When Lifestyles Differ - By Margaret Reiss

When Lifestyles Differ 

There is an extreme lack of knowledge about food allergies in Nebraska restaurants, along with a lack of options for people who suer from them. The number of people affected by food allergies within their lifetime continues to double by the decade across the states, and that doesn’t include those who suer from other food intolerances, like lactose intolerance. Nearly 25% of the US population has at least one food intolerance and an additional *at least* 10% of people have at least one food allergy (CDC, 2023), which is consistent to that of Nebraska. With a third of the population now in need of well-informed food handlers to help them have a safe restaurant experience, the need for improvement only continues to grow. In order to better address the lack of general knowledge about food allergies in Nebraska restaurants, the Nebraska Hospitality Association, Nebraska Department of Education, and Nebraska Department of Agriculture should implement a state-wide, mandatory food allergy training program for all restaurant employees regarding the top 9 most common food allergens. 

Many people will develop at least one food allergy over the course of their life. Around 10% of people in the US (33 million people) develop a food allergy either in childhood or adulthood (FoodAllergy, 2022). It is common for people to discredit the prevalence and needs of individuals with food allergies, but it is a growing population that anyone could become a part of at any time and it deserves recognition even when it is not (yet) a personal concern. Even more common than food allergies are food intolerances, which make up an additional nearly 25% of the US population (Jansson, 2020), both statistics being consistent with the Nebraska population. Being that about a third of the nation now gravitates towards inclusion and alternatives when going out to eat, it is evident that there is a market to be catered to and profited off of.

The consumption of food allergies in an allergic individual attacks the immune system, creating reactions in various bodily systems, ranging from cardiovascular (weak pulse) to gastrointestinal (vomiting) to respiratory (wheezing, anaphylaxis) issues (ACAAI, 2022), whereas food intolerances solely attack the digestive tract (Li, 2024). Symptoms related to food restrictions are never pleasant, but more importantly always run the risk of being life-threatening, and unfortunately they are not always predictable. Stacie Van Cleave, owner of Veg Edible in Benson, spoke of her corporate time in the food industry and how a specfiic guests’ peanut allergy related incident that she personally handled was a driving factor in her decision to accommodate nut allergies when opening her own restaurant (Van Cleave, 2025). It is beyond important for people who handle food and service individuals with allergies to be well-informed about the food they are handling. 

For example, when dealing with food allergies, it is important to know exactly what foods matter most in the conversation. The 9 recognized allergens being: milk, eggs, sh, crustacean shellfish, tree nuts, peanuts, wheat, soybeans, and (as of Jan 1, 2023) sesame, which are required to be labeled on all food packaging in stores (FDA, 2021). Many of the alternatives that people with these allergies look for are simple swaps, like buns for celiacs, cheese or milk for casein allergy (milk protein) and lactose intolerance, and sauces containing a variety of allergens, making it very attainable to better accommodate more people in restaurant service. Some allergies are more common in childhood, like peanuts, and some are more commonly developed in adulthood, like shellfish (Kamdar, 2015). Knowing the targeted demographic is necessary when designing a menu, because these age-specic allergies may play a bigger role in the menu additions and decisions made. 

As far as treatments for food allergies go, there are still not many options. While some intolerances have short-term supplements that aid with digestion and symptoms, like taking a Lactaid for lactose intolerance, allergies do not have a similar supplement or ‘quick x’. The only effective treatment for food allergies is Oral Immunotherapy, which has shown major improvements in children specifically with very severe, oftentimes anaphylactic, peanut allergies. This type of therapy treatment, when successful, consists of a gradual exposure to the allergen until it can hopefully be consumed in a small quantity with a minimal reaction (Cleveland Clinic, 2025). Oral Immunotherapy is more eective in reducing food allergies in children, but it can still effectively lessen the severity of allergies in adults, even if not to the same degree. Even with this effective of an option, it is still generally recommended to avoid the allergen(s) after therapy is completed. Knowing about treatments is important in this conversation because it highlights how prevalent these allergies will remain even if people with them are seeking treatments. This demographic will only continue to grow across Nebraska and the rest of the States, just as it has after recent decades. 

Without proper training, and the ability to identify allergens and their reactions, the risk of a more severe reaction increases. Many restaurants don’t offer info on ingredients, nor alternatives to accommodate dietary restrictions, and oftentimes when they do, they are mediocre at best. The GM at the restaurant Blue Sushi and Sake Grill location in Omaha, NE, said that restaurants are not required to have an allergen menu until the chain has opened 20 different locations. That is crazy to think about considering how many restaurants never open that many restaurants. Approximately 90,000 ER visits per year in America are due to severe reactions to food allergies (James, 2024). Unfortunately there aren’t exact numbers on how many of these incidents come directly because of a restaurant or take out experience due to the chaotic and urgent nature of these incidents in real time, but it is fair to assume that proper training on how to help in these situations would only help prevent the severity of these types of incidents. 

