How to travel well with dietary restrictions and food allergies

For travelers with special nutrition or dietary restrictions, dining out can be tricky and even life threatening, especially when traveling internationally.

Fortunately, there are an increasing number of websites and apps for helping hungry travelers with food allergies, celiac disease, diabetes and other medical issues find memorable meals that meet their dietary restrictions. There are also a variety of products that those with food allergies and dietary restrictions should consider packing when prepping for a trip. Bringing preventative medications and using translation cards for food allergies, special diets and medical needs can break down language barriers and ensure a safe meal. SelectWisely makes translation cards in 60 different languages, which can provide peace of mind to travelers with dietary restrictions.

We spoke with several registered dietitians and nutritionists, many with their own dietary restrictions, who shared their advice for those traveling with food allergies and dietary restrictions.

General tips
Tips for travelers with food allergies
Tips for travelers with celiac disease
Tips for travelers with multiple restrictions
Additional resources

General tips for travelers with dietary restrictions

Lauren Rezende, M.P.H., R.D., Director of Nutrition, Quality Assurance at Healthy Dining Finder, a website where restaurant-goers can find nutrition information for healthy dining options, had the following advice:

• Travelers with medical conditions requiring nutritional vigilance can check HealthyDiningFinder.com. This free resource identifies menus that meet the Healthy Dining nutrition criteria, which focuses on lean proteins, fruits, vegetables and whole grains. Recommended Healthy Dining menu items also have limits on calories, fat, saturated fat and sodium.
• Before locking in your order, your server may need to shuttle back and forth to the kitchen to uncover whether certain ingredients are “hiding” in your preferred menu item. If the server is unaware of what ingredients are in a menu item or the risks involved with cross contact, don’t hesitate to ask for a manager to make sure your meal is prepared according to your dietary needs.
• Look for restaurants that have build-your-own creations, as they allow for maximum flexibility.
• If your meal has been a success, express your appreciation verbally to those who helped you at the restaurant, as well as through a note or a post on social media. If you – and others – do this, restaurants will be encouraged to accommodate the growing segment of diners with special needs and preferences.

Certified nutritionist Tara Zamani, MS, CNS, from ContentChecked, a mobile application that tracks specific allergies or sensitivities to foods and provides a full nutritional breakdown of any food items with a simple scan of the bar code, shared these tips for foodies with diabetes, celiac and food allergies:

• When flying, ask the airline if they offer food for people with dietary restrictions, such as gluten-free meals, dairy-free meals and sugar-free, low-carb, low-glycemic meals for diabetics. If you have one or more dietary restrictions, you may want to prep your own food and take additional snacks on to the plane, as some airlines can only accommodate one dietary restriction at a time.
• Use healthy dining apps on your smart phone, such as Clean Plates (local restaurant directory guide for vegans, vegetarians and people with gluten sensitivity) and Locavore, when traveling within the U.S. These apps offer the healthiest and most local alternatives based on ZIP Code.
• It’s best to choose restaurants that are farm to table, meaning they buy all of their produce from the local farmers market and also offer a seasonal menu based on fruits and vegetables that are in season.
• You may want to ask the manager of a restaurant if they offer food alternatives and replacements to their dishes for people with dietary restrictions. Find out what fresh vegetables or fruits their kitchen has to replace any unwanted food items. Ask the manager if they offer any gluten-free dishes and dairy-free dishes. Ask for the specific ingredient lists and have the server double check with the head chef in the kitchen for any cross contamination, especially for severe allergies like nut and dairy allergies to casein and/or whey.
• Once the food arrives, you can also visually assess if it meets your dietary restrictions. If you are gluten sensitive, make sure that rye, barley, wheat and/or oats are not in your dish. Common food allergens may be hidden in sauces, condiments and/or sides, such as gluten, soy, peanuts and dairy. The only way to be sure is to ask the head chef directly.
• In the U.S., New York, Los Angeles, and San Francisco offer many healthy and tasty alternatives that also cater to food allergies and dietary restrictions. European cities, such as Dubai, Florence, London, Milan, Paris and Rome are similarly savvy and creative when it comes to accommodating dietary restrictions.
• Indian cuisine is accommodating for most with gluten sensitivity, as the majority of the meals are rice, bean, herb and vegetable based. Asian cuisines, such as Japanese and Thai, are suitable for individuals who are lactose intolerant, vegan and/or vegetarian. Most Asian dishes are usually free of dairy and also offer vegan varieties. Italian cuisine offers vegetarian dishes with mostly pasta and veggies (the cheese can be replaced with marinara sauce). Cuisines with mostly lean protein are best suited for diabetics.

