Food Allergies | Part I

Food allergies are estimated to be responsible for how many ambulatory care visits in the U.S. every year: 100,000, 10,000, 300,000 or 50,000?

That is one of the questions on a test given to all the wait staff at Mikuni restaurant. Ten or 20 years ago, if you asked a chef how many times he had to deal with food allergies, I’ll bet he might say once or twice a month, and that’s probably on the high side.


Ask the same chef how they handled it with the customer and what the staff did different to accommodate this guest and the answer might go something like this: the chef would tell the wait-person that just came into the kitchen to tell him of the guest, what items they could and couldn’t order with the specific allergy taken into account. For example, if the allergy was a peanut allergy, he might say that satays, were a no-go, and the nut-encrusted salmon does not specifically have peanuts in it but it is not recommended because of the other nuts used.

He might also say not to order any of the cake desserts unless they were made on sight; a lot of restaurants bring desserts in from local bakeries or get them through their purveyors so they might not know conclusively.

So, now the order comes in and what did the kitchen staff do differently? Probably nothing. The kitchen staff would have taken it for granted that the person ordered something he was OK with, unless the order contained an item that had the specific food item, such as peanuts, left out of that dish. In this case, the cook making it would point out to the server which plate was the one without the peanuts. The manager would probably never even be aware of anything about the incident. The guest would enjoy their meal and depending on whether or not they were local, a returning visitor, say a skier or summer client, or a one-time visitor to the area, you would see them again at a future time or they would be gone. End of story.

I’ve have never been in a restaurant that has had a person have an allergic reaction and can’t even remember talking to any other of my friends in other restaurants mentioning it ever happening to them. Knock on wood.

My, how times have changed. Ask chefs today how often people come in with allergies and they’ll tell you it is a much more regular occurrence. Quite often, there will be at least one or two per week. Of course, some restaurants are going to have a much higher number of people with allergies simply because of the nature of their menu. To see why that is, let’s check out the main nine items on the food allergy list. They are in no particular order: peanuts, eggs, milk, fish, shellfish, wheat, soy, tree nuts and sesame. Of course, there are other foods that people are allergic to, but this list accounts for about 90 percent of food allergies.

Asian food or sushi, would be much more apt to contain more of those items than say a steak house. But, why are there so many more people today who have allergies than there were such a relatively short time ago? I would say some of it has to do with what’s popular now and newer menu items that weren’t on the normal menus back then.

Ten or 20 years ago, I don’t even know if I knew where there was a sushi restaurant. I also think some might have to do with better awareness and just the advancements in medicine that lets people know they are allergic to something as opposed to having intolerance or having a bout with food poisoning.

Now we know that there are a lot more people dinning out that have food allergies and I’ve mentioned the most common foods that people have allergic reactions to. In the next issue, I’ll go over what a food allergy is and what steps Mikuni takes in order to safely accommodate a customer with a food allergy.

I do want to thank general manager Steve Kantanke and Chef Atsushi Mineki from Mikuni for their help in this article. They were instrumental in helping me, as well as showing me proper procedures that they as well as everyone can do to safely serve people with allergies. As you’ll see in the next issue, some things people take for granted as being safe practices are some of the highest offending procedures you can do.

The answer to the question above is 300,000, and that figure only covers people 18 and younger.