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How do you deal with your food allergies when eating out?

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Allergies
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If you have food allergies or intolerance, eating out is often difficult. In this guest post from the Food Standards Agency (FSA), we find out how the times are changing with the introduction of new allergen rules.

Having a food allergy or intolerance can be horrible. I live with one, so I know what I’m talking about. It’s also why I have a strong interest in food labelling. Good labelling ensures I have the information I need to stay safe and healthy. The alternative to that is a debilitating episode if I eat something ‘wrong’.

I joined the FSA’s Food Allergy Branch in 2008. Since then, I’ve been working to see how we can help make a positive difference to people living with food allergies and intolerances. During the past two-and-a-half years we’ve been focusing on the new EU Food Information for Consumers Regulation. On 13 December 2014, this regulation introduces new rules on allergen labelling for prepacked foods and those not prepacked, such as meals in a café, school or hospital.

The work has involved identifying projects to develop guidance, advice, training and tools to make it easy for enforcement officers and businesses to understand and comply with the new rules. Funnily, some interesting issues have been thrown up along the way. How to deal with ‘pop up’ restaurants was just one of them!

Raising awareness of food allergies

We’re fortunate in the UK that almost everyone wants to do the right thing when it comes to food allergy. Almost everyone wants to stop people from becoming ill or, in the worst case, dying. I was able to call on others with an interest in allergy to develop their own projects to enable us to share messages. And understanding how people are affected by their allergies has helped inform our work as you’ll see in this video:

Allergy Awareness Week in April provided an excellent focus. Social media proved to be a brilliant tool. Those with a passion for this issue are not inhibited by their views! This resulted in lots of lively social media conversations. But it also helped to remind me of why I am doing this job – to protect the consumer.

Our current campaign is about to take off in a big way today. I’m on tenterhooks because I really want to see these new regulations improve the lives of people who live with allergies.

There is no denying that the very subject of allergy and intolerances is controversial at the best of times. Take a look at the comments page of most allergy related posts. Each has its fair share of those who understand and support the cause. But there are many who think we are ‘faking it’ or making ‘lifestyle choices’; and others who write us off as being a nuisance.

The new allergy laws are a positive step for consumers. We’re keen to know how the changes will make a difference to you and your lifestyle.

Which? Conversation provides guest spots to external contributors. This is by Chun-Han Chan, a member of the Food Allergy Board at the FSA. All opinions expressed here are Chun-Han’s own, not necessarily those of Which?.

Comments
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alfa says:
12 December 2014

Although raising the awareness of allergies is a good thing, I fear these new rules could have a detrimental effect in restaurants.

Several chain pubs/restaurants already list allergies in their food but to cover their backsides, they tick nearly everything as containing the allergy so there is even less choice available. Chef & Brewer list their burgers as containing milk. Many of their dishes listed as containing milk should be able to be served up free of dairy but staff are unable to tell you what part of the meal is affected.

Indian, Chinese, Thai, Italian, Greek, Spanish are the best places to eat with a milk allergy. Italian chefs are very good at knocking up a tasty non-dairy sauce or dressing.

British and high-end gourmet restaurants can be really bad as the only way many of them seem to make anything tasty is to use butter and cream. They tend to serve up their normal dishes minus the sauce or dressing so you end up paying over the odds for half a very boring meal.

Very few deserts are dairy-free so the only choice is usually raw fruit.

You can go through the menu with the server, think you have everything sorted, the plate of food is put down in front of you and there is a sheen on the veg……. uhh!! they forgot about the butter they put on it.

We also try to avoid dining out on Friday or Saturday evenings when eating places are at their busiest and staff are too busy to deal with allergies.

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JohnGK says:
13 December 2014

Alfa mentions various types of national cooking & others feta cheese etc. Exactly the same problems apply when visiting these countries some of which are outside the EU or in it but EU regulations are less vigorously applied or for many even if they did you may not understand even the characters used on the menu. You have to develop the skill & learn from bitter experience how to minimise the risks. If you cannot or unwilling to do that the only option left is restrict yourself to the countries where you can read the menu as well as you can in the UK. From limited experience the local & English descriptions do not always correspond

My wife has to follow a gluten free diet &, as for many allergies, there is an excellent web site from which a card in the appropriate language can be printed to show to a waiter & also gives menu suggestions. We recently visited Corfu where, as in the whole of Greece, flour is not normally used in the sauces for fish & meat enabling a wide choice. All of the family run tavernas that are the only places to eat outside the few main towns are thus a reasonable choice. She suffered no problems in our very enjoyable holiday.

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alfa says:
12 December 2014

From food.gov.uk
” Milk
40.The rules do not name the animal origin of milk because the word ‘milk’ includes milk from mammals such as cow, sheep, goat, and buffalo etc. It should be noted that all mammalian milk proteins have a similar structure and if someone has an allergy or intolerance to cows’ milk, they are likely to be allergic or intolerant to other mammalian milk. ”

Many people allergic to cow’s milk can tolerate milk from sheep or goat and I really wish they were identified as such.

Take Feta Cheese. If you buy it in Greece, it will not contain cow’s milk so not a problem. In the UK, it often contains cow’s milk. Supermarket pre-packaged feta cheese usually lists animals of origin so not a problem. Catering feta cheese is a big problem because it does not always list contents and very often contains cow’s milk.

There are also products where goat’s cheese will be in the title e.g. Goat’s Cheese Tart. Why do manufacturers have to ruin them for allergy sufferers by putting cow’s milk products in them? There are alternatives so why not use them and make them a truly goat’s cheese product?

So please manufacturers, state the animal of origin for milk products as it means more food could be available to allergy sufferers.

