How to Eat Safely in Italy with Food Allergies

This article originally appeared in the October/November 2024 issue of Dream of Italy.  Become a member to access 1,000+ articles like this – designed to help you enjoy an authentic trip to Italy and live your best Italian life! 

“Let me call the baker,” the restaurant manager insists as he pulls out his phone at 9:30 p.m. on a Sunday evening in Trieste, I look up at him, wide-eyed and already feeling guilty for the extra effort he is putting into making sure my dinner is safe due to my severe food allergies.

My flat mate, Abby, and I are in the Borgo Teresiano neighborhood, sitting at a table just off the Canal Grande, where we can catch the reflections of light across the Adriatic Sea.

Minutes later, I have the reassurance needed to enjoy my meal. Since then, I’ve only had a handful of instances where dining out in Italy has been challenging for me. Italian cuisine tends to be straightforward, created with uncomplicated, fresh ingredients. For those of us with food allergies, this is ideal. Plus, Italians themselves, known the world over for the generous spirit, are often eager to help.

Italy’s Food Allergy Landscape

The recipes for Italian dishes usually only call fewer than five ingredients, most of which are fresh and locally produced, making any food allergy sufferer’s efforts to stay safe much easier. The fewer ingredients, the better! No wonder Italy is the most sought-after country amongst food allergy families in the Allergy Travels Facebook Group that I run.

As an American expat teaching fourth grade at the International School of Trieste, I quickly learn that Italy is the first country where I feel that dining out with food allergies can be done safely at nearly any restaurant and where I am not treated like a burden for asking questions.

I have lived with severe allergies my entire life, meticulously checking that my food is free of peanuts, tree nuts, fish, shellfish, potatoes and a few other allergens. Carrying epinephrine auto-injectors is critical for my safety in the event I ingest one of these foods accidentally.

Though these reactions have happened a handful of times since I was born, because of how severe they can be, I am reminded of the importance of checking every ingredient every time. Although I’ve been lucky to never need epinephrine in Italy, it’s good to know that a medical prescription is not needed to buy epinephrine here.

Growing up, it became routine for my family visit the same restaurants that were careful with my food allergies instead of trying new ones. We found some restaurants were unwilling to try to accommodate me safely, and it wasn’t worth the risk of a reaction. Discovering reliable restaurants is essential, but I never imagined I’d find Italians to be so helpful and willing to accommodate my food allergies at nearly every restaurant I visit.

I’ve since moved back to the U.S., but more than a decade after living in Italy, I still visit often and now consult with individuals and families who want to travel to Italy with food allergies. I also work with tourism boards, hotels and restaurants to be more allergy-aware for guests and visitors.

Dining Out

I vividly remember my first night in Trieste: 24 years old, exhausted from jet lag and struggling to settle into a new city with a language I barely understand. My roommate and I join our new teaching colleagues for dinner at Al Barattolo. That’s when I meet Sandro, the waiter I’d come to rely on during numerous future dinners. Nervously, I hand him my food allergy card in Italian. He eased my worries by carefully checking the ingredients for my ordering, ensuring it is prepared safely. I am then treated to the most flavorful buffalo mozzarella pizza I’d ever tasted. I know this is just the beginning of an incredible start to dining out in Italy.

In 2014, a law was enacted in all European Union countries, including Italy, requiring restaurants and other food businesses to share key allergen ingredients. In Italy, the ingredients can be provided to patrons verbally, but written documentaton must be provided upon request. This law was not in place when I lived in Italy, but since this law, it’s brought much more allergy awareness. It is still essential to always communicate your food allergies when dining out as not all restaurants update their menus.

To aid in the potential challenge of communicating my food allergies, I always carry a translated chef card (or allergy card). It includes my food allergies and an explanation of the severity and how to prepare my food safely. For Italy, I have a copy translated into Italian. I hand this card over to the manager when I arrive at a restaurant.

Clear communication plays a crucial role in food allergy safety. Although I have Italian friends who translate my card, there are companies online, such as Equal Eats, that can do this accurately for you. It’s also helpful to have a few typically safe meals translated in your phone Notes app in case you need them.

When food is unsafe for you, it can often be adapted. I was once in Rome at Ristorante Arlu outside Vatican City. They used peanut oil in most of the dishes, but they still insisted on making a safe pasta with Pomodoro sauce for me with olive oil.

My first realization that each region of Italy offers a distinct dining experience for someone with food allergies occurred during a visit to Sicily. On a long weekend from school during the spring of my first year in Italy with Abby and our friend Jess, we decided to visit Trapani.

All of a sudden, I notice pizza containing pistachio on the menu. I am not used to seeing this ingredient in mainland Italy, and I am surprised at the new level of vigilance needed in order to dine in Sicily. After that trip, I started researching regional cuisine before visiting new destinations.

