Today I am sharing part 1 of a 2-part blog series on living with dietary restrictions. These posts are co-written by nutrition student volunteers Nalani Balasupramaniam and Isabella Gregov. Please note that paragraph #2 is written by Isabella in first person about her personal experiences with eating out at restaurants. While this post focuses on restrictions due to gastrointestinal disorders, I acknowledge that there are many other health issues which can lead to dietary restrictions. I hope that anyone reading this who has struggled with dietary restrictions will feel comforted in the fact that they are not alone. If you have any family or friends who do not understand your difficulties with eating out, you could send them a link to this post to help them learn about your experience. Part 2 focuses on tips for having a safe and enjoyable meal out.
When you have dietary restrictions, eating out can be a challenge. They may impact how frequently you eat out, where you eat out, and how you prepare for such occasions. Even more than that, dietary restrictions can have social and emotional impacts. Negative encounters occur all too frequently and can leave you feeling alienated, embarrassed, discouraged and dissatisfied, regardless of how the meal actually tasted. This post will explore some of the psychosocial impacts of eating out – with real input from myself (Isabella) and from other individuals with dietary restrictions! Part 2 will give some tips and advice on accommodating dietary needs for both diners and staff.
To start off this post, I would like to describe a personal experience when eating out. My mom has Celiac disease and, quite often, staff either do not understand what this is or they do not take proper precautions. On one particular afternoon out, my family and I went to order a quick lunch at a popular food chain. My mother asked up-front if they would be able to accommodate a gluten-free order; she was assured that they were. However, the staff members did not wash the grill or wipe down the counter before preparing my mom’s order. When she pointed this out, she was met with eye rolls and hostility. She was told that she would have to stand back in line and wait for each new customer to order before they would re-do hers. While my mom stood her ground and had them re-do her order first, this is exactly the type of negative encounter I introduced earlier – one that creates alienation and discouragement and can certainly dampen someone’s day. Think back to a time when you had trouble ordering a restaurant. Maybe the staff didn’t understand what you were asking, and you had to send the order back. Or maybe, like my mom, you were met with frustration and carelessness from staff. Perhaps you even sensed embarrassment from the individuals you were eating with. You are not alone! Myself, my mother, and countless other individuals with food restrictions have also had trouble when eating out.
Dining out is supposed to be fun, but for many people with dietary restrictions, the experience ends up being stressful instead.
Fortunately, there are various forums for support for individuals with dietary limitations. Facebook groups like Low FODMAP Canadians, Low FODMAP Recipes & Support, and the Canadian Celiac Association are great places for people around the world to share their knowledge and experiences. We posed a question to several of these pages asking group members about their personal experiences while eating out with family and friends. One of the most common experiences mentioned in these comments was frustration and embarrassment when placing orders. “Even though my friends and family are very understanding, and often they help me figure out options, I feel embarrassed when ordering becomes a complicated issue…after the ordering hurdle is accomplished, I feel like I can relax again–sort of…”says Marti Beck, a member of the Low FODMAP Recipes & Support Facebook group. It can be especially disheartening when the restaurant’s allergy substitutions do not account for the low FODMAP diet. As pointed out by Danni-Louise Fender, another member of that group, “They bring out a book that has some of the main ones listed (gluten, celery, lactose etc.) but they didn’t have a list of ingredients anywhere. It meant I couldn’t choose anything on the list and ended up having a roasted chicken and mash. I could have made myself a nicer dinner at home.” These sorts of incidents can diminish the overall dining experience making it less likely for you to dine out in the future.
