Managing food-related allergens will always be an issue operators need to address. In this article, we explore how operators from the college and university, healthcare and commercial foodservice sectors work with their staffs and customers to minimize the risk and maximize the enjoyment of their menus.

An estimated 15 million Americans, including 1 in 13 children, have food allergies, and those numbers continue to grow, according to the Centers for Disease Control (CDC). In fact, severe allergies are responsible for more than 200,000 emergency room visits per year, according to the CDC. When it comes to gluten allergies, an estimated 1 in 133 Americans have celiac disease, and another 1 million are estimated to have sensitivities to gluten, according to the National Foundation for Celiac Awareness.

When dealing with customers diagnosed with food allergies, paying careful attention to food product selection and preparation, as well as menu development and communication, is no longer just a nice perk. It's a major business incentive, drawing loyal customers. Some states even require allergen training by law. And even when it comes to diners who may not have serious anaphylactic allergies, but who do have less-than-severe intolerances to certain foods, meeting their needs can result in even more loyal customers and improved reputations.

Operators from all segments — commercial, healthcare and institutional — need to be buttoned down when it comes to allergen management because a lapse in this area could result in more than just a disgruntled customer; someone could die. Let's examine the changing landscape for allergen management and training in each of these segments.

College and University Foodservice

While allergies can occur from all sorts of foods, the most common — or "big eight" — are milk, eggs, peanuts, tree nuts, fish, soy, wheat and shellfish.

For students with allergies or special diet needs, approaching university foodservice operators can be daunting. From the foodservice management side, the pressure to assist these students can also raise red flags, as well as nerves, but the good news is that operators have a growing number of tools and training tricks that can help.

"Ten years ago we started to see more students coming to us with food allergies, and this year there seems to be twice the number of students with allergies and intolerances as last year," says certified nutritionist Carrie Anderson, dining court supervisor at Purdue University. The change started with one student with a peanut allergy that caused Purdue to decide not to serve peanuts in certain areas. Now, the university designates certain equipment as allergen-free, including one of three woks that staff use to cook stir-fries each day. Students can also pick and choose their own ingredients from the salad bar to exert more control over the preparation of their dishes.

"We really need to show that colleges are getting on board with allergies — it really comes down to finding the tools and making the commitment," Anderson says. "It's hard with strict budgets, but I think colleges are learning and setting new standards in allergen management." At a recent National Association of College and University Food Services (NACUFS) event, Anderson notes, the majority of conversations revolved around creating allergen-free spaces, labeling, and working with more students with special diets.

For her part, Anderson's commitment to helping students with allergens has a personal connection — her son has a peanut allergy and is lactose intolerant. "That helps bridge a gap between the students and me," she says. "As a shift supervisor, I have a different perspective than many administrators because I'm serving the customers food directly."

This hands-on experience helps Anderson learn what works and what doesn't when it comes to training staff and communicating with food-allergic customers.

To cater to gluten-free and celiac diners, the university offers gluten-free pizza so students can still partake in their favorite foods. The gluten-free crust comes prepackaged separately, with its own pan for easy cooking in a separate oven.

Anderson also studied her ingredient purchases carefully, switching to gluten-free products and shifting away from beef bases, soups, gravies and prepared sauces with wheat. Purchasing allergen-free foods has become slightly easier, thanks to the enactment of the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), which requires that all packaged foods produced in the U.S. indicate if the food contains one of the big eight allergens.

Communication with the students is also key. "We have a brochure and indicate potential allergens on some menus," Anderson says. She also created a special email address for students with food allergies to use, and she encourages them to discuss menus and off-limit foods with her in person, even on a daily basis, if necessary.

"Students have definitely become more vocal than ever before," Anderson says, and this makes her job easier. In some cases, she will prepare the protein of the day plain, without any spices or sauces, often cooking it separately from other foods, and offer customized sides.

Anderson remains wary of labeling menus; new U.S. Food and Drug Administration (FDA) guidelines require foods labeled as gluten-free contain less than 22 parts per million of gluten. In college and university settings that cook from scratch, it remains a challenge to know just how much gluten goes into certain dishes. "We can say made without gluten-containing ingredients, but we can't necessarily say gluten-free," Anderson says. The university is, however, in the process of developing a new labeling program for dishes, which will identify the big eight food allergies.

Still, labeling alone is often not enough for students to prevent allergic reactions. Aside from communication, training is still the most important factor. "Even if we label something on the line as not containing certain allergens, but someone uses tongs that touched other food, that kind of cross-contamination can be dangerous," Anderson says. She remains committed to not only training her frequently rotating staff, but also giving them the tools to succeed, designating allergen-free spaces and using allergy kits.

A couple of years ago Anderson came upon an allergy kit with cutting boards and utensil and pan holders covered in the color purple, the universal color for allergen-free kitchen tools. She further adapted the kit by including a purple sheet tray that staff assembling an allergen-free dish can use to separate themselves. In some cases, staff can move an induction burner or other countertop equipment to the allergy work area to further separate production.

"I work in a busy kitchen — we serve 500 for breakfast, 1,500 for lunch and about 1,900 for dinner — so we're not always able to designate a separate workspace," Anderson says. The purple sheet tray helps with that challenge. Anderson also trains staff to fully clean and wrap these kit utensils before putting them away so they don't pick up flour dust or other food particles. When it comes to cleaning and sanitizing, rinsing alone doesn't cut it. All dishes and utensils must go through the sanitizing rinse to ensure they can be used for multiple applications, including allergen and non-allergen foods.

"Colleges are nervous — they don't want to make a mistake," Anderson says. "Allergy kits and processes help them have a plan and empower others to help these students."

At the start of each semester, the staff, which includes both part- and full-time cooks, goes through intense training on allergen management. Anderson also discusses allergens during regular staff meetings before service. HACCP takes care of the rest. For example, vegetable prep work takes place completely separate from other foods, while nuts and other allergen foods that come in open or damaged boxes get sent back immediately. Nuts and other big eight ingredients get tightly wrapped and stored separately from other foods in the cooler and dry storage areas.

Commercial Sector

While large chains like P.F. Chang's, The Cheesecake Factory, Outback Steakhouse, Red Robin and many others lead the way when it comes to allergen management, smaller, emerging chains and independent restaurants now follow in their footsteps, says Paul Antico, founder and CEO of AllergyEats, an online resource for consumers showcasing more than 600,000 allergy-friendly restaurants nationwide.

"The first and foremost important thing for restaurants is that they make a commitment to becoming allergy friendly and to getting it right," says Antico. "Just because you have a list of dishes with allergens on your website or menu doesn't make you allergen friendly.

"There are three types of restaurants that are allergen friendly," Antico continues. "First, those with servers and cooks who know the menu and can be confident in communicating with allergic customers; second, those that are more progressive and can take off items or leave the butter or egg out of certain dishes at a moment's notice to be more accommodating, and third, those that will do whatever it takes — including using separate spaces and equipment — to make sure they are as allergy friendly as possible."

For restaurants, it makes good business sense to at least be aware of allergen management. "People want a restaurant that gets it," says Antico. "Those in the allergen community are very vocal with each other and also very loyal to restaurants that cater to their needs. In my research I have found people with food allergies will visit their favorite restaurant 40 percent more often."

Antico also discovered that the diner with food allergies dictates the restaurant chosen for that particular meal. "If we assume that 5 percent of the population has a food allergy or celiac disease, and the average party dining out is three, now you're talking about 12 percent to 15 percent of the population," he says. "That one person with the food allergy has the veto vote, especially the kids."