Restaurants run less efficiently when communication isn’t effective. Oftentimes, poor communication in the workplace can be a result of not being well-informed on what it is being communicated about. When food staff don't know how to answer basic questions about ingredients or preparation procedures, there becomes a back and forth to the kitchen on a topic that the relayer-of-information doesn’t understand. While this can be a good learning moment for competent staff, it can also sometimes feel like a game of telephone when the restaurant is busy or if the server doesn’t quite understand the questions being asked and the answers being given. Misinformation contributes to incidents and an atmosphere of distrust for guests, especially those with dietary restrictions. This can be seen in an experience I had as a server. I recently served a table at work where a man had a shellfish allergy. He told me about a previous experience where he noticed the server of his allergy and ordered a bloody mary type of cocktail from their house drink menu. Minutes after receiving the drink and starting to sip on it, he started feeling an allergic reaction to what he suspected may be shellfish in the drink. He alerted his server, who then had to ask the bartender if there was shellfish cross-contamination or something else that could have caused this. He then learned that one of the ingredients in the cocktail was a type of shrimp or oyster juice. By the time she reported back to him, his symptoms had elevated and they had to leave dinner and head to the hospital immediately. This example illustrates how important knowledge of the menu is when handling food and how poor knowledge or communication directly leads to food allergy related incidents in restaurants. It is easy to miss what’s not being looked for. This situation could have been easily avoided by marking the drink as a shellfish allergy (I don’t know if she did or didn’t) and alerting the bartender to double check ingredients, alter the drink slightly, or ask the server to double check ingredients with the table. Additionally, if staff were well-informed on ingredients in menu items in the rst place, they could have suggested something different that carried no risk emphasizing the importance of knowing and being able to communicate about food allergies in a restaurant. 

Many people, especially in the more conservative midwest, view dietary restrictions as fad diets instead of a serious health condition, or view allergies as either lactose intolerance or anaphylaxis with no inbetween. This leads to alternative items in restaurants being outrageously expensive. Typically, a package of gluten free, vegan buns costs about $6 for a 4-pack, a little less in bulk, yet many restaurants who do offer gluten free buns upcharge $4 for the swap. The mentality surrounding who is ordering allergen friendly items matters because people often don’t take things as seriously when they believe it is not a medical risk. Not having proper training and understanding of food allergies contributes to the idea that food allergies ‘aren’t THAT serious’, and leads to food handlers not taking proper precautions when preparing food for individuals with allergies. It also impacts businesses who are trying to cater to certain demographics through food. Stacie Van Cleave also spoke about her immense challenges while trying to start up an allergen-friendly business simply because she was using the word ‘vegan’ to market it. Only after changing her business verbiage from ‘vegan’, which it technically still is, to ‘allergen-friendly’ was she permissed access to the resources she needed in order to get her restaurant started. It is disheartening to see how the negative connotations to certain food-related words have directly and negatively impacted the community with medically-necessary restrictive diets. 

The lack of mandatory training in restaurants leads to uninformed food handlers. When it comes to cross-contamination and properly communicating ingredients and preparation procedures, there is much room for error. When people handling and preparing food don’t understand the importance of certain procedures, like switching gloves or using a different pan, and how negatively impactful they can be to those on the receiving end, they may not take those procedures as seriously, if they are even aware of them to begin with. Currently, allergy training is not required in Nebraska. Only 2 states, Massachusetts and Rhode Island, require food operators to provide food allergen training for their employees at all (ServSafe). The states, as a whole, have a long way to go in accommodating everyone, but Nebraska taking action and putting guidelines into place would help many businesses flourish while giving individuals in the food industry an opportunity to learn practical knowledge and skills they can use in many aspects of their life. 

There should be mandatory food allergy training and protocols for ALL Nebraska restaurants. This type of training should be mandated equally to other regular procedures, like sanitation. This could look like having new server trainees do mock serving interactions with a ‘guest’ who has allergies, where the trainee may need to clarify, inform, or suggest alternatives and procedures that the ‘guest’ should be made aware of when ordering certain menu items. In order to be allowed to serve actual customers, trainees must accurately relay information to the mock ‘guest’ and follow proper procedures for notifying kitchen and managerial staff of the allergy. In the kitchen, there would be dedicated equipment for allergy-friendly meals that all kitchen staff must be able to identify. This is the easiest way to help reduce cross-contamination (Radke, 2020). In addition to separate cookware and surfaces, staff must be trained on cross-contamination and tested on their understanding and practice of it when preparing allergen-friendly meals (with supervision) before being cleared to join the line on a regular shift. Beyond basic training, every restaurant should, at the very least, require a physical, updated ingredient list that all staff can easily access at any time during a shift. This list should be legible and able to be brought to a customer if needed! These are all key ways restaurants can implement allergy safety through simple training procedures. 

