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Travel Health & Safety: 7 Food Allergy Tips

You needn't stay home or court disaster: By preparing for the worst you can sail through most situations with little or no effort on your part.

"You're so brave," said the interviewer to the older guy who had traveled for a couple of decades with a food allergy that could kill him with anaphylactic shock. "Nothing to it," he replied, "I just follow the Boy Scout motto -- 'Be prepared'." And that's the truth. You needn't stay home or court disaster, either. By preparing for the worst, and thereby obviating nearly all risk, you can sail through most situations with little or no effort on your part.

The downside is that you have to give up all sorts of things offered you, from six-course dinners on airplanes to local treats at Singapore food stalls, from that delicious-looking mixed veggie salad to a flaming dessert, for the simple reason that you can't be sure of the ingredients. Then again, the good news is that it all helps in losing weight or keeping the extra pounds off.

Note that I am not talking food intolerances here. About 25% of adults say they're allergic to some kind of food, but only about two percent have a true allergy, according to Consumer Reports on Health. Of the allergies, twice as many people are allergic to fish or shellfish than to tree nuts or even peanuts (the latter actually legumes, not nuts). Intolerance to food does not result in life-threatening situations (such as swelling and eventual closing of the throat and windpipe), the irritating rash or flushing, gas or cramps going away relatively soon. Nearly half of fatal food allergy reactions come from restaurant foods, though, so stay alert.

Here are a few tips I have gathered from interviews, research and personal experience (I have a deadly allergy to peanuts and green peas):

1. Carry a printed card that explains your food allergy and show it to the waiter in a restaurant (or maitre d' at a cocktail reception) and ask about what you order or what is on the buffet table. And have it in the appropriate language if traveling abroad. I go to to get free, simple translations in advance and print them out on my PC. When I have enough advance time, I contact SelectWisely ( and they print up plasticized cards for me in the appropriate language. SelectWisely has customized cards for food allergies of all kinds, plus cards advising of lactose intolerance, celiac disease (gluten-free needed here) and for vegetarians and other sensitivities. (When I didn't have time to order from SelectWisely and Babel Fish didn't have Czech language facilities, recently, I Googled "Czech-English translations" and found a generous lady in Prague who translated for me at no charge.)

2. If the waiter says "it's OK," and hands you back the card, insist that he or she show the card to the chef. Don't be surprised if you don't get a response before your order arrives. "I gave your card to the chef," is the usual excuse. This is not a correct answer, as your card says "Is what I am ordering safe for me? It must contain no (peanuts, in my case)." Demand a response from the chef. In the best case, the chef will come to your table and you can discuss what you want. Second best, the waiter returns and reports that the chef approved your order and is handling it. If the waiter says "I am also the chef," I then talk about the dish I want. If the waiter says, "I am the owner, I know what we use," I say, "Make me feel better, show this to the chef in case something has changed." In Key West, I once had a waiter tell me, "You know that allergies are all in your head, don't you?" (I was with other people, so I didn't just walk out, which I would have done if alone. Instead, I dined on recognizable cheese and wine.)

3. Avoid restaurants where the food by tradition specializes in the food you are allergic to. Seafood restaurants if it's seafood, Thai restaurants if it's peanuts, bakeries if you're gluten-averse, etc. Other experts suggest avoiding buffets altogether, as diners move the serving utensils around from bowl to bowl, for instance, or ice cream parlors, as servers may use the same scoop or confuse your order. (In Philadelphia once, I ordered butterscotch and got butter brickle, which contains peanut butter, and ended up in the hospital after just one big bite.) One reason I love Subway sandwich shops is that I can see what the server is putting into my sandwich, and I don't ask for any of the oils or other things in unlabeled jars or bottles while there.

4. At a cocktail party, eat no canapé unless it is plain cheese that you recognize or plain fruit--you don't even need the crackers with the cheese. Or you can go interrogate the headwaiter, who will probably say the food is catered from outside and the chef/caterer is no doubt ten miles away.

5. When dining out with friends, don't sample their dishes unless you have specifically asked the waiter/chef about their safety, too.

6. Always carry your medications with you, and an epi-pen if your throat swells or other life-threatening reactions ensue. In a small town or rural area, I check out where the nearest hospital is located and note it in my medical kit. (You may wish to join, free, IAMAT (tel. 716/754-4883;, the International Association for Medical Assistance to Travellers, to get a free list of English-speaking doctors and hospitals in foreign climes. Their World Climate & Food Safety Charts advise on sanitary conditions of water, milk and food, thought are not specifically concerned with allergies.)

7. After all this, if you get attentive service, tip generously, to make the waiter inclined to see the next person with an allergy card as a welcome guest, not just a pain-in-the-neck problem.

The Food Allergy & Anaphylactic Network ( offers more tips, advising you to call ahead or visit the restaurant when they are not busy to discuss your concerns, not to add anything to the plate other than what you have discussed ("garnishes" and the like), and having the chef bring the meal to the table so you can ask questions about it on the spot. They suggest, and I agree, that you get up and leave if you don't fully trust the meal will be safe. They also publish "Traveling With Food Allergy," a booklet with helpful information about North America and Western Europe.

A Cautionary Tale (Again)

In one big Las Vegas casino restaurant when they had a chef in from China for a special lunch, I interviewed the headwaiter, the executive chef and the visiting chef (the three together at the buffet table), pointing out, and I noting, the dishes that they said were OK for me, and followed their instructions. I still ended up in the hospital for an overnight stay when I had an immediate anaphylactic reaction to a dish they had pronounced to be "safe." Moral of the story: sometimes even the chef doesn't know what's in the dish, either because of cross contamination or because of some ingredient he didn't check into closely. (The latter usually happens when the restaurant orders readymade ingredients such as pastry crusts and never thinks to look at what's in it.)

If you're thinking of suing, and the only occasion when I did was that time in Las Vegas, note what a lawyer there told me. "Bob, you have a great case, but there's one big problem." "That is what?" "You're still alive. Your estate would have a great case and I would win it for them. But you spent just one night in the hospital and lost a day's worth of business appointments. All you could recover is the cost of that. And that's not worth my time, or yours."

Read more about allergies and travel in "Planning Tips for Travelers with Allergies and Special Needs."

Talk with fellow Frommer's travelers on our Health, Safety and Travel Insurance Message Boards today.