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Vegan, Paleo, Allergies, GERD… Oh My: Navigating Food Challenges When Dining Out

Feb 2014By Emma Young, Contributing Writer 

When I first became vegetarian in the early 1980s, few restaurants catered to the diet. Eating out was a challenge undertaken more for social reasons than any culinary delight. Standard fare was a small side salad and a baked potato.

Thankfully, as the ranks (and buying power) of vegetarians grew, so did my dining options. Now nearly 23 million Americans eat a “vegetarian-inclined diet,” not counting the 7.3 million who are strictly vegetarians, according to a study by Vegetarian Times, which also lists nearby Washington, D.C., as among the top 10 cities in the U.S. for vegetarian dining.

However, my world of delicious choices suddenly imploded in January 2013, with the birth of my daughter, who had severe GERD (gastroesophageal reflux disease) and still has multiple food intolerances. As a nursing mother, I was forced to limit my food choices since they directly impact my baby’s health. When eating a piece of cheese causes your newborn to writhe in screaming agony, you give up cheese. For the near future, I’ve gone dairy-free, soy-free, gluten-free, nut-free and egg-free, in addition to my pre-existing meat-free.

This meant renavigating the restaurant world. After a period of trial-and-heart-breaking-error, I’ve discovered a number of establishments in Prince William that can accommodate my dining limitations and palate. I’ve also discovered that I’m not the only one who has had to learn how to dine out on a specialized diet.

When Food Hurts

For tens of millions of Americans, eating the wrong food can cause serious harm, ranging from gum disease to death. The U.S. Department of Health and Human Services’ 2009 report, “Community Health Status Indicators for Metropolitan Washington,” stated that more than seven percent of residents in Prince William County and more than 10 percent in the City of Manassas have been diagnosed with diabetes. This metabolic disease causes blood glucose levels to rise and can lead to a variety of complications, from nerve damage to hearing loss and even stroke or other acute life-threatening events.

Jenny Hatch, who recently moved to Belgium from Quantico, has diabetes. She said the key to dining out safely is to be aware. “I know pizza is full of fat, which will delay digestion, so my blood sugars will go higher later,” said Hatch. “Most restaurants, even fast-food, have a list of … calories, sodium, carbohydrates, protein, etc. Request it.”

Food allergy sufferers may need to go a step further, ensuring that their food has not come into contact with allergens. Woodbridge resident Hope Hichak is also a nursing mother whose infant son has food allergies. As a result, she avoids eggs, dairy, soy, wheat, peanuts, tree nuts and fish. When dining out, she is wary of cross-contamination. Hichak explained that if a food preparer touches her meal with the same gloves used to prepare a dish that contains problem ingredients, her son has severe gastrointestinal issues shortly after being breastfed.

Shannon Comstock, of Woodbridge, also worries about cross contamination. For her son, who is allergic to tree nuts and peanuts, each exposure to allergens is life-threatening. She said that after he ingests the nuts, his throat instantly begins closing, blocking off his airway. While she is cautious when dining out with him, Comstock also recommends keeping medical supplies on hand. “It’s a good thing to always have Benadryl®, allergy pills and an EpiPen® on you at all times,” she advised.

People with celiac disease or severe gluten intolerances can find restaurant fare to be a minefield of potential discomfort as well. When they ingest gluten, a protein found in certain grains, such as wheat, their body attacks the small intestine. Symptoms, which vary among sufferers, can include bloating, fatigue or brain fog, a feeling of mental confusion.

Linda Mosier, of Montclair, was dealing with a number of health issues before she decided to modify her diet to be gluten-free. “[I] found my migraines, IBS [irritable bowel syndrome] and stomach issues all cleared up. I also had more energy, required less sleep and I don’t have such dark circles around my eyes anymore,” said Mosier.

Trends,Traditions Guiding Choices

Allergies and illness are not the only reasons for removing certain foods from a diet. In many cases, such as my decision to become vegetarian, dietary choices reflect personal values or even fitness goals. Examples include following paleo or vegan diets or religious dietary guidelines, such as keeping kosher.

According to Vegetarian Times, about one million Americans are vegan, eating no animal products, such as meat, dairy and eggs. Katie St. Pierre of Dale City explained her decision to become vegan after viewing ‘Forks Over Knives.” The 2011 American documentary seeks to demonstrate that most degenerative diseases can be controlled by eliminating animal-based and processed foods.

“We went vegan and gluten-free for health reasons and ethical reasons as well. I felt better once I went vegan. I lost weight, and I’m maintaining the weight loss,” said St. Pierre.

The number of paleo eaters is also on the rise. Google Trends showed that Internet searches for “paleo diet” and related phrasing surged in 2013—making it the most searched diet last year, according to the site, which also predicts that gluten-free and paleo will be 2014’s most popular diet plans.

The paleo diet is based on the concept that human beings should eat as they did about 10,000 years ago, in the Paleolithic era, prior to modern agriculture. Adherents avoid processed food and seek to eat wild or grass-fed beef, or other meats that can be hunted or fished. Their diets also include foods that can be gathered, such as nuts, vegetables and eggs.

