People often turn to ethnic foods thinking they will be more allergy friendly, but that is not so. Sauces and condiments are a big source of unknown ingredients, many of which could be allergenic.
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Global cuisines can be a delicious way to experience different cultures. Part of the fun is seeing how different people use exotic and familiar ingredients in uncommon ways.
But this practice can pose risks for those with food allergies. As the ingredients in a dish become less obvious, the potential to eat an unexpected allergen increases.
"Just because you think that a food is OK, you cannot assume," said Dr. Anna Nowak-Wegrzyn, assistant professor of Pediatrics at the Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York.
Nowak-Wegrzyn noted that peanut butter can show up in Asian spring rolls. "It's not very intuitive," she said.
While food allergy experts say that people with allergies should apply the same degree of caution to ethnic foods as any other food they might eat, language barriers, unknown ingredients and different preparation techniques can magnify the challenge to express needs and concerns.
And imported products can increase the risk of ingesting something unknown, although Ming Tsai, an allergy advocate and owner of Blue Ginger restaurant in Wellesley, Mass., said that most manufacturers require a clear list of ingredients on their products.
But if the standards of a country's labeling system are unclear, erring on the side of caution is better.
"You do need to be a little bit more careful," Tsai said. "With kids, I wouldn't use an exotic foreign spice rub, just to make doubly sure. It's better to be safe than sorry."
"Still, the common allergens remain common," said Dr. Jacqueline Pongracic, division head of Allergy and Immunology at Children's Memorial Hospital in Chicago, Ill., referring to the eight most common allergies: fish, shellfish, milk, egg, soy, wheat, peanuts and tree nuts, including walnuts and cashews.
Proper preparation before visiting an ethnic food restaurant can help allay fears and avoid unnecessary allergic reactions. Researching common ingredients in the cuisine can point out obvious allergens to avoid. Thai food, for example, incorporates a variety of of peanut products while Mexican and Italian foods use cheese to flavor and garnish dishes.
It can be helpful to know if different countries use different terms for certain ingredients or cooking techniques. For example, in Africa, peanuts are often called groundnuts. In Chinese, "shu" means "barbecued" and "kow" means "roasted" while "al horno" means "baked" in Spanish and "frito" means "fried." Knowing such terms can offer clues as to how an item might be prepared and whether it may contain and allergen.
Chef cards containing a list of allergenic foods can be ordered online in many languages and can help significantly in communicating needs between the diner and the kitchen staff.
"I believe in doing your homework," said Sloane Miller, a food allergy coach who blogs at allergicgirl.com.
And when in doubt, particularly with children, experts recommend keeping it simple.
"The child can start very young with very simple foods. Stay with foods that work and enjoy the social activity in that restaurant," said Anne Munoz-Furlong, founder of the Food Allergy and Anaphylaxis Network. "It takes the focus off the food but you are still exposed to the culture."
Keeping medication handy and eating with a buddy who is aware of your allergy needs is essential, particularly when trying unknown foods. And when in doubt about a food situation, allergy experts advise leaving.
"Accidents occur when you least expect, so be prepared to institute the treatment plan to help you remedy the situation should an allergic reaction arise," Pongracic said.
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