All restaurants should have an allergen friendly menu option that doesn’t need significant alterations to be enjoyed by people with the top 9 food allergies. While many restaurants offer modifications on their menus, those modifications usually remove main parts of the meal, like a source of protein or the sauce that ‘makes the dish’. The fact of the matter is that everyone needs sustenance and working with a licensed dietician or allergy specialist is an incredible way to ensure that all potential consumer needs are met. People with allergies would usually rather have a simple, whole meal, like a rice bowl with some veggies and beans, and feel included than pay full price for a sauceless, meatless, crouton-less ‘salad’, while feeling like an inconvenience to the kitchen and wait sta. Nutritionists and dietitians exist for a reason , restaurants should utilize them! 

Having a clear menu prevents confusion, leading to less questions and less miscommunication. In addition to having more complete, inclusive options, menu items should be clearly marked as allergen friendly with notes like “DF” for dairy free or “GF” for gluten free with a guide somewhere on the menu that clearly presents what each marking signifies. Listing whether items can be modified, and what modifications are available, is another way to increase inclusivity and simplify communication between sta and guests. Stacie does a great job of this as evidenced by the VegEdible

Q&A section attached to the main menu (Fig. 1). Having a variety of simple grains and proteins on the menu is an easy way to accommodate more people as well, an example being how most Mexican restaurants offer both corn and our tortillas for most dishes because no flavor or fundamental component of the meal is sacrificed in the gluten-free option. Also, offering an alternative to popular sauces that aren’t naturally very allergen-friendly is an easy way to increase inclusivity. The perfect local example of this type of inclusion is at Blue Sushi & Sake Grill, which has developed an entire vegan menu and gluten free menu with multiple cross-over items that contain their alternative sauces and protein options to help achieve the same flavor profile with different ingredients. Because items like the regular spicy mayo contain gluten and egg, they created items like a vegan spicy mayo that doesn’t contain those allergens, but still has a very similar flavor. The combination of substantial menu options for allergic individuals in conjunction with legible menus, or dedicated sections of the menu, for allergy-accommodated options reduces the risk of misinformation and allows allergic individuals to have an enjoyable dining experience. 

Inclusivity means more business! Accommodating as many people as possible prevents restaurants from limiting their clientele. People are way more likely to go somewhere that staff seems informed and helpful and where everyone in their party will be able to equally enjoy themselves. Across countless ‘restaurant trends’ sites, it is said that restaurants could profit 24% or more by simply accommodating people with food allergies, as they make up a continually growing part of the population that is still not generally catered to. When speaking to the only allergen-friendly local restaurant owner in Omaha, it became very apparent how many people depend on one or two sources for all of their allergy-free food. Stacie, owner and founder of VegEdible in Benson, NE, explained that the regulars are who keep them in business, ordering their foundational meal of the day 4-5 of the 6 days they are open each week, something I can personally attest to as someone who has 5 of the 9 major allergens and looks to them for options that can be found nowhere else. Flagship Restaurant Group, which began in Omaha in the early 2000s and has now expanded to states across the nation, is a testament that inclusion brings business and keeps return customers coming back for more. Not only does FRG have informed staff and many options for those with dietary restrictions, but they also became “the largest sushi restaurant group partners of the prestigious Monterey Bay Aquarium Seafood Watch” through their ethical sourcing practices (About–FRG). FRG has shown that being inclusive pays o, literally, while being inclusive of more than just allergies. 

An obvious benefit of allergy understanding in restaurants is that the risk of incidents will decrease, causing fewer liabilities. It is illegal for restaurant staff to serve someone an allergen if they are made aware of the allergy, so not having well-informed staff is a lawsuit waiting to happen. There’s no doubt business runs smoother when preventable incidents aren’t in a restaurants’ history and reviews. In an ideal environment, questions can be answered because people know where to find the right answers and information can be effectively communicated , leading to less allergy mishaps. It is a given that having well-trained and informed staff reduces the risk of incident. If a restaurant is aware of an allergy and serves it to the individual claiming it to be allergen-free, they may be charged with negligence, assault, infliction of emotional distress, unfair/deceptive business practice, and more (Gess, 2017). These are damaging allegations for any business, and especially persuasive when incidents could have been prevented by taking just a few extra minutes or measures. 

