Eating and Traveling with Allergies & Dietary Requirements

Excerpted from Kim Koeller's Interview with Suitcases & Strollers

No, we’re not just talking fussy eating here. If you or anyone in your family has Crohn’s disease, is celiac or has an allergy to nuts, for example, watching what you eat while on holidays can literally save your life.

Kim Koeller, President and CEO of Gluten Free Passport tells Suitcases & Strollers about how to eat out and travel safely with your children who have special dietary restrictions.

Is it safe to eat in restaurants with kids who have severe allergies or medical conditions that restrict their diet?

It can be safe to eat in some restaurants depending upon your comfort level, knowledge of specific ethnic cuisines and kids’ allergies or medical condition. However, we do not recommend that you buy food from any street stall if your child has anaphylaxis.

There may also be times when it is easier to bring your own food with you when travelling depending upon the type of restaurant and the level of awareness of the desired restaurant. Pre-planning is required to determine the best approach for that specific situation.

How can I be sure that the food preparation standards in a foreign restaurant are adequate to suit my child’s severe allergies?

First, inform the restaurant wait staff of your food concern and allergy (e.g. I’m allergic to peanuts). Then, instead of simply asking, “Is this dish peanut free?” you need to ask questions based on ingredients and food preparation in restaurant language terms.

For example, for a peanut allergy, sample questions may be:

  • Are your French fries fried in peanut oil?

  • Are your mashed potatoes real or artificial?

  • Is this dish garnished with peanuts?

  • Does the ice cream container label identify peanuts as ingredients. Is it manufactured in a facility that processes peanuts?

Even though more restaurants around the world are becoming more aware of allergies, it is still critical to understand ingredients and how food is prepared to ensure safe meals everywhere.

My son has G6PD, so he has very specific dietary requirements. Can I rely on the ingredients labels of pre-packaged foods in foreign countries?

In recent years, various geographic regions have instituted mandatory product labeling regulations and voluntary guidelines for manufacturers. These regulations encompass various combinations of food allergens such as celery, dairy, eggs, fish, gluten, milk, mustard, peanuts, sesame, shellfish, soy, sulfites, tree nuts and wheat to name a few. These food allergens and their derivatives are considered responsible for over 90% of allergic reactions on a worldwide basis.

Still, based on the variances in labeling, I believe that it is best to avoid pre-packaged foods altogether when travelling in foreign countries.

For example, since your son has G6PD, I’m not sure if sulfites are one of his triggers. If so, sulfites, spelled sulphites in parts of the world, are included in the labeling laws in Australia, New Zealand and the European Union. Sulfites, however, are NOT included in the US labeling regulations.

Tell us a bit about the App. What is the difference between the App and the passports?

We created 2 mobile apps for Apple devices for individuals and businesses to have instant access to “cuisine-specific” gluten and allergen-free options, meal choices, ingredients and resources at their fingertips.

iEatOut Gluten and Allergy Free is based on the Let’s Eat Out books and the iCanEatOnTheGo app shows you what you can eat in US fast food chains based upon the top 8 allergens as well as gluten.

Is it safe to travel with kids who have severe allergies or medical conditions that restrict their diet?

It is safe to travel, however, managing an allergy-free diet increases the level of complexity involved in ordering meals outside the home and travelling in general. Travelling with a special diet affects every part of the experience from airlines, snacks and restaurants to hotels, cruises and foreign language phrases.

You also need to understand what ingredients and food preparation techniques are safe, what questions to ask the staff and what modifications can be made to easily accommodate specific dietary requirements.

Follow these three steps: Education, preparation and communication. Educate yourself about your travel, eating out options and ethnic restaurant meal preparation. To be confident and safe, arm yourself with information about how dishes are prepared, what ingredients are used and where hidden allergens may be found. Prepare yourself with special airline meals, snacks and medications as well as back-up plans in the event of a mistake, accident or emergency. Communicate your special dietary requirements effectively with airlines, restaurants and hospitality professionals as needed.

What are your top tips for flying with allergies?

  • Book a special meal. For longer flights, order and reconfirm your airplane meals in advance based upon standard airline codes – GFML for gluten free meals, NLML for non-lactose meals, PFML for peanut free meals and even DBML for diabetic meals.

