Hold Everything: Food allergies can make dining out a chore

When Valencia Tims' co-workers take an impromptu lunch at a nearby restaurant, the 29-year-old has to politely decline. Before she dares to venture to a new dining spot, she has to call the manager, or even the corporate office, to get a detailed list of every ingredient on the menu. If Tims takes one tiny bite of soy ' hidden in everything from cheese dishes to salad dressings to vegetable oil ' it can trigger anaphylaxis, which causes her tongue to swell and her throat to close.

Like 11 million other Americans, Tims suffers from severe food allergies. Of the 160 food allergies identified, soy is considered one of the eight most common, along with peanuts, fish, tree nuts, wheat, milk, eggs and shellfish. The only way to avoid a reaction is to completely avoid the food, meaning there's no 'cheating' ' eat the forbidden and suffer the consequences, often life-threatening ones.

'If I go out to eat, I always stick with the same few restaurants and always order the same thing,' said Tims, who was diagnosed with the soy allergy about two years ago, after having a reaction to tofu at a vegetarian deli. 'I like The Cheesecake Factory and Olive Garden because I've talked to people at their corporate offices and confirmed what I can and can't eat. At most places, I can't really trust that the server knows what's in the food, and even if I ask them to ask the chef, I never really know if they got an accurate answer.'

At Yia Yia's in Chesterfield, every server is trained on what goes into each item on the menu. 'Our servers know things down to which salad dressings contain walnut oil and what type of oil each fryer contains,' said manager John Miller. 'Some of our servers have food allergies themselves, so we understand the need to make changes to dishes to accommodate our guests. And if there's ever a doubt about what's in a dish, they know to check with the chef.'

This uncertainty of 'is there really something harmful hidden in my food?' is an understandably common fear for people with food allergies. It's difficult to trust that the average server knows the nitty-gritty of the menu ingredientsor has even been trained in the health risks of severe food allergies ' it's easy to mistake 'I'm allergic' with 'I don't like.'

'When I order, I tell the waitress, 'I'm allergic to fish and nuts and ask her if my order contains either one,' explained Karen Dowell, a 51-year-old nurse from Kirkwood. 'Most of the time, they just shake their head and I have to say, 'It's not that I don't like them; I'm severely allergic. You'll be calling 911 if I eat this.'' Dowell has found out the hard way that common items such as Maull's barbecue sauce and Worcestershire sauce contain trace amounts of anchovies, and it's enough to cause a reaction.

For people allergic to gluten ' a protein found in wheat, rye and barley ' the hidden culprit can be lurking anywhere from thickening agents (often made with flour) to lunchmeat to marinades. As the prevalence of celiac disease, an intolerance to gluten, increases, several restaurant chains have become increasingly more aware of gluten in their menus.

At Outback Steakhouse you can ask for a separate gluten-free menu with symbols indicating what is and isn't gluten-free. At Maggiano's Little Italy, if you alert your server to your gluten allergy, a chef will come out and discuss the gluten-free options that you have; the restaurant even offers gluten-free pasta. At Uno Chicago Grill, there's a computer listing all ingredients, including ones containing gluten.

That's why it's so important for the guests to be as informed as possible about their particular allergies, including common and not-so-common hiding places. 'We rely on the patrons who have allergies to let us know their needs,' said John McElwain, general manager and co-owner of Terrene in the Central West End. He said the best thing to do is call the restaurant beforehand and let a manger or chef know when you'll be coming and what allergies you have. You can even make notes online if booking a reservation through www.opentable.com. 'We've recently had a lot of people allergic to garlic come in wanting steak, but we brine all our meat and chicken in a garlic marinade before the restaurant opens, so there's nothing we can do. If they call ahead, we could more easily accommodate them,' said McElwain.

Accommodation is the name of the game when it comes to restaurants and special dietary requests. Chefs have even been known to divulge their recipes or deliver ingredient labels for inspection so customers can make sure they don't contain hidden allergens. Marilyn Albert-Hack, a 54-year-old saleswoman from University City, has been allowed to read the ingredients list of the breading for Hodak's famous fried chicken, among others, due to her severe reaction to sugar and MSG. 'I have to be diligent about labels, because even if someone says, 'There's no MSG added,' that doesn't mean MSG isn't in something that's brought into the restaurant,' explained Albert-Hack. 'Soup starter is famous for containing MSG, and even if the soup is 'made from scratch,' it may contain a common soup starter with MSG.'

Lou Rook III, the executive chef at Annie Gunn's in Chesterfield, takes pride in the fact that he knows each and every ingredient that enters his kitchen. 'Some hidden MSG flew under the radar in the tomato juice mix we were using to make Bloody Marys, but as soon as we found out, we changed mixes,' he said. 'You have to be diligent with your suppliers about what's in the food you're bringing into the restaurant. If you're getting a flourless chocolate cake from a local bakery, you have to be sure what exactly is in it.'

Rook has a brother who is deathly allergic to nuts, so he intimately understands the dangers of food allergies ' he even keeps Benadryl on hand just in case, which can slow an allergic reaction enough to allow someone to seek medical care. 'You have to be as proactive as possible and you have to do it right,' said Rook. 'If someone's allergic to peanuts, you can't cook in a pan previously coated in peanut oil. You can't take shortcuts and use the same plate if a dish is sent back. You could end up killing someone if you're not careful.'