Where do people with severe allergies go to dinner?

I’ve been hesitant to write about dining out with allergies, knowing it would interrupt my fantasy: That I am an eater just like everyone else, as adventurous and curious and game for whatever falls on my plate as Elizabeth David in the Provençal countryside or Calvin Trillin at the local fair. The truth is, I am extremely allergic to peanuts, and eating out in New York City, where I live, can make me feel like a kid in a very hazardous candy store.

“That’s the whole myth about eating out: You’re supposed to relax and someone else worries about your food,” Michael Mezzina, a Brooklyn-based video editor who also has a serious peanut allergy, told me recently. But for people with the most severe allergies, certain foods can cause life-threatening anaphylaxis, whose symptoms include difficulty breathing, sudden low blood pressure, hives, dangerous swelling, and loss of consciousness. Even a trace amount of an allergen (like almonds chopped on the cutting board that a sandwich is later sliced on) can mean a trip to the ER.

Even so, people with food allergies can eat out, and with gusto. The keys to success are clear communication, patience, and, when possible, researching ahead.

How Diners Strategize

It’s hard to overstate how stressful eating out with a severe allergy can be. But the stress isn’t just from knowing that if one link in the chain of communication is broken, a trusted dish could actually kill you. It’s also because food is bound up in our social lives, family gatherings, even our jobs. Serendipitous dinners with new friends or lunch meetings with co-workers can be difficult to navigate, especially if you don’t like to attract attention.

Mezzina knows that silence can be dangerous, but he still wants to avoid the social discomfort. “If I’m out with a group of people, sometimes I’ll ask [my girlfriend] to [mention my allergy], because then at least it’s someone who cares about you … not just you looking to be taken care of. It’s a stupid line of reasoning, but that’s how I feel,” he told me.

Rachel Miller, a teacher and musician who is severely allergic to peanuts and tree nuts, agreed. “The biggest battle is not the food itself, it’s the stigma,” she said, whether imagined or real.

“Sometimes you feel as though you’re just making the waiter’s day harder, and you’re like, ‘Oh, it’s that guy,’ you know?” Miller confided. To help, she’s started carrying cards that clearly outline her allergies with notes about cross-contamination, a tactic that FARE recommends. “It took some time for me to really be confident about presenting [the food allergy card]. But when you give it to [the waiter] … it’s almost like they’re relieved. You’re taking a little bit of the responsibility off the waiter’s shoulders.”

FARE offers food allergy templates on its website in a variety of languages. If you’re traveling and the language you need is missing, one allergic friend of mine has this tip: Carry blank cards. “I was traveling in Southeast Asia, and I would ask bilingual people at the hotel to please write out on a card, ‘If I eat peanuts, I will die.’” Having this blatant translation is better than asking to translate “allergy,” he said, because in some countries severe allergies are not common, and the seriousness may be lost in translation.

Thankfully, in the United States, the restaurant industry is increasingly aware of how serious allergies can be (some states, including Massachusetts and Rhode Island, have laws requiring food professionals to complete food allergy training, and some states require that menus tell diners to declare their allergies).

Every restaurant I reached out to for this article had this request: Whether by card or conversation, please always tell your server about your allergy, and be honest about its severity. “There is nothing worse than serving someone a dish and hearing, ‘There are no nuts in this, right?’” wrote a spokesperson for Hearth in New York City.

How Restaurants Safeguard

“I think every American has the right to eat safely in every restaurant,” Ming Tsai told me. Tsai, the restaurateur, TV personality, and chef-owner of Blue Ginger and Blue Dragon (both outside Boston), has helped lead the restaurant industry to greater awareness when serving people with food allergies. Tsai’s son was born allergic to seven of the eight most common allergens—something which, as a chef, Tsai says once felt “like an unfunny joke from upstairs.”

When Tsai’s son was two years old, the manager of a Boston area restaurant refused to serve Tsai’s family because of the son’s list of allergies. “I looked at him and I wanted to slug him. I got so angry, and it became my calling.”

One aspect of Tsai’s food allergy protocol includes a food allergy manual (he calls it “the bible”), a detailed spreadsheet that outlines each dish served at his restaurants by component and potential allergen, including points where cross-contamination may occur. That includes noting that shrimp is cooked in the deep fryer, so that guests with shellfish allergies who order vegetable tempura won’t be put in danger.

Picking Your Poison

What makes a good restaurant if you have allergies? One aspect is transparency: you’re confident that the staff knows the ingredients of every dish, or can easily find out, and the menu is predictable from one night to the next. “My favorite places are any kind of diner,” said Mezzina, the video editor. “I’ve never had a bad experience [with my peanut allergy] there … If you say, ‘Do you use peanut oil?’ you’re going to get a clear yes or no, because there are no complicated recipes.”

Because chain restaurants have standardized menus whose nutritional information is readily available online, they can also be good choices, provided you do your research. AllergyEats is one online database and app that uses peer reviews to help guide would-be visitors. Many chains, including Chipotle, Legal Seafoods, California Pizza Kitchen, Rainforest Cafe, and P.F. Chang’s, consistently make AllergyEats’ Top Ten list of allergy-friendly restaurants, because of their strict kitchen protocols for communicating with and accommodating allergic diners. Disney World gets top marks for going above and beyond with allergic children.

Another thing to look for, of course, is a restaurant that values good service. For this reason, people with food allergies have told me, upscale restaurants can sometimes be the safest option; in theory, the more you’re paying for dinner, the greater the expectation that your needs to be met.

Many allergic diners feel safest when they can find a place that either doesn’t use their allergen in the kitchen, or that treats it as a possible health threat. For example, Hearth, a restaurant in New York City led by Marco Canora, lists food allergies as one guiding factor in menu creation, and keeps peanuts completely off the premises expressly because of the relative prevalence of severe peanut allergies, according to a spokesperson for the restaurant. Finding a place that you love that is reliably allergy-friendly feels like the sweetest victory. My neighborhood favorite, Rucola, has not made allergy inclusion a mission, but lucky for me, Northern Italian food is not known for its peanuts. It’s near my apartment, it’s cozy, they make a mean rye cocktail and, at this time of year, shower their house-made pasta in white truffles — and there are no peanuts on the premises.

Read More: Oven Fires, Split Pants and Make Out Sessions: Tales from Open Kitchens