I’ve found safe meals in every region, but some are easier to find than others. Friuli-Venezia Giulia, where I lived for years, has a cuisine that is a mix of more typical Italian dishes but includes hearty dishes from its time of Austro-Hungarian rule. This means dishes with more ingredients—and more room for error. In Tuscany, I found many safe options for me, including pasta and bistecca alla Fiorentina.

Informing the restaurant when making a reservation helps ensure the kitchen is prepared. One night in Florence, after a long day of conferences, I was invited to join my friend Lianne at Trattoria Garga for dinner. She let them know ahead with the reservation about my food allergies, and when we arrived, they were prepared. They cooked dishes off the menu safely for me, like the pappardelle with wild boar ragù. It was a night of exquisite food, company and artwork.

What I’ve always found to be the most challenging for dining out in Italy is quick-order restaurants and food stands. Due to the busy environment and higher risk of cross-contaminated surfaces, these are often better to consider with caution.

Desserts are also rarely safe for those of us with food allergies, whether in Italy or elsewhere. This means bakeries should be avoided. They are too risky with cross-contact, never mind the actual ingredients in many of the sweets containing top allergens like nuts, egg and milk.

Top Offenders: Gluten and Dairy

Out of the 14 top allergens recognized in the EU, there are a few that are pervasive in Italian cuisine and can present a greater challenge. Some of the Italian staples, like pizza and pasta, contain common food allergens like dairy and gluten. Italy is actually known to be exceptionally friendly to those who are gluten-free. About 1% of the Italian population avoids gluten due to celiac disease (compared to 0.75% of the U.S. population), but the prevalence of celiac in school-aged Italian children is one of the highest in the world according to a 2023 study.

There is now an organization, Associazione Italiana Celiachia, Italian Celiac Association (AIC), that helps people with celiac disease locate gluten-free products and safe places to eat, which is especially helpful since gluten is ubiquitous in Italian cooking. I first learned about this organization when I was out for dinner in Florence at a little hidden gem of a restaurant called Hostaria il Desco. On the menu, it proudly displayed a sticker of participation with AIC. Even if you don’t need to avoid gluten, keep in mind that restaurants willing to accommodate gluten-free needs are often more open to accommodating food allergies as well. This is how I ended up having the most delicious tagliatelle pasta with fresh truffle flakes on a solo dinner date. Those with gluten allergies can now find gluten-free pasta, risotto and pizza at many restaurants.

With the rise in vegan restaurants, there has also been an increase in options for those who are allergic to dairy. There are now more milk alternatives at cafes and in grocery stores. There are even dairy-free cheeses and yogurts. Although typical gelato made of dairy is not a safe option, sorbetto could be safe, along with some vegan gelaterias that have popped up in recent years in some of the major Italian cities. There are also kosher restaurants like Ba’Ghetto in Rome and Florence.

Enjoying Aperitivo Safely

“Here is an Allie-safe snack,” the owner of Zoe Food in Trieste says to me as she places my Aperol spritz and a small plate of honey-drizzled cheese and soppressata in front of me. After visiting the restaurant for dinners and celebrations, the owners quickly became used to my food allergies.

With aperitivo as an integral part of the Italian culture, the social drink before dinner is something my colleagues and I frequently enjoyed. During aperitivo, drinks come with complimentary snacks. The first time I saw peanuts in Italy was during aperitivo, and it was initially shocking. These snacks are not ordered from a menu.

Sometimes, the snacks can be little pre-made sandwiches, mini pizzas, or a small bowl of chips. With food allergies, it’s a challenging time to eat, so I recommend eating ahead and packing your own snacks for this delightful pre-dinner tradition.

Shopping at Supermarkets

When first moved to Italy, I arrived armed with the absolute necessities including an Italian dictionary and a very minimal understanding of the language. Now, with the Google Translate app, I no longer need my paper dictionary to check for allergens on food packages. I use the Google Lens feature to watch words translate in real-time. It’s magic and makes the process 10 times faster.

Since Italy is part of the EU, it follows the same ingredient packaging requirements as other EU countries. The top 14 allergens must be labeled clearly on the packaging and are often written in bold type. Like most other countries, including the U.S., precautionary statements like “may contain” are voluntary and not required.

One aisle that can be particularly helpful in the grocery store for those with food allergies is called the “Bio” aisle. Essentially, this means organic foods, but it also includes food without gluten and some of the top allergens like dairy. Although there aren’t many nut-free packaged food options in Italy, there are numerous milk alternatives like Alpro and gluten-free brands and products, like Schar.

