Food Allergy

Navigating Food Allergens: A Comprehensive Guide to Food Allergy Safety

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Trust20 Contributors • 15 minute read
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Food allergies are no joke. In fact, in many cases, they can be life-threatening. An allergic reaction can happen just moments after eating a bite of food–which is why it’s so important for foodservice professionals to be aware of the most common food allergens and how to reduce the risks of exposure.

Food allergies are rising among children and adults, so people working in foodservice must be careful and stay current on the latest information to protect their customers, who may be one of the 32 million Americans with a food allergy.1

Two hundred thousand Americans require urgent medical attention each year due to food allergies–and unfortunately, those numbers are growing as food allergies become more common.

Read on to learn all about food allergies and what your business should do to avoid contributing to that number. In this article, we’ll talk about the following:

Nine Major Food Allergens Recognized by the FDA

What’s the Difference Between an Allergy, an Intolerance, and a Preference?

Hiding Places for Allergens

Preventing Cross-Contact for Food Allergens

Allergy-Safe Food Storage

What Other Allergy-Safe Steps Can My Establishment Take?

What Else Can I Do to Help Customers Who Have Allergies?

Consider Adding Food Allergy Training to the Mix

Nine Major Food Allergens Recognized by the FDA

While there are countless foods that someone might be allergic to, some foods are much more likely to cause allergic reactions than others.

To that end, the U.S. Food and Drug Administration (FDA) recognizes nine major food allergens, and the 2023 FDA Food Code requires allergen awareness education for foodservice workers.

While there are plenty of other food allergens, the nine most commonly recognized in the U.S. are:

  • Milk,

  • Eggs,

  • Fish,

  • Shellfish,

  • Tree nuts,

  • Peanuts,

  • Wheat,

  • Soybean,

  • Sesame.

While restaurants and other foodservice establishments are not federally mandated to provide food allergy warnings on their menus, it’s in everyone’s best interest to include some form of allergen guidance to customers.2

Whether you provide an allergen icon guide on the menu or create a separate gluten-free, vegetarian, or vegan menu, providing customers with some form of communication around the major allergens will make them feel safe in your establishment–and make them more likely to become repeat customers.

What’s the Difference Between an Allergy, an Intolerance, and a Preference?

When a customer asks about an ingredient on a menu item, you may be wondering if that means they have an allergy–or if it’s just something they don’t like. Your customers may not always be clear about this themselves.

These modifications may be because of an allergy, intolerance, or personal practice. And you might not have any way of knowing. 

When handling modification requests from customers, one common misconception is that you can address allergies, intolerances, and preferences the same way across all people–which is simply untrue. A customer might be wondering if a dish has milk in it not because they’re looking to cut calories or don’t like the taste but instead because they have a life-threatening allergy. 

It’s not enough to assure the customer that the dish is dairy-free. You’ll also have to make sure any food that comes into contact with the customer’s meal is also dairy-free so cross-contamination doesn’t occur. 

Be safe, rather than sorry, and always assume a request is due to an allergy. Don’t chalk it up just to picky eating!

The best way to avoid the consequences of a dangerous reaction is for your entire food establishment team to work together to prevent reactions altogether–and knowing the ins and outs of food allergies, intolerances, and preferences is the right place to start.

Let’s break down the key differences between a food allergy, intolerance, and preference

Food Allergy‍

Food allergies are an immune system reaction that impacts multiple organs in the body and can cause a broad spectrum of symptoms.3 The symptoms of an allergic reaction can range from uncomfortable to life-threatening. They might include breathing difficulties, throat tightness and hoarseness, vomiting, abdominal pain, hives, and anaphylaxis, which can be deadly. 

According to the Cleveland Clinic, these symptoms may emerge immediately or over an extended period (usually 30 minutes to two hours).4

Food Intolerance

Food intolerances are not the same as food allergies; however, they can cause many of the same symptoms. Common causes of food intolerances include a missing enzyme needed to digest a particular food properly, Irritable Bowel Syndrome (IBS), sensitivity to food additives, recurring stress or psychological factors, and Celiac disease.3

While intolerances can cause incredible pain, discomfort, and distress for people, they do not cause life-threatening reactions like anaphylaxis. 

Food Preference‍

A food preference may be associated with a dietary lifestyle practice, such as vegan, vegetarian, pescatarian, kosher, halal, paleo, or keto.5 It can also be specific to an ingredient, such as avoiding beef, tomatoes, or cilantro. 

Foodservice workers may mistakenly take preferences less seriously than allergies or intolerances since customers don’t typically follow these practices for health reasons. Though not life-threatening, food preferences can be religiously or culturally significant and reflect closely held values. Because of this, always do your absolute best to accommodate customer requests. 

