Vegetarians avoid the local beef house and gravitate toward vegetarian restaurants to take advantage of the expanded selection of vegetarian dishes. Likewise, if you have peanut allergy, you can expand your menu selections by dining at restaurants that offer a wider variety of peanut-free dishes. Focus on the following types of restaurants:

Fast food chains: A doctor’s telling you to eat fast food? Well, not exactly, but most large fast-food chains are relatively safe places to eat for people with peanut allergy. The most common risk with fast foods involves the use of peanut oil, especially in the deep fryer. A number of French fry chains, as well as one national fried chicken chain I can think of, uses peanut oil. Even if you’re eating at a relatively safe fast-food joint, don’t get lulled into a false sense of security. For example, one of the major chains serves a milkshake made with peanut butter candies.

Steak houses: Your local steak or beef house may be one of the best places to avoid peanuts altogether. These meat-and-potato restaurants commonly serve up pure beef along with potatoes and salads. You still need to be careful about the chef’s secret sauce or barbecue rub and the salad dressings and other items, but a brief conversation with the cook can help you work around these minor complications.

American cuisine: In the United States, we prefer our peanuts in baked goods and desserts, not in the main course, so restaurants that serve the standard American fare are pretty safe.

Italian (et tu Pizza): While Italian cuisine may pose an issue for people with tree nut allergy, Italian dishes and pizza are usually safe for those with peanut allergy, although my co-author informs me that he knows of a gourmet pizza joint that serves peanut-butter pizza. As mentioned earlier, make sure the spaghetti sauce is peanut free.

Seafood restaurants: As long as you don’t have a seafood allergy in addition to your peanut allergy, seafood restaurants are about as safe as steak houses.

Just because I list a type of restaurant as a safer choice doesn’t mean that it’s 100 percent safe. You still have to perform your due diligence and talk with the server, cook, or restaurant manager each and every time you dine out.

Some types of restaurants, particularly those that serve up more exotic cuisine, may be places to avoid:

Thai: Thai foods probably pose the greatest risk, because so many of the main courses contain peanut.

Chinese: Chinese foods almost always have at least a few dishes with peanut. Although they’re generally safer than Thai restaurants, Chinese
restaurants fall into the same high-risk category.

Japanese and Korean: Japanese and Korean dishes typically do not call for peanuts, but the cooks often use imported sauces that may contain peanuts or be contaminated with peanuts. Imported products are not held to the same manufacturing and labeling standards as those produced in the United States. I have some patients who have found Japanese or Korean restaurants where they are completely comfortable eating. However, I personally feel that avoiding these restaurants is the safest option.

Indian, Pakistani, Afghani, and Napalese: Indian foods often contain peanut and pose a huge risk, although some dishes do not commonly use peanuts and therefore may be safe (except for the possibility of cross contamination). Again, I would avoid all Asian restaurants.

African, especially Sub-Saharan: African restaurants often serve up peanut soups and a variety of peanut sauces.

Mexican: While Americanized Mexican food rarely contains peanuts, the same cannot be said for authentic Mexican dishes. Beware of mole sauces, some of which may contain peanut or tree nuts. I do not recommend that you absolutely refrain from Mexican cuisine, but you must certainly approach it with caution.

Mediterranean and Middle Eastern countries: If you’re doing the Mediterranean Diet or eating out at a Middle Eastern restaurant, you’re generally safe concerning peanuts, but if you’re allergic to tree nuts, too, tread carefully in these foreign eateries. Pine nuts are a common ingredient, and these cultures have found a million and one ways to use pistachios and other tree nuts.

Health food restaurants: Health food restaurants may serve up cuisine that’s healthier for the general populace, but for those with peanut allergies, these restaurants can pose some hidden risks, especially in vegetarian restaurants, where peanuts are sometimes used to replace meat proteins.

Asian foods are a common source of accidental peanut exposures both because peanut is easily disguised in these dishes and because peanut is used in enough other foods to lead to cross contamination. If the customer before you ordered the Kung Pao chicken, all sorts of peanut remnants can show up in your supposedly peanut-free dish. This is not just a theoretical concern but rather a very common cause of reactions.

I used to eat Asian foods and thought that if I spoke to the chef and ordered carefully I was safe. Luckily, I never had a reaction related to these Asian foods, but the more I get into this field, the more I realize that I was playing a game of Asian roulette.

Related posts:

1. Peanut Allergy : Steering Clear of the Other Nuts
2. Peanut Allergy : Discovering peanuts in your chili bowl and other unsuspecting places
3. Peanut Allergy : Other baked goods
4. Peanut Allergy : Finding peanuts in ice creams and tasty toppings
5. Peanut Allergy : Deconstructing cookies