Scientific research also reflects and highlights many of the same emotional and social impacts of living with dietary constraints. One Canadian study involving those with Celiac Disease (CD) found that, while those diagnosed with CD experienced relief when first finding out that their symptoms could be managed by making dietary changes (i.e. without medical intervention), negative emotions tended to replace the positive when actually starting the gluten-free diet.1 The most common negative emotions highlighted by this study were frustration and isolation, emotions which were much more commonly experienced by women than men.1 Other struggles included limited food choices when eating out, lack of accurate ingredient lists, not wanting others to feel sorry, and anxiety surrounding improperly trained kitchen staff.1
(Rose & Howard, 2014)
In another study conducted in the UK, researchers asked various questions of those with CD, and directly quoted the responses of the participants. 2 The words of the participants reflect related research but also offer some unique and very relatable perspectives. For example, when asked about social isolation, one individual said, “‘I have found that times we get invited out to a meal with friends has become less and less. Who wants to feed a fussy eater?”2 Indeed, many individuals with food restrictions may receive fewer invitations to eat out with friends. Others may choose to decline the invitations they receive and avoid the situation altogether. This is related to factors such as a lack of enjoyment from food and feeling stigmatized.2 Social stigmatization surrounding CD may be partly due to the belief that avoiding gluten is a personal choice, and so staff and establishments in general are more lax surrounding cross-contamination. This is especially noticeable in the wake of the gluten-free diet fad, as more and more food chains and restaurants are offering “wheat-free” and “gluten friendly” options (terms that do not equal “gluten-free”). One individual in the UK study adeptly pointed this out, saying that they have felt “stigmatised with the public perception of people who ‘don’t do wheat’, it’s a ‘faddy diet’ and ‘what does a little matter’”.2
(Rose & Howard, 2014)
All of the factors highlighted above, from social stigmatization to social isolation to negative emotions, are commonly experienced by people with dietary restrictions. Fortunately, there are positives associated with following restrictive diets. After all, experiencing relief from gastrointestinal symptoms can feel incredibly invigorating, and can provide the motivation necessary to stick with a diet change. Some individuals even reported feeling more confident, as they were able to take control and manage their symptoms themselves.2 Gaining support from friends and family, as well as from communities of people who share the same dietary struggles, is also highly beneficial.
This wraps up part 1 on the social and emotional impacts of eating out with dietary restrictions. Part 2 shares tips on eating out for those with dietary restrictions, as well as tips for anyone who works in the foodservice industry.
Do you have a story about eating out with dietary restrictions (positive or negative)?? Write it in the comments below and let’s start a conversation!
References
1. Zarkadas, M., Dubois, S., MacIsaac, K., Cantin, I., Rashid, M., Roberts, K. C., … & Pulido, O. M. (2013). Living with coeliac disease and a gluten‐free diet: A Canadian perspective. Journal of Human Nutrition and Dietetics, 26(1), 10-23. Retrieved from https://www.researchgate.net/profile/Olga_Pulido/publication/246753031_S2026_Clinical_Features_and_Symptom_Recovery_on_a_Gluten-Free_Diet_in_a_Canadian_Celiac_Population/links/54a6d2bf0cf257a6360a9fcd.pdf
2. Rose, C., & Howard, R. (2014). Living with coeliac disease: a grounded theory study. Journal of human nutrition and dietetics, 27(1), 30-40. Retrieved from https://www.researchgate.net/profile/Ruth_Howard2/publication/236069039_Living_with_coeliac_disease_A_grounded_theory_study/links/552cd1d70cf21acb0920f188.pdf
You lump FODMAPS dieters in with celiacs. This is not correct. FODMAPS is low FODMAPS, not NO FODMAPS. That means FODMAPS dieters have wiggle room. Celiacs must be very strict, with no wiggle room. That slight difference frustrates restaurants and others serving celiacs to no end. Many do not understand why gluten free to one group means they don’t have to wipe down counters, and shared frying oil is ok for that group, but celiacs make a fuss. It makes celiacs appear as if they are just stubborn and hard to get along with, when the truth is that the smallest amount of gluten can make us very sick. It isn’t just a little tummy ache. It can be pain all over our bodies, in addition to flu like symptoms and even seizures.
Thank you for commenting Joan. Yes, this blog post is targeted towards anyone with gastrointestinal dietary restrictions. There are different challenges with different conditions, but we all experience difficulties. Cross contamination for those with celiac disease is of course a very serious health concern and can have significant health impacts. Someone with IBS who accidentally consumes a high FODMAP food is not damaging their digestive system, but still might feel so unwell for a few days they might have to miss work, etc. This post is not about comparing digestive disorders and the physical symptoms, but instead about acknowledging the real emotional and social impacts they can have on an individual.