding the labeling of food with allergen information, studies suggest that 7% of foods labeled with “may contain allergen X” do contain the allergen (S. Sicherer, 2007).  The fact that individuals are under the impression that the warnings are present strictly for legal reasons suggests that there is a lack of understanding of the risks being taken by some allergy sufferers.

Embarrassment

This category is relatively broad but it is important because I think every person with a severe allergy has been subject to these feelings in regards to their allergies more than once.  I know from experience that it can become quite mundane having to inquire about your allergies in a social situation when you are the only person suffering from allergies.  I often feel like I am being a bother and although I always inquire about the establishment’s policy regarding food allergies, it never is without the feeling of being the centre of attention for that brief moment.  Restaurant employees are often trained to deal with allergies but I often find myself in situations where I am inquiring with someone who does not understand allergies.  I, as most other allergy sufferers, can identify unsafe situations when non-allergy sufferers cannot.  Many people are under the impression that if they do not use an allergen in a dish then the dish is safe for an allergy sufferer.  The person who cooked the dish may insist you will be fine eating it when in reality the allergy sufferer knows they are at risk.  It is somewhat embarrassing to have to turn down the food in this situation because it may appear as if you are rejecting the food being offered to you because you are not interested in it.

It is important for readers to be aware of the reasons why allergy sufferers may act as if they do not have allergies.  If you suffer from allergies then being aware of the above information will help you change or reaffirm your behaviour.  If you do not suffer from allergies then being aware of what an allergy sufferer goes through will help you if you are ever in a situation where an allergy sufferer is making a risky decision.  Always remember, why risk it?

Anaphylaxis Canada. (2010). Research. Retrieved from http://www.whyriskit.ca/pages/en/learn/research.php#question_3

The Business of Allergies

Recent research has indicated that the global market for food allergies and food intolerances will reach $26 billion by 2017 (“Global food allergy”, 2012).  The growth in the market is being caused by an increase in demand for allergen free products.  The increase in demand has been caused primarily by an increase in the number of people affected by dietary restrictions and their growing need for varied food choices.

Mo' Allergies, Mo' Products.

Mo’ Allergies, Mo’ Products.

The growth in the market has provided a valuable opportunity for many companies through the release of various products that have allergen free statements. It is no mystery why many companies are sporting the “peanut free” label or are sprawling “lactose free” across their milk cartons to attract the allergy conscious market. However there is a more interesting discussion to be had regarding the way in which companies are seizing opportunities from the increase in demand for allergy free products.

Besides the obvious business opportunities stated above, a more diverse array of companies are trying to profit from the surge in the number of people affected by food allergies.  Many restaurants have an allergy menu that charts which dishes are made using various allergens.  At the very least a majority of restaurants are including the above information on their web page.  As more companies begin accommodating allergies, it is putting pressure on other companies to do the same.  Effectively, it is my belief that providing allergy information to consumers is becoming an industry standard rather than a competitive edge.  Apps such as iCanEatOntheGo are allowing customers to refine searches to “only restaurants that are allergen safe” and websites such as Allerdine.com allows customers to rate restaurants on their allergy–friendliness.  The emergence of social media is causing restaurants to come under increasing pressure to become more aware of their customer’s food restrictions.

The Chicago Cubs are displaying one of the most unique forms of “allergen free” marketing.  The company has recently implemented its “peanut-safe zone”.  The idea involves a skybox equipped with medicine, non-allergen snacks and a nurse on hand. Wrigley Stadium charges $50 per skybox ticket and has 100’s of families on a waiting list to buy a ticket (Parekh, 2010).

In the United States the number of individuals suffering from food allergies or intolerances has grown by 18% over the past decade (Parekh, 2010).  With the emergence of social media and word of mouth marketing, it appears that accommodating this portion of the population is becoming somewhat of a necessity for companies whose primary business is food.  As the allergic and intolerant market grows, companies are innovating more creative ways to help them eat safely. I for one welcome the competition and continued innovation as it helps not just individual businesses, but rather entire industries become more allergy aware.