Woodbridge-based nutritionist Camille Freeman, who is also an associate professor at the Maryland University of Integrative Health, weighed in. “It’s fine to eat paleo if it feels right to you, but it’s not evolutionarily better than many other ways of eating, and it’s not automatically the most healthy way to eat either,” she said. “In general there’s nothing wrong with it as long as people are making sure to get plenty of greens and eating a wide variety of foods.”

Still others make food choices that reflect centuries of religious and cultural traditions. For instance, Jewish dietary laws (called “Kashrut”) include prohibitions on mixing milk and meat and eating shellfish, as well as commandments guiding the slaughter of animals. Food that adheres to these laws is considered kosher.

On keeping kosher while dining out, Rabbi Jennifer Weiner (pictured) of Congregation Ner Shalom said that "intention is a big part of it.”
On keeping kosher while dining out, Rabbi Jennifer Weiner (pictured) of Congregation Ner Shalom said that “intention is a big part of it.”

For Rabbi Jennifer Weiner of Congregation Ner Shalom in Woodbridge, the choice to keep kosher encompasses more than just what is eaten. She explained eco-Kashrut, a movement within the Jewish faith to, in part, eat foods produced and served ethically and sustainably. For her family, this also extends to choosing to dine at locally owned restaurants.

“We’ll go to the same restaurant because we know the owners, and so we feel comfortable with how they treat their wait staff. We go to local restaurants,” said Weiner.

Navigating Restaurant Menus

When it comes to deciding what to include or exclude from our diets, Freeman encouraged a balanced, individualized approach. “Although there is no single diet that’s right for everyone, most of the diets that are popular these days can be healthy for most people,” she said. “No matter what diet you’re choosing, the more fresh, whole foods you eat, the healthier you’ll be.”

After determining what diet is best for you, a challenge remains: Learning where and how to eat out according to your needs.

Area residents shared some of their strategies:

1. Research. Look up menus in advance. “The big chains tend to have an allergen-free menu. I first look it up online and if they don’t, I call ahead. They’re always very friendly about it,” Hichak said.

St. Pierre concurred. “I usually consult the online menu first to see if there’s anything I could possibly eat,” she said. “You have to think of substitutions. Can you substitute the chicken on a salad for artichoke? Can you get a bean burger? Don’t be afraid to try combinations you haven’t tried before. Be adventurous.”

On finding paleo-friendly locations, Dr. Scott Stachelek of Core Chiropractic in Dumfries said, “I’ll look at the chamber of commerce website. I’ll look for bistro-style cafés. Any place that serves a foodie [or] any place that says they use local produce or meats [is] going to be very accommodating.”

Hichak summed up, “Do your research. Be proactive. Make those phone calls. It’ll just make the eating-out experience that much better.”

2. Ask questions. For Comstock, ingredient listings are key to avoiding allergens. “Always ask and tell the server [about the allergy]. Ask someone from the kitchen to come out. Ask if they have ingredient listings,” she said. “If they don’t want to give away all their ingredients, ask a cook to come out and explain what you can have on the menu.”

Communication can also help to prevent cross- contamination of food. “[I’ll] talk to my server and ask them to make sure the cook knows I need it gluten-free and nothing with gluten can touch my plate or I’ll get sick,” stated Mosier.

The American Diabetes Association recommends working with your server and asking questions. Is the soup cream- or broth-based? Can the menu item be prepared without butter or with more vegetables? “Managers are very good about helping you figure out what’s safe to eat and making sure it’s cooked correctly,” said Mosier.

3. Don’t rule out mom-and-pops or chains. The verdict is split on which is better in handling specialized diets. Hichak gave up eating at mom-and-pop establishments. “The staff was not as knowledgeable [about food allergies],” she said. Hichak added that chains tend to have menus that cater to specialized diets.

However, Rabbi Weiner said she feels it’s important to dine at locally owned restaurants, and St. Pierre finds them to be accommodating. “Mom-and-pop places can be more helpful because you’re not just a check. They know you. You form relationships. If they have the ingredients, they’ll work with you,” St. Pierre explained.

Stachelek said becoming familiar with staff is the key regardless of restaurant type. “Get to know the chef or the owner. Tell them who you are and what you like,” he advised.

4. Improvise. “[A place] may not be 100 percent paleo, but you have to live your life,” said Stachelek. For food choices that are not based on ailments, he suggested determining your level of commitment to the diet, and then deciding what your “treats” will be and which exceptions (if any) you are willing to make.

For Rabbi Weiner, this means improvising, since Prince William has no kosher restaurants. She shared, “You don’t want to be socially isolated. You keep as close to vegetarian as possible. You keep as true to the letter of the law as possible and to the spirit of the law. … Intention is a big part of it.”

“The hardest thing is when all your family wants to go out to eat at one place and there’s nothing you can eat there. Don’t be afraid to bring your own food,” St. Pierre said. “I’m not going to not spend time with my family.”

Emma Young is a stay-at-home mother and freelance writer residing in Dumfries. She’s looking forward to eating a large cheese pizza again someday, and can be reached at [email protected] 

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