A growing awareness about allergy risks

Lee Graham, who has celiac disease, making gluten-free croutons at home in Dedham. Lee Graham, who has celiac disease, making gluten-free croutons at home in Dedham. (Wiqan Ang for The Boston Globe)
By Lisa Zwirn
Globe Correspondent / May 6, 2009

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Anna King of Newton tells about the time she made the dish of chicken with 40 cloves of garlic for a dinner party. One of her guests turned out to be a vegetarian, which she didn't know beforehand. "He ended up skipping the chicken and eating all the garlic," says King.

Bridie Hilperts had no clue that her mother and brother couldn't eat shrimp. "We didn't have shrimp when I was growing up," says the Sudbury resident. It wasn't until Hilperts was in the middle of preparing a seafood and pasta dish that her mother mentioned that they'd both recently been diagnosed with a shellfish allergy.

Now, more than ever, hosts must choose menus carefully. No one is shy about food preferences, and many people have food allergies. Restaurants, too, must take extra precaution as a result of the recent Massachusetts law on food allergy awareness and safety. The bill, which Ming Tsai of Blue Ginger actively lobbied for, requires restaurants to educate employees about the risk of allergic reactions and to state on menus that customers should inform servers of any food allergies. If you consider those allergies, other sensitivities, the dietary requirements associated with diabetes, celiac disease, cholesterol, and certain religious prohibitions, cooking for others has become a minefield.

According to Dr. John Costa, medical director of the allergy practice of Brigham and Women's Hospital, the incidence of all forms of allergic disease has increased over the last two decades and peanut allergies have doubled over the last five years. In addition to peanuts, the other major food allergens are tree nuts, milk, eggs, fish with fins, shellfish, wheat, and soy. "Approximately 4 percent of the pediatric population and 2 percent of adults have true food allergies," says Dr. Costa. If you add those with celiac disease as well as people with intolerances to MSG, lactose, and sulfites, closer to 30 percent of the total population has adverse food reactions of some kind, he adds.

Anyone who cooks for others, he says, "needs to be aware that there are people who don't have the luxury to eat an unrestricted diet." The doctor speaks as both a specialist and the parent of a child allergic to peanuts and tree nuts. His advice, simply, is "know your guests."

No one knows this better than Lee Graham of Dedham. The president of the Greater Boston Celiac/DH Support Group (also known as the Healthy Villi) has celiac disease, her son is diabetic, her son's wife can't eat eggs and one of their children has a nut allergy, and one of Graham's daughters is allergic to shellfish. Still, when cooking for her family, Graham puts together a menu they can all eat. For example, the Thanksgiving feast last year included roast turkey, gluten-free gravy, stuffing (without eggs), butternut squash soup, a big salad, and gluten-free apple pie. "Whatever is served must be safe for those around the table to eat," she says.

For all hosts, this means rethinking the dinner plate. Old-fashioned, meat-centric crowd-pleasers, such as beef tenderloin, prime rib, crown roast of pork, and even one-pan entrees like lasagna and paella, might not be a good idea.

Start by asking your guests if there's anything you should know about their food preferences, then plan your menu. Not every dish has to please everyone, but serving an extra vegetable and/or salad for non-meat or gluten-sensitive eaters is a thoughtful gesture. Another option for the cook is to construct a few or all of the recipes so the "base" - a salad, soup, vegetable, meat, or grain - is allergen-free, and offer additions on the side. Nuts or crumbled cheese for the salad, an Asian-style sauce for the vegetables, and gravy for the meat are best served separately. That way, guests won't have to pluck out or scrape off an offending ingredient or not be able to eat the dish at all.

Cooks like Graham have a few go-to dishes that they know their friends and family enjoy. Hers include fish en papillote (baked in parchment), which, she says, "looks dramatic," and flourless chocolate cake. Beef Bourguignon on a chilly night works for many people as does pork tenderloin with ginger and saffron rice, she says. Graham always serves a vegetable dish and a salad. These lighter foods appeal to her more health-conscious friends.

Food restrictions can crop up unexpectedly - just as Anna King and Bridie Hilperts found out. Caterers deal with last-minute requests all the time. Kevin Carter, chef and partner of La Fete Catering in Natick, makes extra portions of vegetable dishes "because there are always vegetarians on the guest list," he says. "But when we know about allergies in advance, we can prepare for it."

Some guests will phone ahead of the event; others just pop into the kitchen and explain what they can't eat. Carter says he can usually create a plate safe for that person to enjoy, but because some allergens are hidden - wheat in soy sauce, nuts in some pastry crusts - it's not always easy to accommodate special needs on the spot.

Thinking like a caterer is now every host's job.

For more information on food allergies, go to