New on the menu: allergens
Uno Chicago Grill
How it got there: Batter mix contains wheat flour
Where: Fried onion topping
How it got there: Onions are cooked in the same fryer as calamari
Vanilla ice cream mixed with Nestlé Crunch
Where: Nestlé Crunch is made on equipment that also processes peanuts and nuts.
Kayla McCarthy has given up on eating out.
The 11-year-old's nut allergies landed her in the hospital three times in the past six months after she ordered foods like pizza and ice cream that she and her family thought were safe.
''I'm scared about what's going to happen," McCarthy said. ''Restaurants need to do a better job with people like me, people with food allergies."
Across the country, restaurants are wrestling with how to accommodate a growing number of customers with food allergies who are demanding greater transparency about the ingredients and preparation of food they order.
Food allergy advocates say they want restaurants to take responsibility for what they serve -- the way they take responsibility for when to stop serving alcohol to customers. But many restaurants say frequent menu changes and language barriers among workers make it difficult to disclose food allergens in all dishes. And they fear lawsuits if they make a mistake.
It's the latest battleground in the food allergy movement that in recent years has transformed almost every space where food is available, from supermarket aisles to school cafeterias. Seeking a middle ground, many establishments in the past year have posted warnings that they are not allergy-free environments, and some, including Ninety Nine Restaurants and Uno Chicago Grill, recently started to list on their websites or in restaurants ingredients in dishes that cause allergic reactions.
Lawmakers nationwide are mounting pressure to put procedures in place that would train workers about food allergies and hold restaurants to specific standards. In Massachusetts, after more than two years battling state lawmakers, the Massachusetts Restaurant Association says it's willing to take what could be the industry's most aggressive steps toward accommodating people with food allergies.
These initiatives, which legislators hope will become law in the coming weeks, include placing warnings on menus that advise customers with food allergies to inform waiters, adding a video about food allergies to the training program for state-certified food managers, and posting signs near food handlers that explain the most common food allergies and ways to avoid contaminating food, such as using new utensils and separate fryers.
In a study last year of 58 restaurants, only about half had a plan in place for how to provide a safe meal, and 25 percent of servers, chefs, and managers surveyed incorrectly believed that it was safe for people to eat small amounts of foods to which they are allergic, according to Scott Sicherer, associate professor of pediatrics at the Jaffe Food Allergy Institute in New York.
A growing recognition of life-threatening food allergies has prompted schools to enforce no-sharing policies at lunch, and a new federal food-labeling law requires manufacturers to disclose whether products contain any of the top eight food allergens: milk, eggs, fish, crustacean shellfish, peanuts, tree nuts, wheat, and soy.
''Food allergies are a problem that isn't going away. It's only getting worse," said Anne Munoz-Furlong, president of the Food Allergy and Anaphylaxis Network. (Anaphylaxis is a severe, potentially fatal allergic reaction, and food is one of the most common causes.) Today, about 12 million Americans suffer from food allergies, according to the advocacy group's latest data, a segment that is growing every year. Between 1997 and 2002, the number of children with nut allergies doubled to about 1 in 125, the network says.
''Pretending it's not there will only get everyone in trouble," Munoz-Furlong said.
Still, these proposed steps for Massachusetts restaurants fall short of the initial bill filed by state Senator Cynthia Creem, which called for all food handlers to receive training on the consequences of food allergies and for restaurants to list on menus food items that cause allergic reactions. During negotiations over the past two years, the bill was watered down because the Massachusetts Restaurant Association resisted such measures.
Peter Christie, president of the Massachusetts Restaurant Association, said it would be too costly to conduct widespread training and list allergens on menus given high employee turnover and frequent menu changes. It's especially difficult, the association says, for mom-and-pop venues that do not write down recipes and places that employ servers and food handlers who do not speak English.
''I understand it's an emotional issue. People's lives are at stake," Christie said. ''But this is a litigious society in which we live. If you misinform a customer, you're subject to a suit. We as an association don't want someone to be sued because they didn't put down an ingredient."
At Coldstone Creamery, customer requests prompted the ice-cream restaurant chain to provide on its website and in its stores information about allergens on its menu. The company also increased employee training on food allergies, according to Nola Krieg, Coldstone's associate tastemaster.
At the same time, Coldstone didn't want to give customers the impression that it could ensure safe products. This spring, the chain put up signs telling customers that its products ''may contain traces of peanuts, tree nuts, soybeans, wheat, or eggs from manufacturing and preparation." The company used to instruct workers to serve people with food allergies by using new utensils and new ice cream to prevent cross-contamination. Now workers are told to do so only if the customer insists, and to warn them that ''there are no guarantees" that the product won't cause an allergic reaction.
Over the past two years, Blue Ginger chef-owner Ming Tsai, who is also a national spokesman for the Food Allergy and Anaphylaxis Network, has created an elaborate system at his Wellesley restaurant to accommodate people with allergies.
When a customer with a food allergy asks about a dish, the server checks the restaurant's ''Food Bible," a binder that contains every menu item with every ingredient and highlights any food allergens. Then the server asks Tsai or the manager whether the dish can be made safely.
The server prints out a meal ticket with red type indicating that this is a food allergy meal and highlights the ticket with a marker. Tsai or the manager on duty initials the ticket, which stays next to the plate until it is served.
Tsai, whose 6-year-old son David has several life-threatening food allergies, said businesses in the hospitality industry have an obligation to serve everyone. But even he's been turned away from restaurants that don't want to take the risk of serving his son.
''People used to discriminate based on skin color and wheelchairs . . . Nowadays there is discrimination against people with food allergies," Tsai said. ''But creating policies to accommodate people with food allergies isn't going to put restaurants out of business. It's going to save lives."
Jenn Abelson can be reached at firstname.lastname@example.org.