Food Allergy, Intolerance, And The Restaurant Shake-up

Part 1 – The Hungry 

Teacher and writer Diane Paul suffered from digestive problems so intolerable and frequent that she decided to work from home and declined invitations from friends and family to get out and enjoy life. For ten years, she worried she was a bother to friends and family because she was so often ill. 

After a decade of discomfort, she was diagnosed with food intolerances by a nutritionist, and advised to cut all products containing gluten from her diet (gluten is a gummy compound found in products containing wheat such as bread, pasta, and biscuits, and in smaller amounts in grains like rye and spelt). 

“Most of the mistakes happen when the chefs are using tinned products and don’t bother to read the label.”

Like many with food allergies or intolerances, she goes out of her way to find restaurants where the food is guaranteed to be gluten-free, dairy-free, and where the staff is knowledgeable.  

She has her favourite places and most restaurants have a gluten-free option on the menu, but she finds that many places have no dietary information available and do nothing special for those with allergies and intolerances. 

Even worse, she says, are catered events where the meals are brought in from a remote location and the kitchen staff aren’t available for questioning.  

“I often meet friends in town for lunch. I want to be relaxed and enjoy the day and not get poisoned or eat nothing,” she said.  

Mother of three Andrea Halsall is the matriarch of a vegan and gluten-free family. It’s not a choice she would have made herself, but her children’s intolerances preclude them from having any dairy or products with gluten – and for the Halsalls even chocolate is off-limits. Like Diane Paul, she struggles to find restaurants she can trust. 

“It makes you quite anxious. You don’t know when a fun evening dining out is going to turn into a nightmare with your children vomiting all night,” she said. 

“Most of the mistakes happen when the chefs are using tinned products and don’t bother to read the label.” 

She is most frustrated, she said, when she asks the server whether there’s a certain ingredient in the food, and when the puzzled server asks the chef and the chef likewise doesn’t know. 

Figures indicate that food allergies are steadily rising in the UK population. Allergy UK estimates food allergy affects around one million adults in the UK and up to 770,000 children. Also, thousands of people suffer from food allergy and food intolerance symptoms such as Irritable Bowel Syndrome (IBS), coeliac disease, migraine, eczema and joint pains. 

In 2011, the NHS' National Institute for Health and Clinical Excellence said of food allergies: "Reactions can be extremely severe; hospital admissions in the UK for food allergies have increased by 500% since 1990, and there has been a dramatic increase in prevalence in the last twenty years, ranging from 6% to 8% in children up to the age of 3 years across Europe and North America." 

Diane Paul and Andrea Halsall, as well as growing numbers of allergy sufferers, are calling for restaurants to take responsibility for helping to protect their health and the health of their children.  

The question posed by the allergy sufferers is – ‘If supermarkets are required to label their goods, why aren’t restaurants required to provide information on the ingredients they use?’ 

Up to now, the status quo has been to put the onus on the customer to ask, to be vigilant, and to stick to the same, reliable restaurants they always go to so as to avoid risk of getting ill. 

But things are about to change for diners with allergies, thanks to new laws coming from the EU that will affect every restaurant in the UK and across Europe. 

Part 2 – The Hand-holders 

If there are restaurants that are unconcerned about the issue, the EU is having none of it.  In November, the EU passed a bill that in three years’ time all restaurants and caterers will be required to supply allergen information to their customers. And for the first time, local officers will enforce the FSA’s edicts, with repercussions for providers not in accordance with the laws. 

Requirements for labels on packaged foods were introduced in 2005, mostly affecting supermarkets.  Then, following questions from restaurants and providers of non-pre-packaged foods, the FSA fleshed out guidelines for them in 2008 and disseminated the information in a variety of forms, including a leaflet, poster, and a longer, detailed document. 

“If it isn’t already, allergy training should be an essential part of proper food safety training at any restaurant, especially given the increasing numbers of people who are discovering they have these needs.”

However, research completed by the agency two years later showed that while the guidelines were helping some restaurateurs get their facts straight, they were far from guaranteeing anyone’s safety.  Most businesses were taking action to notify customers of allergens, especially peanuts and shellfish in their foods, but there was evidence to suggest many were doing the bare minimum. 

According to Sue Hattersley, Head of Allergy at the Food Standards Agency, issues such as cross-contamination, sourcing tinned products, and social factors like embarrassment complicate what was assumed to be a simple process.  

The supposition that customers can simply ask the cook for the allergen information has been shown to be too simplistic. It’s not working, says the FSA, and people are still at risk of unknowingly ingesting something that is poisonous to them. 

“Not paying attention to things like cross-contamination is a risk to health and safety,” said Clare Jones, a Manchester nutritionist.  “If it isn’t already, allergy training should be an essential part of proper food safety training at any restaurant, especially given the increasing numbers of people who are discovering they have these needs.” 

According to Ms Jones, the FSA is a largely toothless agency that has had little opportunity to do much more than ask nicely. “They do impeccable research, but unfortunately they have little power to bring about any fast changes.” 

