Eating out can damage health

In many social circles, being allergic to foods such as wheat or dairy products is now as fashionable as Jimmy Choo boots.

Only a few years ago it was rare for people to recognise that they had food allergies. As a nutrition consultant, I have noticed a marked increase in the incidence of sensitivity to food. It is not easy to say how many people are affected or to what level the problem is on the increase.

According to Jonathan Brostoff, professor of allergy and environmental health at King's College, Camberwell, true allergies affect about half to one per cent of the population. It follows that around 100,000 Londoners suffer from food-related sensitivities or allergies.

In the case of an allergic reaction, the immune system will swiftly respond once food is swallowed, often with dramatic results. Symptoms vary, but range from swollen lips to breathing difficulties, abdominal cramps, nausea or vomiting, dizziness and even death. Sufferers are generally well aware of what to avoid, and often carry medication in case of emergencies.

Far more common than an allergic reaction is sensitivity or intolerance to specific foods. It is estimated that these can affect 40 per cent of the population and are responsible for many everyday symptoms such as bloating, dark circles under the eyes, headaches, fatigue and afternoon drowsiness.

Now that so many people seem to have allergies and intolerances, restaurants have a lot to gain from being tolerant and accommodating, yet most allergy sufferers will agree that eating out is a minefield.

Identifying which foods are causing the problem is only half the battle. How do you incorporate this in a practical way into your social life? What is the best way for customers to enjoy dining out without getting sick, or, perhaps worse, incurring the wrath of an illtempered restaurateur?

Perhaps the most important factor in avoiding problems is to explain to the waiter exactly what the nature of the allergy is, and ask what the kitchen can do. It is imperative that each side makes themselves clear, as no one enjoys sending back food.

There is little or no education or training for restaurant staff in this area. "Education, awareness and training is key," says Ian McKerracher, chief executive of the Restaurant Association. "Restaurateurs should, as a matter of course, ensure all serving staff know the menu (and any changes each day), know what ingredients are used, and be prepared to react appropriately if a problem occurs. The message that must be hammered home to staff is 'If you don't know, don't guess.'"

Sadly, many staff do guess, often because interrupting the workings of a kitchen to find exact ingredients of many dishes is made impossible by short-tempered chefs. Most London restaurants claim to be tolerant and patient, but then they would say that, wouldn't they? As I have an allergy to gluten, I know from experience how often mistakes are made, mostly due to the ignorance of the restaurant. This is often combined with a change in attitude. Five minutes ago you were a valued customer, but when the ordering process begins you have immediately become an irritant. I have found that the rule of thumb is that the better the restaurant, the more likely they are to take notice of individual requests.