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wavechange says:
12 December 2014

I used to have an injection to hand when eating because of a food allergy but the problem subsided and then disappeared. Even though I have no current problems I still read the allergy information on foods.

It really annoys me to read ‘cannot guarantee free from nuts’ and similar labels, which are very unhelpful to those who have a problem. Fortunately the number of foods that are known to cause very serious allergies is small and I believe that food processors should do more to keep them out of foods.

The Food Standards Agency has an Allergy Allerts service to send emails when a problem is discovered.

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alfa says:
12 December 2014

Some products do state the reason for a trace of a product. It is usually because it is not produced in an allergen-free environment so cross-contamination is possible. It can also be because ingredients cannot be guaranteed to be allergy-free as they were manufactured elsewhere.

It would be helpful for products to state why they are not guaranteed to be free of an allergen so consumers can make up their own mind if the product is suitable for them. A trace of an allergen will not hurt some sufferers whereas it could be life-threatening for others.

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wavechange says:
12 December 2014

I agree, alfa. Rather than covering their own backs, the companies making and packaging the products should ensure that they do source their ingredients more carefully.

I was initially surprised that the supermarkets were being targeted because they were selling chicken contaminated with campylobacter, when the problem lay with the growers and processors. I now realise that the supermarkets are to blame for selling us chicken contaminated with faeces. It was interesting to know that so many supermarkets are buying chicken from the same processors.

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Charlotte Fitzgerald says:
12 December 2014

Good tip Wavechange – here’s the link should anyone like to sign up http://www.food.gov.uk/about-us/subscribe

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Sandra says:
13 December 2014

I’m disappointed to see that the new rules still show no recognition of the food intolerances associated with Interstitial Cystitis (or Painful Bladder Syndrome). This is a chronic form of cystitis with no identifiable bacteria and no reliable treatment, thought by some to be an autoimmune disease. Whilst the foods which trigger an attack of cystitis symptoms vary from one sufferer to another, some of the main suspects are spices (in particular chilli) and acid foods like lemon juice, citric acid and vinegar. None of these are covered by the new rules.

To give one small example – on a recent visit to Pizza Express I ordered arancini (rice balls) as a starter, described on the menu as ‘with spinach and cheese’. When I tasted them I could tell they contained chilli so had to send them back. Currently I have no real way of protecting myself apart from asking, every time I order something in a restaurant or cafe, for a full list of ingredients. This is embarrassing (as I’m sure a lot of people think I’m just being fussy) so I tend to just judge the level of risk and ask selective questions, but in the recent case there was nothing in the menu description of the arancini to suggest they would be spicy.

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wavechange says:
13 December 2014

Sandra – If a menu does not show how spicy a dish is, it’s probably best to walk out.

It seems unlikely that acidic foods will contribute to the problem because the amount of acid in the stomach will be much more than in the foods you have mentioned.

From the NHS website: “There is currently no scientific evidence that changes to your diet will benefit interstitial cystitis, although some people believe eliminating certain food or drinks can improve symptoms.” Until there is proper scientific evidence it is not reasonable to expect food to be labelled. Until the 80s we did not know that the bacterium Helicobacter pylori was responsible for stomach ulcers and we still do not know why many of us are infected but have no symptoms.

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Judith says:
13 December 2014

I too have rare allergies that are ones included in the fourteen covered by the new legislation. My main ones are cinnamon, vanilla and spicy foods.

More legislation is needed requiring the listing of each ingredient that currently appears under the general terms: “flavourings” “natural flavourings” and artificial flavourings.

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Sandra says:
13 December 2014

If there is no scientific evidence that changes in diet can improve IC symptoms, then that is a flaw in the way the research has been done. I, and many, many other sufferers know that it can and does. IC is an ‘unsexy’ illness, and has had very little resources spent on it in terms of research.

You say it’s unlikely that acidic foods contribute to my symptoms. I just know that they do, and I need people selling food to understand that when I ask what ingredients are in things.

Finally, in terms of not ordering anything unless it says how spicy it is. Would I avoid a cheese sandwich because it didn’t state ‘not spicy’? Or fish and chips? So why should I need to be suspicious of ‘rice balls with spinach and cheese’?

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wavechange says:
13 December 2014

Sorry Sandra. I forgot that the topic was eating out rather than food labelling. I agree that it is reasonable to know what ingredients are in food.

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Richard Jones says:
14 December 2014

It is interesting that all the comments are based on lactose intolerance and talk about milk and cheese however there is no mention of an allergy to cheese itself. I do not have a problem with milk products but I am allergic to cheese and have been since my childhood. There are many problems associated with eating out and buying sandwiches from shops either wrapped or unwrapped. In restaurants I always ask whether the food, no matter what it is, has cheese in it. This is because I have been caught out so many times when these so called gourmet chefs decide to plaster cheese over all sorts of meals that no one would normally expect. Who puts cheese on a mixed grill? When I ask the waiting staff about cheese their usual response is ‘no but we can put cheese on it if you want’ completely missing the point after being told I am allergic to cheese. Sandwich shops are a hazard because usually the preparation counter is strewn with grated cheese from other sandwiches which can then be transferred to the bread or roll. This happened to me recently in Yorkshire and it was only when I received my meal that I noticed yellow bits on my rolls which I sent back. Even supermarkets sell cheese covered rolls but there is often nothing to indicate that these are coated except the yellow colour and they are often in the next tray when some customers put unwanted ones back in the wrong tray. There are never any warnings other than about nuts and I am glad that at least my allergy is not life threatening unlike the poor souls with nut allergies. I could go on ad infinitum but I have made my point and will support any action to sort out this problem with menus and labelling

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