Look for labeling that says “senza,” meaning “without.” For example, a package that says “senza glutine” is without gluten. It’s still essential to never assume anything with these labels and always read the ingredients. I recently found Misura, an Italian food brand, has some “free from” options, including cookies that are free from egg and milk.

For those with other dietary requirements, including low- or no-sugar foods, the pharmacy often has an entire section of food options that meet different dietary needs and restrictions.

Outdoor food markets are popular throughout Italy. Browsing stalls brimming with vibrant fruits and vegetables is fun and also offers some fresh options. I can often find some ripe tomatoes and sweet peaches. However, be aware that loose nuts are often sold at these markets.  For this reason, if you have a nut allergy try to avoid using the baskets they often provide to collect your produce, in order to avoid cross-contamination.

Choosing Where to Stay

“I’m having trouble finding a large grocery store near the apartment. Can you recommend any nearby?” is the WhatsApp text I send to the owner of the charming AirBnB I rented in Polignano a Mare right on the coast in the Puglia region of Italy two summers ago.

I arrive midafternoon, hoping to get a few groceries to keep in the refrigerator in case I had any trouble finding a restaurant for dinner. I roamed around the seaside town, marveling at the cliffs, but my stomach was growling in between the sweeping sea views. I knew I needed to find some groceries in case I didn’t have luck dining out. The host responds within minutes with a few options I hadn’t easily found on Google Maps.

Many families and individuals with food allergies opt to stay at apartment-style accommodations where they have kitchen access and more control over their food. Since I find restaurants to be accommodating overall in Italy, I’m comfortable staying in either hotels or apartments. I’ve found that there are unique benefits to both types of accommodations.

When staying at an AirBnB, there are a few things to consider with food allergies. Before choosing the apartment, I check that there is a grocery store in close walking distance. I also look to see if there is a dishwasher in the kitchen. This way, I can easily re-wash the dishes if I have any concerns they have been contaminated. I read the past reviews to make sure the host has been friendly and helpful to others. I like to know I can message the hosts for any local questions about grocery stores and restaurants.

If you have environmental and pet allergies like I do, it’s important to check if pets are allowed in the apartment. I also look at the photos to ensure there’s no carpeting to avoid dust mites and pet dander that get easily trapped.

When I stay at a hotel, I look for similar qualifications when it comes to my environmental allergies.  I also appreciate having access to a concierge who can assist with calling restaurants ahead to let them know about my food allergies and to make sure they can safely accommodate them.

This summer, while in Milan staying at the NH Collection CityLife, I asked the concierge to make reservations ahead of time for a special meal. When we arrived, the chef had a copy of my allergy card and could make Milanese dishes like risotto alla Milanese, ossobuco and costoletta alla Milanese safely for me. I may not have been able to easily try these dishes at other restaurants, especially without advance notice.

Italy allows me to feel both safe and included in the eating and dining experience. It’s a place where I’ve formed bonds and found friendships in some of the most unlikely situations often because of my food allergies.

 

The 14 Allergens

  • celery
  • cereals containing gluten (such as wheat, rye, barley and oats)
  • crustaceans (such as prawns, crabs and lobsters)
  • eggs
  • fish
  • lupin
  • milk
  • mollusks (such as mussels and oysters)
  • mustard
  • peanuts
  • sesame
  • soybeans
  • sulphur dioxide and sulphites (if the sulphur dioxide and sulphites are at a concentration of more than 10 parts per million)
  • tree nuts (such as almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts)

Quick Italy Food Allergy Tips 

  • Remember the phrase Sono allergica a ________ “I am allergic to”
  • Always make sure you have epinephrine on you at all times. The Italian name of epinephrine is adrenalina, and the Italian auto-injectors are FastJekt and Jext, in case you need replacements on your trip.
  • If possible, make a reservations at restaurants ahead of time and ask them if they can accommodate you or email restaurants where you have more of a chance to explain in writing.
  • Use a translated chef card to give the restaurant server/manager/chef that explains your food allergies.
  • Have a few go-to food ideas in mind and choose simple dishes.
  • Educate yourself on regional differences in dishes and ingredients.
  • If there is an allergen menu or key on the menu, use it as a guide to then check with staff about the dish with a chef card. Menus are often updated and ingredients change.
  • Trust your gut on whether you think those who work at a restaurant get it or not and make sure the chef card goes to the kitchen/chef/manager.
  • Keep some pre-packaged safe snacks in your bag for moments of hunger when you don’t have time for a sit-down restaurant.

—Allie Bahn

Allie Bahn is a Philadelphia-based travel writer, creator and consultant. She is the travel expert for Allergic Living, the largest online allergy magazine. Follow Allie on social media at @miss_allergic_reactor