Food Allergy and Foodservice: A Comparative Study of Allergic and Non-Allergic Consumers' Behaviors, Attitudes, and...

Background: Food-allergic reactions in restaurants often result from miscommunication between customers with allergies and staff, or from staff members' insufficient knowledge of food allergies. This study examined the behaviors, attitudes, and risk perceptions of food-allergic consumers when dining out or ordering from foodservice establishments (FSEs) compared to consumers without food allergies. Methods: A representative pan-Canadian survey was conducted amongst three groups: one of individuals without food allergies (n = 500) and two of food-allergic individuals (allergic-convenience sample [n = 500] and allergic-general population [n = 500]). The convenience sample comprised members of Food Allergy Canada, a national patient advocacy organization. Some participants with food allergies had experienced reactions linked to an FSE (43% convenience, 27% general). Weighted responses from food-allergic groups were compared to those of non-allergic ones using chi-square (p < 0.05). Statistical comparison between allergic groups was not attempted due to inherent differences in their allergic condition. Results: In several questions, responses from the non-allergic group differed significantly from those of the allergic-convenience sample, but not from those of the allergic-general population. Food-allergic-convenience respondents were more likely to avoid ordering food or dining out than non-allergic ones, with the highest avoidance (66%) noted for third-party platforms. Cost was the main barrier for non-allergic and allergic-general populations, whereas the allergic-convenience sample prioritized allergy-related concerns. Although at a lower rate than for participants with food allergies, food allergies influenced restaurant selection for 44% of participants without food allergies when dining with individuals outside their household. Most allergic respondents perceived that FSEs underestimate the seriousness of food allergies (82% convenience, 71% general), yet they felt safe while dining out (60% convenience, 85% general), pointing at loyalty to specific FSEs as a risk mitigation strategy. Conclusions: This study highlights a potentially higher burden of disease (psychological and social strain, reduced quality of life) among a subgroup of the food-allergic population (convenience sample), as reflected in their behaviors, attitudes, and risk perceptions towards meals prepared in FSEs. Nevertheless, both allergic groups expressed shared concerns and needs related to safety (e.g., ingredient disclosure for all menu items, prevention of allergen cross-contact, ability of an FSE to offer a safe meal, establishing clear communication processes for allergy-related information), which FSEs and regulators should consider when designing risk management strategies.