Nut Allergy? 5 Food Traps To Avoid When Dining Out

If your child has a nut allergy, make sure to be extra-vigilant with these dining options.

When you or your child has a nut allergy, it can feel daunting to know when and where it is safe to eat out without being exposed to the common allergen. How do you eat out with a nut allergy when nuts and nut products can be easily hidden in foods to help enhance flavors and textures? What about the risk of cross-contamination between nut-free dishes and nut ingredients?

Keep reading to learn how to navigate eating out with a nut allergy, including places where you're most likely to encounter a food trap.

What Is a Nut Allergy?

A nut allergy develops when a person's immune system becomes too sensitive to the proteins found in nuts. When exposed to those proteins, the immune system is triggered. The result? An allergic reaction. Food allergy symptoms can range from mild to severe.

If someone with a nut allergy ingests tree nuts, they may experience:

  • Abdominal cramps
  • Diarrhea and vomiting
  • Itchiness in mouth, throat, eyes, and other areas of the body
  • Hives (which can be itchy and/or painful)
  • Swelling of the lips, tongues or face
  • Nasal congestion, sneezing, runny nose
  • Anaphylaxis

What Is Anaphylaxis?

Anaphylaxis is a life-threatening allergic reaction that requires immediate medical intervention. The most common triggers are allergies to food, insect bites and stings, latex, and medications.

Many people believe that peanuts are nuts, but they are actually a legume, so why do they get lumped in with tree nut allergies? According to the American College of Allergy, Asthma & Immunology (ACAAI), between 25% and 40% of people who experience allergic reactions to peanuts also experience allergic reactions to tree nuts.

How To Eat Out When You Have a Food Allergy

Before you step foot in a restaurant—or anywhere you plan to eat—there are a few smart strategies to keep in mind that can help you avoid exposure to an allergen like nuts or peanuts.

According to the advocacy nonprofit Food Allergy Research & Education (FARE), simply doing your homework ahead of time and knowing where you're eating, what they serve, and how flexible they are when it comes to serving people with food allergies can greatly reduce your chances of experiencing an allergic reaction.

FARE suggests the following tips:

  • Bring a Chef Card: A Chef Card is a wallet-sized card that spells out what you are allergic to and how food needs to be prepared to avoid an allergic reaction. FARE has a handy template that includes nine different languages.
  • Research where to eat: Ask your allergist for recommendations on where to eat safely. Look online to read the menus and consider calling the manager to ask if they can safely cater to folks with a specific food allergy.
  • Choose familiar restaurants: When traveling or eating in an unfamiliar place, consider choosing a chain restaurant you know. Food allergy awareness rising, and chain restaurants are the most likely to use the same ingredients and food prep methods across locations.
  • Keep it simple: Try to order simple meals that are less likely to be contaminated. For example, if you have a shellfish allergy and the restaurant serves fried shrimp, skip the French fries, which could be fried in the same oil, and opt for cole slaw instead.
  • Carry epinephrine: If your allergies are severe enough that you have epinephrine (aka EpiPen), then make sure you carry it with you. Epinephrine is the first line of defense during anaphylaxis. Discuss with your allergist if emergency services are necessary after using epinephrine.

If you're not sure about a specific restaurant, you can try looking it up on Allergy Eats, where restaurants are rated based on food allergy safety from people who have direct experience dining at those establishments. You can even search for eateries based on your specific allergy.

How Nuts Hide in Plain Sight

Avoiding nuts can be even more challenging than it appears. According to FARE, 33 million Americans have a food allergy, and 3 million of those report having peanut and tree nut allergies. Reactions to exposure range from itchiness and hives to anaphylaxis and death.

For these people, the biggest concern isn't about eating something obviously peanut-filled like a PB&J. Much of their worry centers on hidden nuts in foods that don't come with labels such as an eggroll that was sealed with peanut butter, a bakery cookie made with almond flour, or chili sauce with nuts in it, for example.

Not all peanut-containing foods are easy to spot. Although the Food Allergen Labeling and Consumer Protection Act mandates that peanuts and tree nuts (along with six other major allergens) must be disclosed on a product, there are no such guidelines for food prepared in restaurants, bakeries, or kitchens where there are, of course, no labels.