The Takeaway 

The bottom line is that food allergies, intolerances, and preferences should all be equally respected. There is no way to tell how severe a reaction may be just by looking at a customer, and consumers are trusting foodservice professionals to respect their requests–and ultimately protect them from the possibility of a reaction. 

You’ve probably heard of lactose intolerance when your friend says they can’t eat pizza or ice cream without getting an upset stomach. Is this the same as a dairy allergy? Not really!

While someone who is lactose intolerant and someone with a dairy allergy may have similar symptoms, their systematic responses are different.

A dairy allergy, most common among children, causes an immune system response. An allergic reaction to dairy can cause hives, swelling, and even anaphylaxis (which is life-threatening). 

Lactose intolerance causes digestive problems, which can be uncomfortable but not deadly. It is much more common, potentially occurring in 60-70% of the population.6

Food businesses can respect their customers' food preferences by including icons for common preferences, such as vegan, kosher, or halal, alongside menu allergens markers.

Hiding Places for Allergens

It’s also important to know all the foods on your menu that might contain allergens. Sometimes, allergens hide behind different names or as ingredients in things you wouldn’t expect. 

If your customers ask if your bread is dairy-free, don’t just look for “milk.” Look for ingredients like casein or ghee. These can also trigger a reaction.

Use this chart to help you learn some sneaky items that might contain allergens and make your customers sick.

Allergen

What to Look For

Milk

  • Casein 

  • Cheese 

  • Custard

  • Ghee

  • Ice cream

  • Lactose

  • Pudding

  • Whey

  • Yogurt

Eggs

  • Albumin

  • Artificial crab meat

  • Fat substitutes

  • Mayonnaise 

  • Meringue

  • Pasta

  • Salad dressings

Peanuts

  • Baked goods

  • Chocolate

  • Egg rolls

  • Enchilada sauce

  • Marinades, glazes, sauces

Tree nuts (Almonds, Brazil nuts, Cashews, Hazelnuts, Pecans, Pistachios, Walnuts)

  • Chinquapin

  • Desserts

  • Pesto

  • Pine nut

  • Nougat

  • Trail mix

Sesame

  • Benne

  • Bread, bagels, buns

  • Baba ghanoush

  • Gomasio

  • Tahini

  • Pasteli

  • Stir fry

  • Sushi

Soy

  • Edamame

  • Miso

  • Teriyaki sauce

  • Tofu

  • Vegetable broth

Wheat

  • Bread

  • Cereal

  • Flour

  • Noodles, pasta

  • Semolina

  • Vegetable starch

Fish

  • Bouillabaisse

  • Ceviche

  • Nam prik

  • Mam tom

Crustacean shellfish (Crab, lobster, shrimp)

  • Clamato/Bloody Mary mix

  • Etouffée

  • Gumbo

  • Paella

  • Jambalaya

Sources: KFA7 and Verywell Health8

Preventing Cross-Contact for Food Allergens

It doesn’t matter how well you label your menu items or communicate with your customers if you don’t take steps to prevent cross-contact in your kitchen and storage areas.

Two food safety terms are crucial for protecting customers but are often used interchangeably (and incorrectly). 

Cross-contamination and cross-contact are similar and can have some of the same prevention methods, but knowing the difference can prevent foodborne illnesses and allergic reactions at your establishment. 

What is Cross Contamination?

Cross-contamination is one of the most common ways food becomes unsafe and involves the transfer of harmful bacteria or viruses from one substance to another. 

What is Cross Contact?

Cross contact is when a food or ingredient that causes allergies or intolerances transfers to another food during storage, preparation, or cooking.

How to Prevent Cross Contact and Cross-Contamination

Both cross contact and cross-contamination usually occur via one of three pathways: food-to-food, equipment-to-food, and people-to-food.

You can prevent cross contact by following these practices:

Remember: cross-contamination means a food has become unsafe for anyone, and cross contact means that a food might be dangerous for those with allergies and intolerances.

Allergy-Safe Food Storage

When receiving foods in your kitchen, check labels for allergens and store them properly to avoid cross contact. You should always work with trusted suppliers to ensure food is not exposed to allergens before it gets to you.

The proper receipt and storage of food can go a long way in preventing allergic reactions caused by cross contact. The Centers for Disease Control (CDC) estimates that more than half of allergic reactions are caused by eating at restaurants.

Don’t risk it! Instead, follow these steps from the loading dock to the storage room to ensure food doesn’t become unsafe before it arrives in the kitchen.

  1. Inspect the shipment for spoilage and physical damage like leaking or broken items.

  2. Check the temperature of time-temperature-controlled items.

  3. Never leave TCS foods out for more than two hours.

  4. Keep non-TCS foods on shelves at least six inches above the floor, not touching walls or ceilings.

  5. Use airtight containers and put the date on them.

  6. Keep raw and ready-to-eat foods separate.

  7. Follow “First In-First Out” (FIFO) by using the oldest items in your kitchen first.

  8. Keep storage areas clean to prevent pests.

  9. Label chemicals and cleaning products and store them separately.

What Other Allergy-Safe Steps Can My Establishment Take?

