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The Food Allergy Awareness Act Increases Food Allergy Awareness in Massachusetts Restaurants

March 2011


Dr. Michael Pistiner serves on KFA's Medical Advisory Board
By Michael Pistiner, MD, MMSc (originally written for the American Academy of Allergy Asthma & Immunology)
Clinical Instructor, Children's Hospital Boston, Harvard Medical School
Northeast Allergy Asthma & Immunology

For many people in the U.S., dining out is a social activity that requires little thought. No cooking or cleanup means ample time to spend with family and friends. For families of children with food allergies, dining out can prove difficult and, often times, lead to restaurant avoidance. 

But it doesn't have to.

Studies show that improved communication and food allergy awareness in all types of eating establishments — from sit down to take out — is needed to increase safety in food-allergic patrons. According to the National Restaurant Association (NRA), 130 million people eat from a food establishment each day. Recent studies report approximately 4% of the U.S. population live with food allergies. Each day millions of people with food allergies will be eating out.

One study reports that in those with known peanut or tree nut allergies who had an allergic reaction while eating a dish they ordered, 55% didn't notify the establishment of their allergy — and in 78% of reactions, someone in the establishment knew that peanut or tree nut was in the dish.1

In another study, many restaurant staff reported that they feel confident to safely serve food-allergic patrons, but demonstrated deficiency in food allergy knowledge. This is a dangerous combination that highlights the need for food allergy education in this setting.2

Collaborative Communication

By working together, families of food-allergic children and eating establishments can help prevent food-allergic reactions and make dining out less stressful.
     •  Talk to a manager, if possible.
     •  Consider calling ahead first, especially at sit-down eateries.
     •  Speak with the chef around lunchtime for a planned dinner.
For years, food allergy advocates have been encouraging legislation directed at restaurants and other eating establishments — but food allergy education has not been a requirement in the U.S. until recently. The most comprehensive piece of legislation to date — the Food Allergy Awareness Act — was just signed into law in Massachusetts and will be put into play in over 14,000 Massachusetts eating establishments. These select restaurants will be required to implement a new set of regulations designed to increase food allergy awareness in restaurants.

New regulations in Massachusetts require:

1) A notice on menus and menu boards that states, "Before placing your order, please inform your server if a person in your party has a food allergy";
2) Food allergy awareness posters posted in clear view of all staff; and
3) At least one food protection manager to view a food allergy education video.
4) An optional “Food Allergy Friendly” program that is currently under development.

Remember: vigilance and wise food and restaurant choices will continue to be necessary. Try not to visit a restaurant at peak business hours. Busy restaurants take short cuts resulting in a greater risk of not getting necessary allergen information. Also, always carry emergency medicine, especially when dining out. If there is any question that an allergen-free meal cannot be safely served, do not risk a reaction. Instead, politely leave the restaurant.

The Takeaway
If you choose to dine out, notify the eating establishment of your child’s food allergy each time you go, even if your child has previously eaten there and is ordering the same safe item again. Subtle changes may be made to the menu or item that could be relevant.

For more information on the regulations in Massachusetts, visit


1. Furlong, T., et al. (2001). Peanut and tree nut allergic reactions in restaurants and other food establishments. Journal of Allergy and Clinical Immunology. 108, 867-70.

2. Ahuja, R., et al. (2007). Food-allergy management from the perspective of restaurant and food establishment personnel. Annals of Allergy, Asthma & amp; Immunology. 98, 344-348.

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Page last updated 7/29/2012

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