Registered dietitian Marion Groetch, MS, RD, director of nutrition services with the Jaffe Food Allergy Institute at Icahn School of Medicine at Mount Sinai in New York City, works with many patients who have severe food allergies. She instructs them on how to read labels and encourages them to try to lead as normal a life as possible while also being safe.

"Always be prepared for an accident. Make sure you have epinephrine with you at all times. Always read product labels and be aware of areas that might be of high risk," says Groetech.

5 Allergy Food Traps To Avoid

While allergens can potentially be anywhere, there are a few places where the chances of being exposed to an allergy are particularly high. Thanks to increased tree nut and peanut allergy awareness, many companies—including local shops with websites and social media—have nut allergy-safe options. Some shops even cater specifically to those with nut allergies by being 100% nut-free.

With many daycares and schools going nut-free, even families with no nut allergies need to be careful to pack nut-free lunches and snacks for school. Swinging by a bakery or a convenience store can feel too risky, so making safe snacks at home is sometimes the best option.

Still, you can't avoid eating out forever. When you do venture out, consider where you might run into these common allergy food traps.

Bakeries

Cookies and baked goods carry a risk of cross-contamination. Even if you're selecting something as seemingly plain as a sugar cookie, it's possible that the cookie or the equipment it was made on came into contact with nuts. What's more, a number of bakeries use almond flour rather than (or in addition to) wheat flour.

Ice cream parlors

Cross-contamination is an issue here, too. You may think you're ordering a simple scoop of vanilla, but because the ice cream scoop has been used in other flavors, traces of nuts could get into your child's treat. Even if you request that the server use a clean scoop, traces from earlier in the day could have gotten into the ice cream. The same goes for toppings.

Traditionally nut-heavy cuisine

Peanuts and tree nuts are a staple in certain culinary traditions. They are commonly featured in many Asian, African, Indian, and Mexican foods. Think of dishes like satay, panang curry, pad Thai, and some korma sauces.

Many Chinese restaurants cook with various nuts and may use peanut butter to seal egg rolls. Woks are typically not washed between orders, so even a nut-free dish carries a risk of cross-contamination if prepared in the same cookware.

Nuts are also a part of a number of traditional Mexican dishes, such as mole and enchilada sauce.

Sauces, casseroles, and complex meals

A variety of sauces use peanut butter or peanut flour as a thickener. Be particularly aware of peanuts in chili, chili sauces, and even pasta sauces.

With casseroles and more complicated meals with lots of ingredients, it can be difficult to know exactly what you're getting, so when you're dining out, simple meals, simply prepared, are safer.

Groetch says that if your child has very severe food allergies or multiple food allergies, you're often better off not ordering anything off the menu at all. Instead, make a request like, "Can you order me a chicken breast in olive oil and garlic cooked in a separate pan, using a clean pan and clean utensils?"

Desserts

Nuts are common ingredients in desserts, so there is a risk in ordering one that has a hidden peanut or tree nut ingredient (ground nuts, nut flour, or a nut ingredient in a sauce) or has come in contact with peanut or tree nuts. Fresh fruit is a safer option.

Key Takeaways

Tree nut and peanut allergies can be life-threatening, which is why it is so important to take special precautions when eating out. Talk to your allergist or health care provider for tips to stay safe and create a list of eateries where you and your family can reasonably eat safely. By knowing what to avoid and having a plan that includes what to do in an emergency, you can reduce your risk of exposure to allergens while eating out.

Updated by Sarah Cottrell
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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Anaphylaxis. American Academy of Allergy Asthma & Immunology. 2023.

  2. Tree Nut. American College of Allergy, Asthma & Immunology. 2023.

  3. Dining Out. Food, Allergy, Research & Education FARE. 2023.

  4. What Is Epinephrine?. Allergy and Asthma Network. 2023.

  5. Facts and Statistics. FARE Food Allergy Research & Education. 2023.

  6. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA). US Food and Drug Administration. 2004.

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