Tips for travelers with food allergies

Rene Ficek, Registered Dietitian and Lead Nutrition Expert at Seattle Sutton’s Healthy Eating, offers the following dining out tips for travelers who are allergic to dairy, nuts and other foods.

• Be sure to show your food allergy card at restaurants, if you have one. Those with severe allergies should be sure to get one before traveling to any destination where there may be a language barrier. Don’t be afraid to ask the kitchen to modify a dish or to prepare something that isn’t on the menu; most restaurants can quickly throw together a veggie-only salad or another simple dish. (Note: this is easiest if the kitchen isn’t too busy, so you may want to eat at non-peak times).
• If you feel confident about your discussion with the chef and his or her ability to accommodate your special requests, there should be no need to feel concerned about the end product. Severe allergies can induce anaphylaxis, and it’s essential to always be prepared with an epinephrine delivery device like the EpiPen in case the unthinkable happens.
• The best way to ensure healthy air travel is to bring your own food and snacks, but make sure you read up on what you can and cannot bring on a plane with you.
  • Sandwiches, wraps and salads are easy to carry and eat on an airplane.
  • Fruit travels extremely well; bananas, oranges, tangerines, grapes and apples are particularly easy to carry and eat.
  • Dried fruits are both portable and delicious.
  • Granola bars, energy bars and crackers are very portable.
  • Sliced cheese is tasty on crackers but must be kept cold or eaten within four hours after removal from the refrigerator.
  • Consider packing vegetable chips and other junk food alternatives.

Jan Patenaude, Registered Dietitian, Certified LEAP Therapist and Food Sensitivity Specialist, shares her tips for foodies with allergies to specific foods and food sensitivities.

Flying:

For people with food allergies, such as nuts, flying may be the most worrisome part of traveling due to the prevalence of peanuts being served on flights. For some people, even small amounts of nuts can trigger a deadly reaction.

Although airlines and airports cannot guarantee nut-free flights (nor are there regulations on what food items passengers can bring aboard) there are steps passengers with nut allergies, can take to mitigate risk.

• Download and fill out the Food Allergy & Anaphylaxis Emergency Care Plan from Food Allergy Research & Education (FARE), and keep it with your essential travel documents in your carry-on, handbag or wallet.
• Choose the first flight of the morning; this is when the plane is at its cleanest and increases the chance that any nut traces from previous flights have been removed.
• Read the airline’s allergy policy and check what they serve to make sure they don’t have in-flight snacks containing your allergen.
• Notify the airline ahead of time and also inform the flight attendants when boarding that you or someone you’re with has an allergy.
• Bring disposable wipes to wipe down surfaces such as seats, armrests and tray tables.
• Always carry autoinjectors! Consider bringing multiple because the effects of epinephrine last around twenty minutes, and it could take considerably longer for help to arrive than if you were on the ground.
• Pack and bring your own food to eliminate the possibility of accidental contact or ingestion.

Restaurants:

• Be warned, a favorite dish that was ‘safe’ in one restaurant may have different ingredients at another restaurant.
• Be aware that some ethnic restaurants use common ingredients to imitate standard foods. For example, wheat flour shaped and flavored to resemble chicken or beef in vegetarian dishes.
• Ingredients may appear in unexpected places. Examples include crushed walnuts in pie crust and nut meal in soup.
• If you order meat, poultry or fish, seasoning is routinely used in meat preparation. Tell the waitstaff you do not want any seasonings. Sauces like au jus are used for flavor and appearance and usually contain hydrolyzed vegetable protein, soy product, msg, pepper, garlic or other ingredients. Request no au jus on your meat. Additionally, meat and poultry is frequently marinated. Request no marinade. Emphasize the entree should be cooked on aluminum foil to avoid contamination from sauce used on other orders.
• If you have had a good dining experience, show your gratitude to the waitstaff and chef with a generous tip. For that extra touch, leave a complimentary note with the tip. Compliments are appreciated and will encourage the staff to take extra care the next time you, or another patron with food sensitivities, visits.

Hotels:

• Look for rooms or suites with refrigerators and microwave ovens. Refrigerators can help you stock your own snacks and keep medications cool. (Note: mini-bar refrigerators are not cold enough to keep perishable food.)
• Make use of the coffee pots to heat water for tea or cereal.
• Pack shelf stable, microwavable mixes or grain mixes that you can add water to and microwave to heat.
• Stop by a local store for small boxed milk, nut milk or juices. Many are shelf stable and can be served with any cold cereal and sliced bananas with some jerky or nuts for protein.

