For a restaurant that can mean an easy increase in sales, just by covering that extra percentage of customers as a result of being allergy friendly. For a roughly $1,000 investment in training, the profits can easily outweigh the initial costs.

For successful allergen management, restaurants may need to create separate workspaces or areas in their kitchens to cook meals free of allergens and make sure those spaces are clean. Using purple utensils and cooking supplies, or different-shaped or different-colored plates also helps. Some restaurants have a manager walk through the entire process, from taking the order to making and serving it, to ensure no cross-contamination occurs. But, making sure every staff member in the restaurant understands the importance of allergens is most important, says Antico.

Some organizations and certification bodies offer videos and other tools and techniques to train staff. In-person classes, webinars and online sessions addressing varying levels of training for both cooks and managers are common forms of training today.

"There is so much more acceptance in the industry when it comes to diners with special dietary needs," says Betsy Craig, founder of MenuTrinfo, a food allergy-related consulting firm.

Training on food allergy-related issues continues to become more popular. For some, it can be a steep learning curve. For example, "most people don't realize that if you move a person with a food allergy during a reaction you
actually increase the severity of the reaction. Restaurants may know how to handle a situation if someone is choking on steak, but they don't always know what an allergic reaction looks like," Craig says.

Food storage plays a key role in allergen management. "Once we saw a Mexican restaurant in a major metropolitan city that was using a gluten-free seasoning but stored flour two shelves above so you could actually see white specks from the flour in the seasoning," Craig says. "They also flavored their rice with a non-gluten-free chicken base —
it's easy to miss some of these hidden sources of gluten."

That's why it's important to train staff to be able to identify the hidden language indicating the presence of gluten or lactose. Whey and casein, for example, are forms of dairy. Egg whites can be labeled as albumen.

Another common mistake among restaurants is using the same frying oil for allergen-free foods and those that contain gluten or other allergens, like putting French fries in the same fryer and oil used for breaded product or fish. In the prep stations, cooks may separate proteins from vegetables but not thoroughly clean a station after preparing fish, for example. Peanuts and other nuts on a salad bar can also pose problems, especially for children.

While gluten-free diners usually have plenty of menu choices, those with celiac disease must be careful about cross-contamination in the kitchen. The same goes with severe allergies, like an allergy to shellfish. Legal Sea Foods does an excellent job of separating shellfish handling, storage and preparation in the kitchen, using separate equipment, utensils, pans and workspaces, Antico points out. The chain also trains servers to ask ahead of time about allergies, and then order and serve allergy-free dishes properly.

Healthcare

Allergen management in healthcare facilities is becoming increasingly more prevalent. "This is because now we have the tools and means to diagnose it more than in the past," says Laura Watson, director of patient services at Utah Valley Regional Medical Center and current president of the Association of Healthcare Foodservice. "Healthcare is probably in a slightly better position to manage allergens than other industry segments."

Case in point: many healthcare facilities keep extensive electronic records on their patients, including information about food allergies, intolerances and sensitivities. Healthcare facilities also have many dieticians and nutritionists on staff to help with menu and recipe development.

"We use software that allows us to input all of our recipe and ingredient information to keep track of all items with allergens, and when patients come to our hospital, they are asked about food allergies, and this information is recorded in our patient database from the moment they're admitted," says Watson. "When people tell us they have a food allergy, we also make sure to drill down to get more specifics — sometimes when patients say they have allergies they might really have a food intolerance or religious preference that excludes certain foods from their diet. They might say 'allergy,' though, to make sure their preferences are heard." Either way, the hospital takes these requests seriously.

Healthcare facilities also tend to have more space on hand, allowing for separate, allergen-friendly meal production. Facilities like Utah Valley that offer room service also make allergen management easier because meals are made to order and easily customizable. "When patients place an order our call center is able to bring up their information, asking further questions about their allergies if needed," Watson says. "The menu item is flagged in our system to indicate that it contains one of the big eight allergies or gluten, and the order taker can pass this information on to the patient." Staff can note substitutions in the order, and the ticket is flagged as it goes through production and service.

"We do have some patients who are frequent customers with a tremendous number of complicated allergies," Watson says. "They call us even before they arrive at the hospital for a procedure, and we can keep their previous orders in our system so we can see how we've accommodated them in the past."

Like any other segment, training is key to successful allergen management. "Part of the ServSafe training we require for all production staff includes training about allergens," Watson says. The hospital continues to reiterate the importance of allergen management, especially because of the nature of the customer base. "When we give our patients a menu, they know no one has tweaked it; we have our staff strictly follow standard recipes, and we don't use any 'secret' ingredients. Everything has to be very transparent."

At the back of the house, creating separate workspaces and using separate equipment and utensils helps prevent cross-contamination. Even a flattop has to have a separate space for gluten or other foods with allergens, or staff should use a separate sauté pan as an alternative. Because the hospital has a full-service bakery, gluten-free items come in preprepared packaging and are cooked in separate ovens away from that area.

"Customers are so much more savvy than they've ever been," Watson says. "First, they will look for the obvious choices for them, but if they don't see anything they can eat, they will ask — they are not afraid to speak up. In a hospital setting, they expect us to know what's in our food. That's also the expectation I have for my staff."

Regardless of industry segment, knowing what's in the food products purchased and the menu items created — and then communicating this information to staff and customers — is vital for managing allergens in the kitchen. Nowadays, operators have the tools, techniques and training to make successful allergen management even more of a reality.

The Language of Allergies

Food allergies:

Severe rash, respiratory issues and, in the most severe cases, life-threatening anaphylactic shock may result from ingesting or even breathing in powders or residue from certain foods. The "big eight" of food allergies are milk, eggs, peanuts, tree nuts, fish, soy, wheat and shellfish.

Food intolerances or sensitivities:

Though not life-threatening, symptoms usually occur gradually or only when large amounts of the offending food are eaten.

Celiac disease:

This autoimmune disease is triggered by the consumption of gluten, which is found in wheat, barley, rye and, in some cases, oats (because of cross-contamination). A reaction can cause permanent damage to small intestine villi, resulting in the malabsorption of nutrients.

Gluten intolerance:

Discomfort or gastrointestinal distress can result from an inflammatory response caused by the presence of gluten in foods.

Allergens: Quick Tips and Considerations for Operators

• Create a special workspace for allergen- and gluten-free meal prep and away from bakery and pizza areas where flours are used.
• Clearly label nuts and other potential allergens in dry storage and coolers.
• Designate certain equipment for allergen-, gluten- and lactose-free cooking, if space and budget permit.
• Avoid cross-contact.
• Purchase or make your own allergy kits, complete with purple chopping boards and purple-handled pans and utensils, which are kept clean, covered and stored away from flours.
• Buy premade, gluten-free baked goods if you don't have the space to make your own safely.
• Make more meals from scratch so you know the ingredients in every dish.
• Design menus carefully and communicate with customers
• Eliminate certain foods, like peanuts and raw eggs from menus altogether.
• Get to know your regular customers by opening up lines of communication to address special diet needs and remaining flexible.
• Use symbols and language on menus to denote potential allergens, and list ingredients for main dishes on websites and menu kiosks for better transparency.
• Read ingredient labels carefully when purchasing products, prepared sauces and other foods may contain gluten or allergens.