  • BYO snacks. Pack your own carry-on snacks keeping in mind airport security regulations. Bring enough food to get your child to your destination and for your excursions throughout your trip. For example, if you’re flying eight hours take two to three meals worth of food including protein and carbohydrates, in case of delays. These foods may range from those that require no preparation (such as protein bars, cookies and fruit) to hot water preparation (such as dried soups) to foods requiring a small cooler (such as dips and vegetables). Upon arrival, remember to discard any food that is not pre-packaged prior to entering customs.

  • Carry your medication onboard. In case of anaphylaxis and an emergency, carry medications, including several epinephrine auto-injectors, such as EpiPen or Twinject, and any other related medicines. Make sure the medications and snacks are with you at all times for easy access and not stored in the overhead bin in case of turbulence.

  • Take extra care if flying with anaphylaxis serious allergies. Significant care and caution are critical to managing anaphylaxis, a potentially life-threatening condition. To minimise risk and ensure a safe journey, review the in-flight food options, emergency protocol and allergy policy prior to booking your flight. Notify the airline representative about the severity of your child’s allergies and ideally, book the first nonstop flight of the day. Request that you can pre-board to sterilise all surfaces as required and communicate your needs to the flight attendants.

My child has a severe, life-threatening allergy to peanuts but we want to travel to Thailand (or any other non English-speaking country). How can I ensure that she will be protected in situations where the staff may not speak English?

We created chef translation cards for safe allergy free dining in various languages, as downloadable pocket-size paper cards from www.AllergyFreePassport.com.

Unfortunately, we currently do not offer these cards in the Thai language. Therefore, we recommend that you purchase a Thai allergy translation card from Allergy Translation. Once in Thailand, you can present this to the wait staff and/or chef at your restaurant. It may also be helpful to print extra copies in the event that the restaurant staff or chef wants to keep them for future reference.

You also need learn to navigate a Thai restaurant menu and communicate the right questions and answers based on common culinary practices. We would highly recommend that you are also aware of other terms including peanut oil (also known as arachis oil in Europe) which is commonly used for frying in Asian, Indian, French and French-influenced cuisines. In addition, other names for peanuts include: beer nuts, cacahouéte, cacahouette, cacahuéte, earth nuts, goober nuts, ground nuts, mandelonas and valencias. Allergy specialists often advise peanut-allergic individuals to also avoid tree nuts. Those allergic to peanuts may also react to lupin (such as lupin flour and lupini beans).

What should families with allergies carry in their emergency travel medical kit?

You need to make sure you prepare yourself with medications as well as back-up plans in the event of a mistake, accident or emergency.

Consider what medications, supplements, herbs and other health remedies you use at home for your child when they have an adverse food reaction. Try to duplicate these same items in your emergency medical kit when travelling. For example, since I do not have anaphylaxis, I do not need epinephrine auto-injectors. However, in my personal emergency medical kit based on my food allergy symptoms, I always carry an antihistamine, antacids and aloe vera for stomach upset, digestive aids, bath salts and analgesic ointment in the case of an adverse food reaction.

In the case of anaphylaxis and an emergency carry the medications including several epinephrine auto-injectors, such as EpiPen or Twinject, Benadryl, and any other related medicines.

How can the Allergy Free Passport help?

Our Let’s Eat Out! series of books, ebooks and mobile apps empowers people with the necessary knowledge required to eat out, travel and explore the world. Too often, people feel like they have to be prisoners in their own home and experience social isolation as a result of their dietary requirements.

Knowledge is power. The more you know about ingredients and food preparation, the easier it is to dine out safely. Moreover, asking questions about specific ingredients and culinary preparation techniques puts the control back in your hands as a diner. Our Let’s Eat Out! resources provide menu item descriptions so you know what is in each dish and what specific questions you need to ask on an allergen-by-allergen basis.

We spent over six years researching and writing the Let’s Eat Out! series. We reviewed thousands of recipes across the globe to determine ingredients and food preparation techniques. We incorporated personal experiences and feedback from over 50 focus group members into the series.

The cuisine passports are also based upon the content from our Let’s Eat Out! books and offer expert advice in small convenient sizes which allows easy carrying in your backpack, purse, briefcase or jacket pocket. We also created the Multi-Lingual Phrase Passport which provides over 1,200 translations critical for international travel while managing special diets. The phrases include translations from the English language to French, German, Italian and Spanish to assist while visiting foreign speaking countries.


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