Tips for travelers with celiac disease

Rachel Begun, M.S., R.D.N., culinary nutritionist and special diets expert, has celiac disease, travels a lot for work and practices the following tips on a regular basis.

The key is planning ahead, so you don’t get caught off guard with nothing safe to eat. Even though gluten-free options are much more available than ever before, that doesn’t mean all restaurants have options available and, even if they do, that doesn’t necessarily mean they are healthy.

• Research accommodations before you board the plane and be prepared for the worst-case scenario. When booking a flight that offers a meal, choose the gluten-free option. Snacks and meals for on-board purchase don’t always offer much in the way of gluten-free, and the gluten-free options may be out of stock by the time the flight attendant gets to you. Bring all your meals and snacks with you, especially in the event that your flight is delayed or canceled.
• If possible, book a hotel room that has a kitchenette or a mini-fridge. This allows you to take back control of some of your meals. If you know you’re eating out for dinner, perhaps you can eat breakfast or lunch in your room. Some hotels will provide a mini-fridge if you ask, even if it’s not regularly available in the room.
• Check out GlutenFreeTravelSite, which provides reviews of restaurants and resorts—all by gluten-free consumers who have visited the location.
• If you are traveling abroad and there is a language barrier, make sure to bring gluten-free dining cards with you. You can download them at Celiac Travel for free. They are now available in almost every language!
• Don’t be afraid of eating at local restaurants. Many cook from scratch and have a better handle on every ingredient that goes into your dish.
• Research and book all restaurant reservations ahead of time. Get recommendations from the gluten-free community, as they are the best judges of what is truly gluten-free.
• Call restaurants ahead of time to book your reservation and ask questions to see what their approach is to accommodating gluten-free. That initial conversation will give you good insight into their experience serving gluten-free customers. Review the online menu before going to the restaurant to narrow your options to a few items so you can have a focused conversation with restaurant management about how they prepare these items. Getting a safe meal goes beyond knowing what ingredients go into your meal. It’s equally important to know what utensils, equipment and surfaces are coming into contact with your meal. For example, an omelet may seem to be gluten-free based on its ingredients. However, if that omelet is prepared on a griddle that is also where pancakes are made, then your omelet isn’t likely to be truly gluten-free. A simple request to have the omelet prepared in a dedicated or sterilized skillet goes a long way.

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Tips for travelers with multiple restrictions

Darshi Shah, CNT, CPT, INHC, health coach, board-certified Nutritional Therapist, and author of the forthcoming book “R.I.G.H.T. Diet for Autoimmunity,“ is a non-celiac, gluten-sensitive nutritionist who eats free of gluten, avoids dairy and is also a vegetarian. He shares his experiences and tips for traveling foodies who have multiple allergies and/or dietary restrictions like celiac and lactose intolerance:

• When you have gluten sensitivity, enjoying dining out has been redefined to not getting sick and eating safely. This means it is better to enjoy a salad that you know is safe, rather than experiment with a dish without knowledge of how it was made.
• When traveling, Shah brings a Magic Bullet (a compact blender), some almonds and buys local fruits so he can make smoothies to fill gaps in eating out.
• Call the restaurant ahead of time at a non-peak time so the chef/manager can focus and discuss the details of their menu with you. Explain clearly and succinctly the medical consequences of not sticking to your diet. Ask them what they recommend and who your server will be. When you dine, make sure you ask for that server by name. Review the dietary information. Confirm that when you’ve been served, it is appropriate (gluten-free, dairy-free, vegetarian, etc.). The final step is a thank you call. While it doesn’t impact you anymore, it can show them that the extra attention to detail was appreciated, and it helps the next person.

Additional resources

Traveling with celiac disease: Guidance from the U.S. National Institutes of Health.

Food allergies: What you need to know: Advice from the U.S. Food and Drug Administration.

Managing food allergies while traveling: Tips from Food Allergy Research & Education.

AllergyEats Restaurant Guide: The most widely-used guide to allergy-friendly restaurants in the U.S. with tens of thousands of restaurant reviews.

Find Me Gluten Free: A crowdsourced listing of over two million gluten-free businesses; also available as an app.

Gluten Free Jetset: A blog from the author of The Gluten-Free Guide to New York City.

AllergyTranslation.com: Offers customizable allergy translation cards.

Select Wisely Cards: as mentioned above.

American Medical ID has all kinds of bracelets, jewelry, tags, and other items to communicate your conditions in case you can’t.

Traveling with Kids Who Have Food Allergies: Tips from a mom with a food allergic child.

Main image: iStock/Creatista