Hosting Holiday Guests with Food Allergies

| Posted On Nov 21, 2011 | By:

At this time of year, millions of Americans leave their homes to get together with loved ones for the holidays.  It can be a wonderful time for families and friends, separated by distance and responsibilities, to come together to relax, reminisce and renew.  But it can also be a chaotic time:  extra folding tables and chairs create treacherous obstacle courses through homes already packed with more people than usual, children hopped up on sugar and excitement run around “just being kids,” and hosts cringe as fragile trinkets (and pets) are threatened by the onslaught.

As we know, food is central at these gatherings.  Hosts put extraordinary efforts into preparing wonderful and oftentimes lavish meals for their guests. The ingredient lists can be long, grocery store lines can be longer, and patience can be exceptionally short.

Food allergies can certainly complicate these already complicated matters,  but it is necessary to plan well in order to prevent allergic reactions or to be prepared to manage an allergic reaction should one occur. With 8% of US kids having a food allergy and about 3 % of US adults, it is quite likely that you may  host a person with food allergies this holiday season for whom exceptions cannot be made.

Preventing an allergic reaction allows no room for compromise, for social reasons or any other circumstance.  It makes no difference if Grandma spent 45 minutes putting the frosting on the cupcakes, or if Cousin Ann thinks that the chicken is probably safe.  At first, it may seem extreme to those who are not aware (“It couldn’t be more than a tiny amount of the walnut, after all!”)  However, some people can experience severe allergic reactions with even microscopic amounts of allergen.  Once friends and family know what it takes to manage food allergies, most would work to ensure their loved one is safe, healthy, and comfortable for the holidays.


 Two Basic Tips to Avoid Allergic Reactions

Label Reading: In most cases, strictly avoiding the allergen is necessary.  Learn the current labeling laws and get comfortable with reading labels.  Because manufacturers can change the contents of products at any time, it is important to read the ingredients before the product is served. Some manufacturers include advisory statements like “may contain traces of …..” It is safest to avoid food items that have these statements on the label.  To learn more, please visit

Avoiding Cross-contact: Cross-contact, the presence of an unintended allergen, is a common cause of allergic reactions. Allergens are not neutralized by heating or drying. Contact with even small amounts of allergen can cause serious allergic reactions.  Common sources are serving utensils, eating utensils, cups, dishware, hands, aprons, sponges, dishrags, and any objects that have contact with food or saliva.  Special attention should be given to young children who frequently explore their environments with their hands and mouths.  Clean hands with soap and water or hand wipes. Clean eating surfaces with soap and water or commercial cleaners.


Having a conversation about the specific food allergy with plenty of time in advance is a wise and respectful approach.  Maybe a host is not comfortable with safely preparing the planned meal or an alternative for the guest with a food allergy. Meals can then be brought in by the family or guest, and hopefully, this conversation can be open and understanding.

Many hosts also wouldn’t want their guests to be uncomfortable.  With a bit of education, they can rethink some standard practices, like putting out certain candies or snacks (e.g. mixed nuts).  Or, with some heightened awareness among everyone present, parents of a child with a food allergy will not need to watch Cousin Seth like a hawk after he ate a handful of peanuts without washing his hands and then started playing cars with their kid with the peanut allergy.

Hosting a holiday get-together and being off your own turf is stressful enough for the host and the visitors, respectively.  But people with food allergies have them wherever they are and with whomever they are around.  Having a solid understanding of what is necessary to manage a food allergy will help ease the potential for stress around food allergies and the holidays.

Additional information can be found at, Allergic Living, American Academy of Allergy Asthma & Immunology (, Asthma and Allergy Foundation of America (, FAANFood Allergy Initiative,  and the Kids with Food Allergies Foundation.

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About Dr. Michael Pistiner

Michael Pistiner, MD, MMSc joined Harvard Vanguard Medical Associates in 2011 as a pediatric allergist and is an instructor in pediatrics at Children’s Hospital Boston, Harvard Medical School. He is a fellow in the American Academy of Pediatrics where he is a member of the Council of School Health, Section of Allergy & Immunology, and a member of the American Academy of Allergy Asthma & Immunology where he is a member of the Adverse Reaction to Food Committee. He is a food allergy educator and advocate and serves as a voluntary consultant for the Massachusetts Department of Public Health, School Health Services. He also serves on a team assembled to implement a law designed to increase food allergy awareness in Massachusetts eating establishments and is a medical advisor for Kids with Food Allergies Foundation. Dr. Pistiner has received awards from the Food Allergy & Anaphylaxis Network in 2009 and 2010, as well as the American Medical Association Young Physician Section Community Service Award (2010) for his work on the Food Allergy Awareness in Restaurants Act. He is co-creator of, an allergy education website, and has recently authored "Everyday Cool With Food Allergies," a children’s book designed to teach basic food allergy management skills to preschool and early school age children.


  1. This is excellent. Thank you for writing this.
    Lisa Giuriceo- Support Group Leader- The Food Allergy and Asthma Support Group of North Jersey

    Comment by lisa Giuriceo on November 15, 2012 at 1:23 pm


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