Many families will leave the cooking and cleaning to others this Thanksgiving holiday, and be dining at restaurants or other people's homes instead. But failure to establish a clear line of communication between patron and establishment when dining out or with your host when eating with friends and family, along with surprise ingredients sometimes found in traditional dishes, are frequent causes of allergic reactions. And sometimes even clear communication can result in errors, such as restaurant staff that provide answers to ingredient questions with incomplete or inaccurate information.

If your family is planning on dining out this year, know how to avoid high risk situations. Here are some examples:

Creative Chefs

Thanksgiving is a holiday filled with traditional dishes - ones that many have known and loved for years. But never assume that a dish contains only traditional ingredients. In an effort to add new or unique flavors to dishes, chefs will often experiment with other surprise ingredients, so don't be caught off-guard when ordering. For example, many whipped potato side dishes contain walnuts in them. Other examples of unexpected ingredients sometimes found in traditional Thanksgiving dishes:

- Cranberry sauce: pecans, wheat
- Gravy: peanut butter, soy, Worcestershire sauce (fish)
- Mashed potato: cheese, cream cheese
- Pumpkin pie: peanut butter
- Stuffing: almond, crab, oysters, shrimp
- Sweet potato casserole: eggs, milk, pecans, walnuts

Buffet Style Restaurants

As is always the case, you can avoid problems by steering clear of help yourself dining styles, where serving utensils are sometimes shared between dishes or food is accidentally dropped into other food containers. If you do find yourself in a buffet style restaurant, work with the manager and order from the menu instead. If you are in someone's home, make arrangements to serve yourself first.

Fried Foods

You should avoid fried foods, as they are often all prepared in the same cooking oil. For example, if a fryer was used to fry shrimp, and the same oil is later reused to fry chicken, the chicken will then contain shrimp protein, and could cause an allergic reaction in someone who is allergic to shrimp.

Desserts

A study of allergic reactions to peanuts or tree nuts in restaurants found that 43% of the reactions were caused by desserts*. For example, many wait staff may not have an all-inclusive knowledge of which desserts contain nuts, and may incorrectly inform you that an item is nut-free. Often the best choice is to avoid eating desserts completely while dining out. Instead, have a special allergen-free - and worry-free - dessert or treat waiting for you when you return home!

Establish Clear Communication

In the same study, it was found that of 106 individuals with known food allergies who suffered allergic reactions while dining out, only 45% gave prior notification about the allergy to the dining establishment*. And for at least 83 (78%) of these 106 reactions, someone in the establishment knew that the food contained the allergen as an ingredient; in 50% of these incidents, the food item was "hidden" (in sauces, batter, dressings, etc.), making visual identification impossible. So be sure to inform wait staff, and ask questions! Also be sure to keep your medications, such as an EpiPen, on hand just in case. And remember, these tips can also be applied to any other traditional dishes you may encounter throughout the year.

With some preparation and by following these tips, you can help assure yourself of an allergy-free Thanksgiving holiday. So that most importantly, you can enjoy this special time with friends and family!

*Furlong, Terence J., M.S.; The Journal of Allergy and Clinical Immunology; 01-NOV-2001; 11692117 (PubMed ID)

Labels: allergens, allergy free, dairy allergy, dining out, ingredients, peanut allergy, Thanksgiving, traditional dishes, tree nuts allergy, wheat allergy