Training and new materials can be expensive, but they soon return the investment. Stacie at VegEdible she made it clear that the investment is always worth it. She urges other businesses to join in on inclusion and reap the benefits that have blessed her business, stating how easy it is to have dedicated equipment from the very beginning if it’s never contaminated. If all restaurants kept one of their fryers gluten free, that’s a thousand dollar investment that accommodates 30% more people. Training program costs aren’t outrageously expensive but it’s understandable to still take every expense into account. Individual courses cost $25/each, a small price to pay when preventing incident claims and increasing clientele (Food Allergy Awareness Training Program, 2019). So although the training and equipment needed to safely operate an allergy-friendly restaurant environment is an investment, it costs no more than other standard training and equipment that the restaurant industry already views as necessary. 

In summary, it is feasible to incorporate more inclusion for individuals with food allergies within restaurants. As has been illustrated throughout this proposal, the need for allergen-friendly spaces in Nebraska will only continue to rise. Nearly a third of the population has money to spend in the spaces they are welcome, so welcome them with educated arms and loaded menus. In order to address the lack of general knowledge about food allergies in Nebraska restaurants, the Nebraska Hospitality Association, Nebraska Department of Education, and Nebraska Department of Agriculture should implement a state-wide, mandatory food allergy training program for all restaurant employees regarding the top 9 most common food allergens. Everyone deserves to eat out safely and comfortably. 

Works Cited 

“About.” Flagshiprestaurantgroup.com, 2023, www.flagshiprestaurantgroup.com/about. Accessed 19 Apr. 2025. 

ACAAI. “Food Allergy.” ACAAI Patient, 2022, 

acaai.org/allergies/allergic-conditions/food/. 

CDC. “More than a Quarter of U.S. Adults and Children Have at Least One Allergy.” Www.cdc.gov, 27 Jan. 2023, 

www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220126.htm. 

“Child with Peanut Allergies Builds Tolerance with Same Food.” Cleveland Clinic, 2025, my.clevelandclinic.org/patient-stories/370-child-with-peanut-allergies-turns-to-same-food -to-build-tolerance. Accessed 19 Apr. 2025.

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Clinic, Cleveland. “Oral Immunotherapy (OIT) Is a Treatment for Food Allergies. Under Your Healthcare Provider’s Supervision, You Eat Small Amounts of a Food Allergen Every Day.” Cleveland Clinic, 8 Apr. 2025, 

my.clevelandclinic.org/health/treatments/oral-immunotherapy. Accessed 12 May 2025. “Current States.” ServSafe, 2017, www.servsafe.com/Allergens-Microsite/Current-States. FDA. “Food Allergies: What You Need to Know.” FDA, 2 Apr. 2021, www.fda.gov/food/buy-store-serve-safe-food/food-allergies-what-you-need-know. “Food Allergy Awareness Training Program.” Kendall Reagan Nutrition Center, 3 July 2024, 

www.chhs.colostate.edu/krnc/programs-and-services/food-allergy-awareness-training-pro gram/. Accessed 19 Apr. 2025. 

Food Allergy Research & Education. “Facts and Statistics.” Food Allergy Research & Education, 2022, www.foodallergy.org/resources/facts-and-statistics. Gess, Taylor. “When Food Turns Deadly – Minnesota Law Review.” When Food Turns Deadly, 25 Jan. 2017, minnesotalawreview.org/2017/01/25/when-food-turns-deadly/. James, John. “Allergy Facts.” Asthma & Allergy Foundation of America, Apr. 2024, aafa.org/allergies/allergy-facts/. 

Jansson-Knodell, Claire L, et al. “High Prevalence of Food Intolerances among US Internet Users.” Public Health Nutrition, 14 Sept. 2020, pp. 1–5, 

https://doi.org/10.1017/s1368980020003298. 

Kamdar, Toral A., et al. “Prevalence and Characteristics of Adult-Onset Food Allergy.” The Journal of Allergy and Clinical Immunology: In Practice, vol. 3, no. 1, Jan. 2015, pp. 114-115.e1, https://doi.org/10.1016/j.jaip.2014.07.007.

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Li, James. “Food Allergy vs. Food Intolerance: What’s the Difference?” Mayo Clinic, 28 Feb. 2024, 

www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-2 0058538. 

“Menu.” Veg.edible , 2021, eatvegedible.com/pages/menu. Accessed 12 May 2025. National Restaurant Association Educational Foundation. “Current States.” ServSafe, 2017, www.servsafe.com/Allergens-Microsite/Current-States. 

Radke, Taylor J., et al. “Restaurant Food Allergy Practices — Six Selected Sites, United States, 2014.” MMWR. Morbidity and Mortality Weekly Report, vol. 66, no. 15, 21 Apr. 2017, pp. 404–407, www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6615a2.pdf, https://doi.org/10.15585/mmwr.mm6615a2. Accessed 17 May 2020. Van Cleave, Stacie. How to Be Allergen-Friendly, Creating VegEdible. 3 May 2025.