Dining out with food allergies: How to avoid hives, nausea and more
Delicate and fragrant, simmering away in curries, the sight of mussels almost tricks me into forgetting that I'm allergic to them. I'm often tempted to try them, especially, when I see my friends savouring bowls of the shellfish and crab meat.
And then I remember, that even a taste of it, could result in angry red, painful boils on my arms, legs and neck and face. Cue days of spending pressing salt-water handkerchiefs on the hives while juggling reams of medications.
Sadly, mouthwatering and aesthetically-appealing food isn't quite worth that amount of trouble.
Yet, my food allergies pale in comparison to others. For instance, Dubai-based Laaleen Sukhera, a corporate communications professional, is constantly vigilant, cross-checking with waiters and managers about hidden ingredients like fish powders or oyster sauce and inquiring whether utensils have been properly segregated. "I always ask what’s safe to order, and they’ll make it for me in a separate pan," she explains. Yet, even with such precautions, mishaps can occur. Just months ago, an accidental taste of three tiny dots of caviar sent her reeling to the hospital. Similarly, Aheli Prabhakar, a Dubai-based professional, who retches at even the smell of eggs, must constantly steer clear of any egg-based dishes, which includes pancakes, as delicious as they are.
When I'm at restaurants, I speak to managers and request no cross-contamination with fish, seafood, and ingredients like oyster sauce and fish curry powder. Shared oil and utensils have the same effect too.
Food allergies are a lot more than just avoiding certain dishes, they require a relentless attention to detail and of course, the grit to keep asking questions, despite the nagging worry that you sound annoying and fussy. “I would rather ask ten questions than end up in the hospital for a week,” says Chandini Sinha, a Dubai-based homemaker, who suffers swellings after eating anything with soy sauce.
Why do we endure hives, nausea, and endless hospital visits—and how can we still enjoy a good evening out despite it all?
Why do we have food allergies?
Some of us can't enjoy our favourite foods, no matter how much we love them—and the reasons behind this can be surprisingly complex. For some, food allergies strike suddenly, even in adulthood. Pallavi Bhatia, a Dubai-based homemaker, who developed an allergy to gluten in her early twenties. "If I eat anything with gluten, I break out in rashes," she shares.
The science behind food allergies
Sneha Susan Kuriachan, Specialist in Internal Medicine at Aster Clinic, Deira and Unni Rajasekharan Nair, Consultant Internal Medicine, Medcare Royal Speciality Hospital explain that food allergies occur when the immune system mistakenly identifies certain proteins in food as harmful, overreacting to them. The response can range from mild symptoms like itching or hives to severe, life-threatening reactions like anaphylaxis.
The process starts subtly. "The first time you encounter an allergen, your body might not react, but your immune system is taking notes, creating special antibodies called IgE to 'remember' the allergen," says Katherine Greene, a Dubai-based physician.
Elaborating on the science behind allergies, Greene says, “When a person is first exposed to an allergen, their immune system doesn’t immediately react but instead becomes sensitised by producing Immunoglobulin E (IgE) antibodies specific to that food protein.”
When someone has a food allergy, their immune system mistakenly identifies a specific protein in the food as harmful, an allergen, Upon exposure to the allergen, the immune system produces antibodies called Immunoglobulin E (IgE). These antibodies trigger the release of histamines and other chemicals from immune cells, leading to allergic symptoms....
These IgE antibodies attach to mast cells and basophils, which are found throughout the body, especially in areas like the skin, lungs, and digestive system. Upon subsequent exposure to the same allergen, the IgE antibodies recognize it and signal the mast cells and basophils to release histamine and other chemicals like leukotrienes and prostaglandins.
The severity of allergic reactions can vary based on factors like the amount eaten and whether the food was cooked, raw, or processed. You cannot predict the severity of your next allergic reaction based on the last one...
This release results in the classic symptoms of an allergic reaction, such as swelling, hives, itching, and in severe cases, anaphylaxis, a life-threatening condition that involves airway constriction, a sudden drop in blood pressure, and difficulty breathing. The severity of the reaction depends on the individual and the amount of allergen they’ve consumed, with some people experiencing only mild discomfort, while others may face life-threatening symptoms.
Kuriachan warns: Don’t risk consuming a food you're allergic to just because your previous reaction seemed mild. The severity of allergic reactions can vary based on factors like the amount eaten and whether the food was cooked, raw, or processed. "You cannot predict the severity of your next allergic reaction based on the last one," she cautions.
Allergies run in families
Allergies can transcend generations. "If one or both parents have allergies, not just to food, there's a higher chance their children will develop them too. This genetic predisposition is known as atopy," explains Greene.
For Abu Dhabi-based school teacher Kethaki Ramakrishnan, this hits close to home. "My mother has a life-threatening allergy to peanut butter, and I inherited the same. I’ve only had it once by mistake, and I ended up in the hospital for three days," she recalls.
