Eating out can be fun. However, the experience can be complicated if you have a nut allergy. This blog will cover how to safely eat out with a nut allergy. 

What is a Nut Allergy?

Peanuts and tree nuts are among the Top 9 Food Allergens^[1]. Between 25% and 40% ^[2]of people with a peanut allergy are allergic to at least one tree nut. Nut allergies are typically lifelong. Research has shown that approximately 20%^[3]of children outgrow peanut allergies. The incidence of children outgrowing tree nut allergies is even lower, with approximately 10%^[4] managing to do so. 

Allergic reactions to nuts typically happen within a few minutes of consumption. They can range from mild to life-threatening.

The following symptoms of an allergic reaction include:

• Skin reactions (hives, redness, or swelling)
• Itchy throat or mouth
• Tightening of the throat
• Difficulty breathing or wheezing
• Digestive problems (diarrhea, nausea, or vomiting)  
• Runny nose

Nut allergies are among the most common culprits of food-induced anaphylaxis^[5]. Anaphylaxis is a life-threatening medical emergency that can cause airway swelling and a drop in blood pressure. The first-line treatment for anaphylaxis is epinephrine^[6]. Epinephrine, also known as adrenaline, reverses the effects of anaphylaxis. Epinephrine is often administered via autoinjector. Autoinjectors (e.g. EpiPen) can only be obtained with a prescription. An emergency room visit is required once epinephrine is injected into the body. It is vital that nut allergy sufferers know how to properly use an autoinjector.

How to Eat Out With a Nut Allergy 

Eating out with a nut allergy can be complicated. It comes with the added stress of avoiding foods that could trigger a life-threatening allergic reaction. 

Nut allergy sufferers should take the following measures when eating out:

• Research - Look up a restaurant before you eat there. Most food chains have allergen information on their websites. Smaller, locally-owned restaurants might not. 
  
  
• Prepare - Take two epinephrine autoinjectors^[7]with you along with any other  medication your doctor has prescribed (e.g. benadryl). Consider buying a chef card^[8]that outlines what you are allergic to. 
  
  
• Communicate - Inform the restaurant of your nut allergy. They will, in turn, inform you about their menu items and the precautions they could take while preparing your order. Show the restaurant your chef card if you have one.

What to Avoid 

Lessen your odds of having an allergic reaction by avoiding these traps^[9]:

Ethnic Restaurants - Eating ethnic food can be risky for those with a nut allergy. Ethnic restaurants (e.g. Asian) often cook with nuts and unrefined peanut oil^[10]. 

Deserts - There is a high risk of cross-contamination with dessert items, particularly ice cream if the scoops are shared. 

Buffets - With so many foods near each other and customers helping themselves, there is a high risk of cross-contamination.

Pre-Made Foods - Restaurants that serve pre-made foods will not have the ability to manipulate the ingredients.  

My Experience 

I am allergic to peanuts and tree nuts. I have been living with these two allergies for sixteen years. Food chains have always been a safe bet for me. Very rarely will I eat at a small business. I tend to be less trustful of them. I spent most of the Summer of 2024 in Washington D.C. Ironically, most of the restaurants there are small businesses.

I ate out with my co-workers twice. I googled the menu of the first restaurant we ate at. While many of the menu items did not contain nuts, there was a risk of cross-contamination. Hence, I only ordered Mexican Coca-Cola.

My co-workers and I went to an Italian deli for our second time eating out. I informed the deli staff of my allergies. A staff member warned me of the one meat to avoid. They also assured me that the sandwich makers would be told to change their gloves when preparing my sandwich. This staff member even went as far as to write "NUT ALLERGY" on my order ticket. I took further precautions by writing directions in the “special instructions” box of  my order ticket. Fortunately, I was able to eat my sandwich without incident.