Inform Your Server

Food Allergies

by Alison L. Mead

Food Allergies

Colin Ruel

On a Saturday night in 2006, Paul Antico, an investment manager, found himself in a bind while taking his young sons out to dinner in Wayland, Mass. Two of his three children su ered from serious food allergies, and their go-to, allergy- friendly restaurant was full. “As we started driving around I realized I didn’t know how to find a restaurant I would feel comfortable at,” he recalled. “That was a big wake-up call.”
Paul’s not alone. Food allergies— milk, eggs, fish, shellfish, tree nuts, wheat, peanuts and soybeans the most common among them—are an increasingly serious health concern, affecting over 15 million Americans, including 5.9 million children. Symptoms vary from hives to anaphylaxis, but there has been a noticeable increase in allergy severity over the past decade. According to John Lehr, CEO of Food Allergy Research and Education (FARE), a national advocacy organization for Americans with food allergies, a food allergy reaction sends someone in the United States to the emergency room once every three minutes. But recently, Massachusetts has led the charge in changing the way restaurants approach customers with food allergies.
Unbeknownst to Antico, in 2005, Massachusetts State Senator Cynthia Creem had received a letter from high school student Julia Stern, expressing frustration with her experience dining out with food allergies. The letter moved Senator Creem to contact Chris Weiss at the Food Allergy & Anaphylaxis Network, the Massachusetts Restaurant Association, FARE and local interest groups to discuss legislation to better address the needs of these consumers. In 2009, Massachusetts passed the Food Allergy Awareness Act into law, and regulations offcially went into effect in 2011. The law is the first of its kind in the nation. The act mandates that all establishments preparing and serving food must have a certified food protection manager on staff. The staffer receives certification after viewing a training video about food allergies that describes best practices for avoiding cross-contamination of allergens (including obvious procedures, like washing hands between handling ingredients, and less obvious ones, like maintaining a separate sink for shellfish on restaurant premises).
The law also aims to raise the level of communication between consumer and food establishment, starting with a required—and hopefully now-familiar— notice on menus: “Before placing your order, please inform your server if a person in your party has a food allergy.” With these mechanisms in place, dining out still requires a great deal of trust between diner and restaurant when food allergies are involved. “It’s really all about communication,” said Edgartown Board of Health agent Matt Poole. “And how the person interacting with the consumer communicates the specifics to the food handlers.” Dr. Michael Pistiner, a pediatric allergist at Harvard Vanguard Medical Association cautioned, “The patron still absolutely needs to communicate, choose wisely and be just as vigilant as [they] ever were.”
And while the law only requires one trained staff member, Poole encourages restaurants to extend their training to as much of the staff as possible in an effort to create a culture of awareness around allergies. In fact, the Massachusetts Department of Health explicitly states that this program should supplement, not replace, any existing procedures.
But for West Tisbury resident Moira Silva, whose four-year-old suffers from severe peanut and tree nut allergies, the law is one more level of protection for her son. “I’m grateful for it, I think it [the training] makes a big difference,” she said. “I hope that the trickle-down effect from whoever takes it is strong enough that everyone gets on board and understands, because there are just so many inconsistencies.”
On Island, many restaurants had embraced allergy-friendly operations even before the law was passed. “We’ve always been sensitive to someone having a sensitivity or aversion to particular types of food—that’s not uncommon in the business,” said Colleen McAndrews of Offshore Ale Company. “It’s something everyone was practicing anyway; [the law] is just another layer of awareness.”
With its ample signage and knowledgeable staff, Scottish Bakehouse, has been a safe-haven for people with food restrictions long before the law was passed. Owner Danielle Dominick, who suffers from food allergies herself, has always been cognizant of the difficulties of eating out. “The act didn’t change anything about how we’re working,” she said. “We’re just pretty militant about contamination. If you get something that you shouldn’t be eating it’s just uncomfortable, and food should be an enjoyable experience.”
A year before the bill finally became a law, Paul Antico made a career change. Concerned with the lack of support for diners with food allergies, he founded allergyeats.com, a consumer-populated restaurant review site that provides information about the allergy-friendliness of restaurants across the United States. Antico is just one example of a growing movement of consumers taking it upon themselves to provide information and facilitate conversations around food allergies.
“The intent [of the law] was to give an awareness that will then spark further education and the creation of protocol within the restaurant,” said Dr. Pistiner. This is where he sees the law as having fallen short—that it encourages education but doesn’t mandate protocol. Still, Dr. Pistiner sees the law as progress. “When starting something that has the potential to affect so many eating establishments, in order for there to be positive change, it’s got to be a step-wise approach,” he said.
Looking forward, many advocates hope to see restaurants work towards earning “allergy friendly” certifications that would be granted by the Department of Public Health. Chef Ming Tsai, a Boston chef who was involved in crafting the 2009 bill, keeps a list of every item and ingredient he serves in his restaurant—what he calls “The Bible System”—which could be used as a model for restaurants when re-vamping their operations.
And other states have begun to get up to speed: Rhode Island passed a food allergen-awareness law in July 2013; a similar bill is currently being reviewed in Maryland. In Hamilton, Ontario, two restaurants are carrying EpiPens as a trial experiment, and Virginia is looking at implementing a similar trial. With the frequency of food allergies on the rise, growing awareness is inevitable. Antico hopes that all of this movement will eventually culminate in national legislation.
For now, Massachusetts is on the forefront, and the response on the consumer-end has been largely positive. “People find Massachusetts to be
extremely allergy-friendly,” said Antico. “Even if the individual pieces mightlack little bite, there seems to be a heightened level of awareness that this is an issue.” And that, he said, is huge.