Module 5. Experiences of Consumers with Food Allergies
After the module, students will be able to:
- Identify the impacts of food allergies on individuals' lives, including social impacts
- Encourage the creation of food allergy prevention programs in restaurants
- General feelings and perceptions about dining out
- Reported behaviors when dining out
- Past dining experiences reported by adults and children with food allergies
- Past experiences of food allergy reactions
- Consumer expectations from foodservice establishments
- Additional information
Note: all content in this module is from the following three sources:
- Kwon, J., & Lee, Y. M. (2012). Exploration of past experiences, Attitudes and preventive behaviors of consumers with food allergies about dining out: A focus group study. Food Protection Trends, 32, 736-746.
- Kwon, J., Sauer, K., Wen, H., Bisges, E., & Myers, L. (2014). [Dining experiences of customers with food allergies]. Unpublished raw data.
- Leftwich, J., Barnett, J., Muncer, K., Shepherd, R., Raats, M. M., Hazel Gowland, M., & Lucas, J. (2011). The challenges for nut-allergic consumers of eating out. Clinical & Experimental Allergy, 41, 243-249.
Customers with food allergies and parents of children with food allergies often:
- Feel a strong sense of personal responsibility about being safe when dining out.
- Experience anxiety and/or fear when eating outside the home, especially when going somewhere for the first time, due to complications of identifying and explaining allergens.
Perceived causes of allergic reactions when eating out:
- Hidden ingredients
- Poor communications between "front of house" and "back of house"
- Inconsistent and insufficient product labeling
- Unknown change of ingredients and/or supplier
Perceived barriers for establishments to provide allergen-free food
- Lack of employee training, knowledge, and awareness
- Inconsistency from location to location for franchises and other restaurants with multiple locations
- Frequent changes of product
Perceived risks of food allergy reactions and characteristics of food service facilities
- Ethnic restaurants, due to potential hidden food allergens in sauces
- Buffets, due to potential cross-contacts
- Specialty restaurants with complicated food ingredients
- Up-scale restaurants, due to quick changing chef recipes
- Small establishments (e.g., ice cream shops, snack shops), due to the common use of nuts and potential cross-contacts
- National chain franchise restaurants, due to the minimal training level of employees
- National chain franchise restaurants, as preparation is simple and allergenic ingredients are handled separately (i.e., in pre-portioned packages)
- Establishments where food is prepared from scratch, as they avoid pre-prepared food, which has high risk cross-contact
- Overall clean establishments
- Establishments with allergy-friendly practices (i.e., specific policies, rules, and food allergy training)
- Establishments where staff shows concern for ensuring the safety of customers with food allergies and accommodating special requests
Consumers with food allergies choose places that have the following qualities:
- Have been safe in the past
- Do not have an individual's allergen on the menu
- Accommodate special orders or requests
- Provide allergen information, especially online
- Have knowledgeable staff in terms of food allergen on the menu
- Have a good reputation among the allergy community
Before going out to eat, consumers with food allergies do the following:
- Call the restaurant ahead of time
- Check online menus, ingredients, and allergen information when available
- Seek food allergy related information through extensive investigation
- Take advice from members of the food allergy community, such as Food Allergy Moms (http://allergymoms.com/index.php) and AllergyEats (http://www.allergyeats.com/)
- Parents of food-allergic children often bring "back-up food" for situations when doing so is easier than explaining needs or when they feel that a service cannot provide safe food for their child
When ordering food, do the following:
- Try to keep orders simple
- Notify the server and/or manager of allergens and needs to avoid embarrassment or unwanted attention
- Staff members were accommodating when special requests were made.
- Staff exhibited a good attitude, understanding, and/or empathy when it came to meeting needs.
- Staff exhibited a lack of understanding and empathy regarding needs.
- Staff appeared frustrated when a special request was made.
- Staff did not attempt to accommodate consumers' needs.
- Staff did not take consumers' requests seriously.
- The server or other staff members did not believe food allergies to exist or did not think reactions are would be severe.
- The consumer had an allergic reaction (requiring antihistamine, epinephrine, and/or a hospital visit/emergency medical attention) to the food served.
Reported consequences of children's food allergy reactions:
- Become upset and terrified during the reaction
- Feel shaky, panicky, and agitated for several days after the incident
- Limited what they ate after the incident
- Frightened for child's life (during the reaction)
- Sad about child's experience
- Recognized the need to educate others
- Decided to home-school children if food allergic reactions occurred at school
Establishment responses to food allergic reactions:
- Staff apologized sincerely
- The restaurant paid for medical costs of the food allergy reaction
- Staff members handled the situation professionally
- Staff immediately or continually denied their fault
- Apologies seemed insincere
- Staff appeared unsympathetic
- Staff did not grasp the severity of what had happened
- Customers were charged for a meal even though the meal was not completed
- Staff was impatient, not knowledgeable of food ingredients, and did not know where to locate allergen information, etc.
- Establish procedures to prevent dishes from being contaminated by allergens
- Identify the top eight major allergens on menus
- Use specific allergen symbols
- Use "contains" statements
- Have specific allergen-free menus
- Provide allergy safety training for staff on the following topics:
- The increasing number of individuals with food allergies
- Consequences of food allergy reactions
- Common food allergens (The Big 8)
- Ways allergen exposure can happen
- Reading labels for potential allergens
- How to prevent cross-contact
- How to communicate with customers and restaurant staff about food allergies
- How to recognize allergic reactions
- Prepare foodservice staff, particularly managers and servers, to be able to confidently answer the following consumer questions (Walkowiak, 2011):
- What protocols do you have in place to serve food-allergic individuals?
- Which items on your menu are not safe, given my specific food allergies?
- How are diner's allergies communicated to the kitchen and other staff?
- How is the kitchen set up to prevent cross-contact?
- Is separate equipment used to prepare orders for food-allergic individuals?
- What kind of oil will be used in the preparation of my order, and is it safe, given my allergies?
- Can I see the list of ingredients for a given menu item?
- Provide allergen information online.
- Have relevant and up-to-date food information on hand, such as recipes, ingredient lists, preparation methods, etc.
- If applicable, market as an allergen-friendly restaurant.
- Use signage to make the use of common allergenic ingredients clear
- For example, "We use X allergen in our facility" or "We have X allergen-free products")
- Give full, honest, and straightforward disclosure with regarding what can and cannot be accommodated and when answering questions or providing any other information.
- Do not be afraid to say "I don't know" when unsure. Do not assume or pretend you know the answer when you are not sure about it.
Coping with food allergies - a guideline for consumers with food allergies
Parekh, R. (2010). Market for food-allergy-friendly biz more than peanuts. Advertising Age, 81(36), 32.
Kwon, J., & Lee, Y. M. (2012). Exploration of past experiences, Attitudes and preventive behaviors of consumers with food allergies about dining out: A focus group study. Food Protection Trends, 32, 736-746.
Kwon, J., Sauer, K., Wen, H., Bisges, E., & Myers, L. (2014). [Dining experiences of customers with food allergies]. Unpublished raw data.
Leftwich, J., Barnett, J., Muncer, K., Shepherd, R., Raats, M. M., Hazel Gowland, M., & Lucas, J. (2011). The challenges for nut-allergic consumers of eating out. Clinical & Experimental Allergy, 41, 243-249.
Walkowiak, A. (2011, March 14). AllergyEats founder offers tips for dining out with food allergies and intolerances. AllergyEats. Retrieved from http://www.allergyeats.com/blog/wp-content/uploads/2010/06/AllergyEats-Dining-Out-Tips-Release-FINAL-110314.pdf