Lindsey McManus is the Deputy Chief Executive of Allergy UK, an organisation which offers advice to people living with allergies. Interviewed before the new legislation was published, said that the FSA would have an incredibly difficult time enforcing allergy and intolerance standards when they put the responsibility of completing inspections onto the local authority. “The local authorities already have so much to do,” she said. “They have to decide which things are important but we will ask them to be open-minded and aware and take food allergy and awareness seriously - people with allergies aren’t just being picky.”  

Part 3 – The Practical 

Changes in the industry up to now have been made by consumers voting with their feet, with restaurants that accommodate for allergies and intolerances getting the repeat business of these diners as well as the custom of the friends they bring along. 

At Nutters Restaurant, it’s what they do on a day-to-day basis, says owner and exec chef Andrew Nutter. “I wouldn’t say it’s a pain – I love giving my customers an experience they can’t get in other restaurants.” 

“In four or five years you’ve seen incredible increases in the number of people with allergies or intolerances,” he said. “Back when we opened 18 years ago, no one had even heard of gluten. It’s amazing how the industry has changed.” 

“Back when we opened 18 years ago, no one had even heard of gluten. It’s amazing how the industry has changed.”

There is a downside to catering for dietary needs, which includes the times they have seen someone’s dietary requirement crumble at the end of the meal. “We’ve watched a customer who can’t eat dairy order crème brulée at the end of the meal, and seen vegetarians break down and eat a bacon sandwich at the end of a night of dancing. For a chef who’s bent over backwards all night, this is absolutely devastating. If you’ve got a dietary requirement, just stick with it.”  

Despite experiencing a small number of customers who for general health or weight loss reasons have requested allergy-related foods without really having one, he supports the new laws and suspects they will have a big impact.  “You have to have someone really clued in to train the chefs – show them pictures of what will happen, the lethargy, spots on the skin, trouble breathing – and explain that everything you are serving needs to be considered, including things that come from our bakers and other providers.” 

Tragus Restaurants, operators of over 295 restaurants including chains Café Rouge, Bella Italia, and Strada, have recently instituted an online food allergy and intolerance training course for restaurant staff.  The training, which includes a final assessment and certification, has had positive feedback from Tragus’ staff and customers. 

According to Stuart Vivian, Learning Manager at Tragus and co-creator of the course content, the programme did not grow out of complaints, but instead in recognition of a trend in the industry. 

“We felt this issue was something of growing importance and that we should be doing.  We don’t want customers to feel like they are being a pain. We want them to be able to get on with enjoying their evening.” 

Clare, our nutritionist, weighed in. “The restaurants that are cooking things for themselves, sort of the better class of restaurants, and the bigger chains that have a large corporate structure behind them and get training that way – they do well,” she said. “The grey area is what’s in between, where parts of the ingredients are brought in from big suppliers and that’s where there’s room for error creeping in.” 

Calls to several Manchester city centre restaurants, all having had their hygiene checks in the last six months, yielded the following insight: a small café with a two-person staff remembered receiving the guidelines from health officers, but weren’t confident they understood what it all meant; two large chain restaurants with corporate backing said they had received documents from health officers and had compulsory training for the staff fed to them from on-high, and had added special items to the menu; the owner of one large restaurant that did not have a corporate structure said she couldn’t remember receiving any information on allergies, had not taken any special measures nor conducted allergy training. 

Part 4 – The “Teeth” 

The “teeth” that the FSA will rely for enforcement from 2014 onward will be the local authority’s environmental health officers. 

Across the country, it’s been at the discretion of each local authority as to what extent officers encourage adherence to the guidelines. While some local authorities in the UK have been disseminating the FSA’s allergy and intolerance guidelines but done little to check back and make sure they are being followed, others have been more pro-active and pursued restaurants whose negligence made customers ill. 

There’s a law looming ahead; and decisions will have to be made. 

Manchester City Council’s Executive Member for the Environment, who heads the department in charge of food safety and hygiene, declined to give details on what the city will do as they get ready to enforce the allergen guidance for the first time. Though initially unwilling to comment on the subject, this statement was later issued through the City press office: 

"The health and well-being of Manchester residents is a major concern to the City Council and our environmental health officers, who work hard to make sure the city's restaurants meet hygiene standards, will be in a good position to enforce the new allergen regulations when they come into place in 2014." 

What’s also unclear is what exactly restaurants will have to do. The FSA have not mentioned that allergen-free menu items must be provided. Likewise, the FSA haven’t said that all restaurants will be required to use one particular method of sharing information; binders with ingredients lists and notations on menus are two recommended systems but neither is compulsory. 

There’s a law looming ahead; and decisions will have to be made.  

By all indications there will be a teething stage for local authorities as they and the FSA reconsider their inspections and information-sharing with the public. 

The consolation is that the inspections are nearly three years down the road, and there is room for the parties involved to wiggle before they commit themselves to allergy and intolerance readiness. 

But once reassurance is on the menu, the highly-selective and hungry might collectively breathe a bit easier, no matter what they choose to eat. 

Follow Karen on Twitter @karenregn