Navigating Food Allergies as a Foreigner the SMART Way
I was born with numerous food allergies. Growing up in the ‘60s and ‘70s with life-threatening food allergies was incredibly rare, as were the means to managing them. On several occasions, I had to rely on self-induced vomiting for a remedy (epinephrine auto-injectors wouldn’t come onto the market until my early twenties). Thankfully, I grew out of most of my allergies by the time I was a teen, although I remain severely allergic to peanuts, pistachios, and other legumes to varying degrees. After a couple of decades managing my allergies, I’d grown pretty adept at navigating the food-allergic life. Then I moved to Southeast Asia.
I flew to Singapore in January 1985, armed with zero knowledge of Southeast Asia or its food (this was well before Google would have informed me that Southeast Asian food includes lots of nuts and legumes). By that time, thankfully, I carried an EpiPen with me, although I had never actually used one.
My first years in Asia were a learning experience in many ways; some of the most “memorable” lessons came from managing my food allergies. To paraphrase Kelly Clarkson: what didn’t kill me made me (slightly) smarter.
For those food-allergic travellers out there, below are five tips that I hope will help you on your journeys.
1. Study ahead of time
For my kick-off lunch in Asia, I went to a Chinese restaurant with the rest of my team and several clients. The first dish was a cold duck salad, which sounded safe enough. I confidently dug in my chopsticks and took a couple of bites. Big mistake. I would soon learn that one of the main ingredients in the dish was chopped peanuts. I stopped eating and found my way back to my hotel. Three days later, after an EpiPen and several bouts of vomiting, I was finally able to get off my hotel room floor. Not a great way to start my Asian adventures.
If I had bothered to do some basic research on the culture’s signature dishes and ingredients ahead of time (and maybe even studied the language), I could have saved myself a lot of trouble. With all the information available on the web nowadays, restaurant research is relatively easy. Find an item on a menu that seems safe and double-check with the waitstaff at the restaurant. A chef card translated into the country’s native language always comes in handy too!
2. Medications like epinephrine and antihistamines should always remain close at hand
I remember grabbing a drink one night at a hotel bar with a good friend. I finished my beer before he did (not an uncommon event!), and being the joker that I am, figured I would swap our beer glasses when he turned his head so I could get another swig of beer. Once my lips came into contact with the glass, I knew I was in trouble. He had been eating peanuts! I immediately ran upstairs to my hotel room. Thankfully, I had epinephrine on hand and was able to stave off a more severe reaction.
I now carry medicine with me at all times, in my briefcase, my other briefcase, and my carry-on. I cannot stress how important it is to keep emergency medications on your person. It has saved me on numerous occasions. Traffic can be horrendous in many Asian cities, and I have yet to find any pharmacy in the region that sells antihistamines, let alone an epinephrine auto-injector!
3. Ask questions
When I came to Asia, I was often afraid to ask about ingredients or request that a dish be prepared without certain ingredients. This led to several instances of unnecessary allergic reactions. In hindsight, I should have worried more about my throat (which closes when I eat peanuts) than saving face, which is a big concern in Asia. At times, of course, waiters or friends may not know what goes into specific dishes. In such cases, or anytime you are in doubt, don’t eat it!
There can also be language barriers to overcome. For many servers, English is not their first language. As such, I have found that I need to be very specific with my questions—instead of asking about legumes, I ask about peas, beans, bean sprouts, bean curd, and bean paste—use local terms as much as possible!
4. Remember the hidden ingredients
Over the years I’ve had several food experiences that resulted in urgent visits to the doctor and/or hospital due to anaphylactic reactions. Often, these visits were because I ate a seemingly safe dish that had a sauce or spread containing nuts or legumes.
Once at a hawker centre, I ordered a seemingly safe plate of satay. Being much wiser after having spent a few years in the region, I avoided the peanut dipping sauce. Unfortunately, despite only eating skewered meat, I experienced an allergic reaction. I later learned that the satay chef had used peanut oil to baste the meat, and while peanut oil is nowhere near as deadly for me as peanuts, I still had a reaction.
In another instance, I ordered a basic chicken sandwich only to discover after taking a bite that it contained a pesto sauce made with pistachios. I also remember eating Indian food and wondering why I kept getting sick afterward. Eventually, I found out that papadum (which is served with many meals) is often made with ground lentil or chickpea flour. Thai green curry can include green beans, and some chili crab is made with peanuts.
In sum, there’s more than meets the eye for many food items in Southeast Asia. Those “hidden” ingredients? They are often the most dangerous ones.
5. Tell others
When travelling, especially with a group, I often kept quiet about my allergies as I did not want to inconvenience others. This occasionally backfired when I ended up having a reaction. I soon realized that telling the people you know is essential when living with a food allergy—in the case of a severe reaction, they may need to assist in administering your medications.
Often, I’ve found that friends and family are more than willing to omit certain ingredients or make special arrangements to accommodate allergies. I have also found that many restaurants—and even some hawkers—are quite willing to accommodate my special requests such as noodles without bean sprouts or fried rice without peas.
In summary, when travelling abroad, remember that food is a major part of every culture and that you can enjoy it as long as you are SMART about it: Study ahead of time, keep Medication close at hand, Ask questions, Remember the hidden ingredients, and Tell others.
— Nels Friets
Nels is the Co-Founder & Vice Chairman of tryb Capital, a Singapore-based financial investment group that invests in emerging financial technology solutions. Nels is also an investor in Allergy Amulet with the Bulldog Innovation Group, a network of Yale alumni investors.