Modern lifestyles and rising allergies
There are several factors that are also involved in allergies. Specialists point to the hygiene hypothesis, which suggests that reduced exposure to microbes during childhood might cause the immune system to overreact to harmless substances. Environmental pollution and dietary habits further complicate the picture. “It’s a complex web of reasons why someone might suddenly develop an allergy," Greene explains. Cross-reactivity is one example: when proteins in certain foods resemble allergens the immune system is already sensitized to. "For instance, someone allergic to birch pollen might react to raw apples."
Understanding food allergies requires untangling genetics, environment, and immune responses—proving that the reasons behind those untouchable favourite foods are anything but simple.
Living with allergies
No doubt, it can be exhausting. You need to scan every menu, ask several questions and watch your friends enjoy a meal that you can’t touch. It’s like walking through a culinary minefield, where even the smallest step has outsized consequences. There’s also the fear of seeming overly fussy or dampening the fun for others, as Amal Hussein, a 32-year-old graphic designer in Dubai, knows all too well. Living with a severe shellfish allergy since childhood, she explains, “I can’t eat shrimp or crab, and the reaction is immediate hives, swelling, or difficulty breathing.”
What’s worse, some people don’t take her allergy seriously. “Once, I was accidentally offered a spring roll at a friend’s party. I didn’t know it was stuffed with crab,” she recalls. Within minutes, her lips swelled, and she started wheezing. “I ended up in the emergency room that night.”
Her allergy has a rather iron-clad grip on her life, as she avoids seafood restaurants entirely, wary of cross-contamination. “Even the smell of shellfish being cooked can make me feel unwell,” she explains. Dining out requires careful planning, including detailed conversations with waitstaff to ensure her meal is prepared in a separate pan and free of any shellfish traces.
Sometimes, the allergens are so common that they just find their way to you. Sarah Al-Farsi, a 28-year-old teacher living in Abu Dhabi, fights a daily battle avoiding anything to do with peanuts. This means, she must think twice before accepting a chocolate bar too. “Someone offered a chocolate bar to me, and within minutes, I couldn’t breathe. I had to be rushed to the hospital,” she recalls. Living with a peanut allergy means being hypervigilant: Double-checking ingredient labels, and even questioning waiters and managers about harmless dishes such as salad dressings or baked goods. “Even something as small as peanut oil sets off a reaction, so I need to keep guard,” she says. “It means that I can’t eat desserts that others enjoy, but I’ve made my peace with it. I just must carry my medication everywhere, because, you never know.”
How to manage food allergies when dining out
Both Hussein and Al-Farsi maintain that while living with such allergies does get tedious, it’s not impossible to have fun. It requires vigilance and preparation, and much sensitivity from others, from friends to restaurant staff, too. For instance, Eda Gungor, Co-founder of SEVA, Dubai, explains that for people with allergies, transparency and communication is key. You need to ask about allergies when taking orders, and certain menus are careful about listing potential allergens. “We also work closely with guests to customise dishes wherever possible, ensuring their experience is both enjoyable and safe,” explains Gungor.
Ruhil Badiani, a Dubai-based physician at Cornerstone Clinic lists down some important rules to remember, when eating out:
Eating out can be challenging for those with food allergies, such as gluten, seafood, or fish allergies. However, with the right precautions, it can still be an enjoyable experience. Here's how to manage allergies effectively while eating out.
Before choosing a restaurant, check its menu online to identify allergen-friendly options. Many establishments now include allergen information on their menus, such as gluten-free or allergy-friendly dishes. Websites and reviews from other allergy-sensitive diners can also provide helpful insights....
Do your research in advance
Before choosing a restaurant, check its menu online to identify allergen-friendly options. Many establishments now include allergen information on their menus, such as gluten-free or allergy-friendly dishes. Websites and reviews from other allergy-sensitive diners can also provide helpful insights.
Inform the restaurant
When making reservations, mention your allergies. Upon arrival, inform your server about the specific allergens you need to avoid. Clearly communicate the severity of the allergy, emphasizing that cross-contamination can be just as harmful as direct exposure.
Be specific and ask questions
When ordering, inquire about ingredients and preparation methods. For example, ask if a dish is prepared using the same utensils or fryers as allergen-containing foods. For gluten, confirm if sauces or dressings contain wheat. For seafood or fish allergies, ensure that dishes are cooked separately to prevent cross-contact.
Carry an allergy card
An allergy card, listing your allergens in clear, concise language, can be a valuable tool. Some cards even include translations for travel abroad. Handing this card to your server or chef can help ensure your message is understood.
Choose simple dishes
Complex dishes with many ingredients increase the risk of accidental exposure. Opt for simpler meals where each ingredient is easy to identify. Grilled proteins, steamed vegetables, or salads, with allergen-free dressings, are often safer choices.
Bring your own condiments or snacks
For severe allergies, consider bringing your own safe condiments or dressings. For example, gluten-free soy sauce packets are a handy option for sushi restaurants.
Always carry emergency medication
If you have a prescription for medications, carry it with you. Ensure those dining with you know how to administer it in case of an emergency.