Abstract
BackgroundThere is wide international variation regarding food allergy knowledge among restaurant staff. Further, attitudes towards food allergy remain under-researched. Insights into the independent determinants of knowledge and attitudes are limited due to lacking mutual statistical adjustment for determinants/confounders in the vast majority of prior studies. In this study we aimed to contribute novel data on the food allergy knowledge and attitudes among restaurant staff in Germany whilst also examining potential determinants of both outcomes using multivariable approaches.MethodsWe collected data face-to-face from 295 staff members in restaurants in Düsseldorf, Germany. Knowledge was assessed by asking participants to name three common food allergens and to answer five true/false-statements. Seven items assessed attitudes. A total of 16 potential determinants were examined using logistic regression models with backward selection.ResultsOnly 30% (n = 89) of the respondents correctly named three food allergens and 41% (n = 120) attained a perfect score on the true/false statements. The vast majority expressed positive attitudes toward the need for cooperation and shared responsibilities for food-allergic customers. However, the expressed attitudes towards serving customers with food allergies and validity of customer-reported food allergies were unfavorable. Determinants of food allergy knowledge (e.g. the type of restaurant, professional roles, or levels of school education) and of unfavorable attitudes (e.g. gender) were identified.ConclusionsFood allergy knowledge was suboptimal among restaurant staff and attitudes towards customers were rather poor. While we identified some determinants, additional studies are needed to systematically examine potential determinants for targetting educational interventions in the future.
Highlights
The prevalence of food allergy is substantial [1], affecting > 10% in Europe [2]
Food allergy knowledge was suboptimal among restaurant staff and attitudes towards customers were rather poor
While we identified some determinants, additional studies are needed to systematically examine potential determinants for targetting educational interventions in the future
Summary
The prevalence of food allergy is substantial [1], affecting > 10% in Europe [2]. Often symptoms (e.g. urticaria, nausea, dyspnea) may be mild, but in a few instances symptoms are severe, with rapid onset, and may result in life-threatening anaphylaxis. Avoidance of allergens is highly challenging in real-life, when patients’ opportunities to exert dietary control are limited, for example when eating outside one’s own home [4] or in a restaurant In such circumstances allergen exposure is often caused by cross-contact during food preparation or the inclusion of ingredients that cannot be reasonably expected by consumers [4]. An US study found that at least one quarter of staff hold important misconceptions, for instance, that it is safe for affected customers to consume small amounts of the allergen or that heating of foods destroys allergens [5]. In this study we aimed to contribute novel data on the food allergy knowledge and attitudes among restaurant staff in Germany whilst examining potential determinants of both outcomes using multivariable approaches
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