If your team implements these five strategies, you’ll be on the right track to prevent situations that could leave you and your restaurant liable for negligence.

Make Sure Everyone is Informed

Tell front and back-of-house team members that the customer has a food allergy so that everyone can be on their toes about protecting the customer at every stage of the operation. 

Learn What Ingredients Are in Each Menu Item

Restaurants may not always list food allergens on the menu. By doing your due diligence and memorizing the allergens in the dishes you serve, you can provide helpful and accurate information when a customer tells you they have allergies.

Designate an “Allergen-Safe” Area in the Kitchen

If you have the space, consider creating a safe food prep area in your kitchen with separate utensils, cutting boards, and equipment. That separate space allows you to protect dishes from contamination of proteins and oils from allergens. 

If you can’t create a separate area, remember to prepare allergen-free meals first and keep them covered. Always wipe down, clean, and sanitize surfaces thoroughly before preparing food for a customer with allergies. Even a small amount of a substance can cause an allergic reaction.

Practice Good Hand Hygiene

Handwashing is a key factor in food safety, and it also can help prevent allergic reactions. It is good practice to wash your hands whenever you come in contact with any of the nine major allergens, even if you aren’t currently dealing with a customer with allergies. Always wash your hands before serving a customer with food allergies.

Learn Your Labels

The federal government requires that packaged foods have labels indicating they contain the major food allergens, but you or your team may remove foods from their packaging during storage and prep. Your kitchen should create a labeling system that helps prevent cross contact.

Include Menu Icons

Food businesses can respect their customers' food preferences by including icons for common preferences, such as vegan, kosher, or halal, alongside menu allergens markers.

What Else Can I Do to Help Customers Who Have Allergies?

By preparing ahead of time and memorizing these scripts to serve customers with food allergens safely, you will be proactively protecting your customers from allergy-related incidents. 

  1. Greet the customer: “Are there any allergies, intolerances, or food preferences I should know about?”

  2. Double check with the kitchen: “Is this the correct order for my table with the [insert allergy] allergy?”

  3. When serving food: “I confirmed with the kitchen that this was prepared away from [insert allergy]. Does everything look and taste right to you?”

When you’re serving a customer who requests a modification, these questions help establish clear communication. You should also learn these five steps to offering an inclusive meal to help you communicate with those with allergies, intolerances, and preferences.

  1. Plan ahead for allergies, intolerances, and preferences. 

  2. Actively listen to your customer and understand the specifics of a request.

  3. Repeat the modification back to the customer to ensure clarity.

  4. Provide reassurance to your customers.

  5. Ensure the final dish aligns with their expectations.

Allergic reactions aren’t uncommon in restaurant settings, but planning ahead can prevent an emergency that could leave you and your restaurant liable. 

Consider Adding Food Allergy Training to the Mix

While the knowledge in this article will put you on your way to a solid understanding of food allergy awareness, it is not a replacement for allergen awareness training.

Food allergies affect approximately 32 million Americans–that’s 10% of the total population. With numbers like these, foodservice professionals absolutely must take allergies seriously. Understanding the difference between an allergy and an intolerance, recognizing common allergens, and knowing how to avoid cross-contamination could mean the difference between life and death for some customers.

Training can help you create a comfortable environment for your diners and even save lives. Food allergen training will cover critical information about allergies and intolerances 

like recognizing symptoms and reactions, emergency protocols, and methods of prevention. 

According to the FDA Food Code, you must learn about the major food allergens if you work in the food industry, and managers are responsible for ensuring that their whole team receives this training. Investing in food allergy training for your team shows your customers that their health and safety is a top priority. Plus, it could set your business apart from others who may need to take allergens more seriously.

Choosing an accredited allergen awareness program can save managers time and headaches by providing staff with the knowledge necessary to keep customers safe and follow the law. Allergen awareness training is something every foodservice facility should consider to better protect those they serve.

Let's make sure we're doing everything we can to create a safe and enjoyable dining experience for all of our customers.

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Sources

  1. Food Allergy: Facts and Statistics
  2. Jeanette Bradley: Do Restaurants Have to Provide Food Allergy Warnings on the Menu?
  3. Mayo Clinic: Food allergy vs. food intolerance: What's the difference?
  4. Cleveland Clinic: Food Allergy vs. Intolerance: What’s the Difference? 
  5. Allergy Life: Battle of the Terms- Food Allergy versus Food Intolerance versus Food Preference
  6. NIDDK: Definition & Facts for Lactose Intolerance
  7. KFA: Food Allergens
  8. Verywell Health: Foods to Avoid When You Have a Shellfish Allergy
  9. CDC: Restaurant Food Allergy Practices — Six Selected Sites, United States, 2014