Traveling with food allergies and intolerances: a planning guide

Traveling with food allergies or intolerances goes best when you plan your food as carefully as your route: research where you can eat and shop, carry translated cards that explain your needs, keep medication and safe snacks in your carry-on, tell the airline and hotel early, and know where the nearest hospital is. FARE recommends a travel kit with all your medications and extra epinephrine, even for short trips, plus copies of your emergency care plan.

Needs differ. Someone with a peanut allergy is planning around the risk of a severe reaction. Someone with celiac disease, IBS or lactose intolerance is planning to avoid days of symptoms on a trip they have looked forward to. The steps below cover both, and the allergy-specific ones are marked clearly.

FARE’s advice for traveling abroad and the Celiac Disease Foundation overlap on most of the essentials:

1. Learn the local cuisine and which common dishes use your allergen or trigger foods.
2. Research restaurants that can cater to you. Local celiac or allergy associations and bloggers have often already found good options.
3. Find the nearest grocery stores, pharmacies and hospital to where you are staying.
4. Choose lodging with a kitchen, or ask the hotel whether the room has a refrigerator and microwave.
5. Contact your airline, cruise line or tour operator early about meals and your needs, then confirm again closer to the date.
6. A few weeks out, refill prescriptions and print translated cards.
7. A few days out, pack safe non-perishable snacks and backup meals.

On a group or school trip, FARE suggests asking the leader how they have handled allergies before, and sitting with the guide at meals so they can help explain your needs to staff.

A translated card lets you explain your needs clearly even when you do not share a language with the kitchen. FARE offers free chef card templates in 11 languages, including Spanish, French, Italian, German, Portuguese, Japanese and Chinese, and the Celiac Disease Foundation recommends celiac language cards for gluten-free travel.

• List your allergens or trigger foods and ask for your food to be prepared away from them.
• Learn how your allergens are written in the local language, so you can spot them on labels too.
• Bring several copies; restaurants sometimes keep the card in the kitchen.
• Treat the card as a conversation starter. FARE notes translations can differ slightly because of regional dialects.

Labeling rules are not the same everywhere. FARE advises researching the country’s labeling laws. In the UK and EU, for example, the 14 major allergens are emphasized inside the ingredient list, often in bold, rather than in a separate “Contains” line. Our guide to reading food labels for allergens explains the differences.

Airlines vary a lot, and FARE notes they cannot guarantee an allergen-free flight. Its travel guidance suggests:

• Read the airline’s allergy policy before booking, and tell the airline when you book, then follow up by phone.
• Consider an early-morning flight, since some airlines give planes a thorough going-over at the end of each day.
• Remind the ticket agent, gate agent and flight attendants about your allergy.
• Ask whether you can board early to wipe down your seat, tray table and armrests. Some airlines do not allow this.
• Do not eat airline or airport food unless you have checked the ingredients.
• Bring your own safe food, and check the airline’s rules on carrying it on board.

For intolerances and celiac disease, the Celiac Disease Foundation suggests requesting a gluten-free meal when you book and confirming it at check-in, while still packing backup food in case it does not arrive. It also notes a doctor’s note can help you take medically needed foods, such as yogurt or soups, through airport security.

The TSA allows EpiPens in both carry-on and checked bags, and allows larger amounts of medically necessary liquids, gels and aerosols if you declare them at the checkpoint. The final decision rests with the TSA officer. FARE’s guidance for people with food allergies:

• Keep epinephrine on your person, not in checked luggage or the overhead bin.
• Carry two doses if prescribed. FARE calls this critical, and ACAAI notes a second dose is needed in about 20% of anaphylaxis cases.
• Keep the printed pharmacy label on the device, and ideally a doctor’s note confirming your allergy and need to carry it.
• FARE’s medical advisers prefer X-ray screening to hand inspection, and say there is no scientific evidence that airport X-rays reduce epinephrine’s effectiveness.
• Make sure travel companions know where your medication is and how to use it.

For any medication, the CDC’s Traveling Abroad with Medicine advice is to:

1. Keep medicines in their original labeled containers, showing your name, your provider’s name, the generic and brand names, and the dose.
2. Check with the embassy of your destination, and any country you change planes in, that your medicines are allowed.
3. Ask your prescriber for a note if you carry injectables such as EpiPens.
4. Pack medicines in your carry-on in case checked bags are lost or delayed.
5. Bring enough for the whole trip plus extra for delays.

The Celiac Disease Foundation adds a useful point for intolerances: bring enough of your usual over-the-counter medications, vitamins and supplements, so you do not need to check unfamiliar brands for gluten or other triggers while away.

The Celiac Disease Foundation points out that finding something to eat in transit is usually harder than at your destination. FARE suggests packing non-perishable snacks and backup meals, keeping them easy to reach in your carry-on, and packing snacks even when you do not expect to need them.

• Packaged snacks you already know you tolerate, with their labels intact.
• Backup meals that need only hot water, such as soups or noodles that suit you, or microwavable options.
• Simple whole foods that are easy to find and check locally.
• Wipes for tables and trays. FARE notes soap and water or commercial wipes remove allergens from hands, while hand sanitizer gel does not.
• A small day bag with medication, snacks, a backup meal, money and wipes, as FARE suggests for days out.

If you follow a low-FODMAP approach, travel can be a good time to stick with foods you already know suit you rather than testing new ones. Keeping a quick food and symptom diary on the road can also help you notice what is and is not working.

Check your cover before you go. The CDC’s Yellow Book chapter for travelers with chronic illnesses notes that most domestic US medical policies do not cover illnesses or injuries that happen and are treated outside the United States. It suggests a travel health plan with a 24/7 assistance line and emergency medical evacuation coverage.

• Ask your current insurer what, if anything, is covered abroad.
• Read how a travel plan handles conditions you already have.
• Keep your policy number and assistance line with your emergency care plan.
• The CDC also notes some insurers only pay for 30 days of medication at a time, so plan refills for longer trips with your provider.

This is general information, not insurance advice. Policies differ, so read the terms and ask the insurer directly about your situation.

FARE’s first piece of advice for travel abroad is to enjoy the experience: safe eating does not have to mean missing out. A few habits help:

• Travel with a companion who knows your reaction symptoms and can help if needed.
• Use your translated card every time you order, even at places that served you well before.
• Have a backup plan for each meal in case a restaurant cannot help. Our guide on talking to restaurant staff about allergies covers what to ask and when to leave.
• If you have a severe allergic reaction, use your epinephrine as directed and call the local emergency number straight away.

It is normal to feel anxious about eating away from home. Planning ahead does a lot of the work, and our guide to food anxiety has gentle ideas for the moments it still feels hard.