Global food allergy and intolerance products. (2012, 12 10). Retrieved from http://www.prweb.com/releases/2011/4/prweb8310957.htm

Parekh, R. (2010). Market for food-allergy-friendly businesses more than peanuts. Advertising Age, 81(36), 32-32. Retrieved from http://ezproxy.lib.ryerson.ca/login?url=http://search.proquest.com/docview/759995012?accountid=13631

A friend’s experience

Hi! My name is Mathew, and I’m allergic to peanuts, tree nuts, and milk. I have never had an allergic reaction that was severe enough for me to be hospitalized, but a friend of mine who has a severe nut allergy was recently hospitalized twice in two days. I wanted to share her experience.

Youth raising their arms at a music festivalAfter a weekend out at the VELD music festival, she arrived home late on a Sunday night.  Tired from 48 hours of dancing, drinking, and not sleeping, she lay down in her bed to get much needed rest.  After a few hours of sleep, during which she did not eat or apply any cosmetic products, she began to feel the symptoms of an allergic reaction.  She eventually decided to take some antihistamines.  She then went to her parents, because the symptoms were slowly becoming more severe.  Her parents did not feel that she needed to be taken to the hospital – but she found that speaking and breathing were slowly becoming more troublesome, so she called a cab to take her there.

The dashboard of a taxi cabUpon arrival at the hospital, she saw the triage nurse and was shifted from waiting room to waiting room.  Eventually she mentioned that her throat felt very tiny, but it may just be her asthma.  She was immediately rushed to the emergency room where she was hooked into an IV and given an epinephrine injection.  She was held in the hospital to be monitored until she was eventually sent home with some medication.  A few hours after she arrived home, the hives re-appeared. She took antihistamines again and went to sleep.

An ambulanceShe woke up from her sleep with trouble breathing.  Thinking that it was her asthma, she took her puffer.  Her troubled breathing persisted.  She called 911, went outside and passed out.  She woke up in the hospital being treated for her reaction.  She says that the process the second time around was very similar to the first time.

She knows that what happened was an allergic reaction, but she has no idea what caused it.

A Heritage Trip to Ireland and Scotland

My name is Mathew Keating. I am 19 years old, and I have a nut allergy.

Irish flagI recently took a heritage trip to Ireland and Scotland. I have traveled to Europe before and, from experience, was under the impression that there was a lack of food labeling standards and general knowledge among the population in regards to food allergies.  Although those previous experiences were concerning, they were not a major worry while planning my trip, since I had dealt with such issues many times before.

To my surprise, I was mistaken on how Ireland and Scotland dealt with the issue of allergies. In both Ireland and Scotland, most of the locals and corporations Irish landscapewere very aware of allergies.  The labelling was very good, if not better then Canadian labeling.  Nearly every product had allergy warnings, including differentiation between products that have nuts, “may contain nuts” or “are not suitable for nut allergy sufferers.”  This was very good to see and made me feel very comfortable when choosing what to eat.

Although the labelling was very detailed, I found it to be excessive at times.  In some instances, a brand that offered a very large variety of foods – including everything from deserts to vegetables – would label every product with the same warning, “not suitable for nut allergy sufferers,” without exception.  At times, I felt they were doing this to minimize any possible risk, even when the risk may have been virtually non-existent.

European ingredient label

The locals were very aware of what allergies were and how they must be dealt with.  They knew how careful one must be when an allergy is severe.  Most restaurants knew to read the labels of the ingredients they used in their food and to be careful when preparing food.  Fortunately, only one restaurant throughout the three week period turned me away, as they were not confident that they could make safe food for me.

Although the labeling seemed over the top at times, I was very relieved to know that companies and citizens of the country were understanding of the issues surrounding allergies. That helped me to enjoy a safe and wonderful trip!

If you’re planning a trip to Europe, check out these useful resources:

–          Why Risk It? – Travel Section

–          Anaphylaxis Canada – Travel Section

–          Food Allergy & Anaphylaxis Alliance

–          European Food Labelling Laws

And don’t forget to watch our Travel video!