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Accommodations and anxiety: Navigating WU Dining Services with food allergies

Top 8 Friendly dining stations at the Bear’s Den, the Danforth University Center and the Village cater to students with common food allergies. (Zoe Oppenheimer/Student Life)
As a high school senior touring colleges last spring, I distinctly remember walking into the DUC at Washington University in St. Louis and seeing colorful posters hanging from the ceiling: “No. 3 Best Campus Food, Princeton Review.”
As someone who has managed food allergies to dairy, eggs, peanuts, tree nuts, fish and shellfish for my entire life, I wondered how accurate this statement would be for me.
According to Food Allergy Research and Education (FARE) — the world’s largest non-profit organization dedicated to food allergy research, education and advocacy — 32 million Americans, including 1 in 10 adults, suffer from food allergies. While nearly every college student has to make the transition from home-cooked meals to dining hall food when they move to campus, those with food allergies have additional obstacles to overcome.
WashU’s Bear Essentials for New Students checklist instructs students with food allergies to reach out to campus dietitian Rebecca Miller before arriving.
“I was a little worried about coming into college not knowing how to manage my food allergies, so I set up a meeting with [Miller],” said sophomore Morgan Romo, who is allergic to tree nuts and milk.
According to Miller, Dining Services allergy protocol includes preventing cross contamination of what the Food and Drug Administration (FDA) recognizes as the top 8 allergens (milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans) at a designated station in each of the three main dining locations on campus: the Bear’s Den, the Village and the Danforth University Center.
At the Top 8 Friendly station, menu items are made without any of the allergens, and there are “enhanced sanitation procedures, dedicated staff & training, as well as process monitoring,” as stated on signs posted at the Top 8 Friendly station in BD.
The dining team plans to keep sesame ingredients away from the allergy-friendly stations next year. Sesame was recently declared the ninth major food allergen by the FDA.
Before the dedicated Top 8 Friendly stations were introduced during the 2020-2021 school year, students with allergies would work with campus dietitians and Dining Services, who would then inform Bon Appétit Management Company — the company that runs WashU dining — that they needed special services, said Ryan Goodwin, resident district manager at Bon Appétit. (Bon Appétit, Dining Services, and the nutrition team are three different departments that work in collaboration with one another.)
Previously, the Top 8 Friendly stations were known as the Comfort stations, which served “real comfort food,” according to Goodwin. “We took that sort of premise but made it Top 8 Friendly,” he explained. “So we have carved items, we have plain chicken, steamed vegetables, simple grains or starches, and we opened it up to everyone.”
Last year, the Top 8 Friendly stations were only open during lunch at the DUC and during dinner at BD and the Village. Services have been expanded to all meal periods this year due to the high utilization of the stations last year, Miller said.
Many students with allergies are appreciative of this change. “I think it’s really helpful that they’ve introduced the Top 8 Friendly [station] because I don’t have to worry about what’s in it,” Romo said.
Sophomore Nicole Chen, who is allergic to peanuts, tree nuts, shellfish, eggs and sesame, said that these stations are the only ones she visits.
Other than bakery items and pre-packaged items, nuts are never used in Dining Services’ production in order to mitigate the chance of cross contamination, according to Miller. Peanut and tree nut allergies are among the most severe, with reactions to these foods making up over half of all food-related anaphylaxis deaths, according to the National Library of Medicine.
Miller added that the chef team has production protocols to keep food separate and labeled in the pantries and refrigerators. All of the menu items and packaged food have stickers indicating which of the common allergens they contain, and menus with ingredient lists are also published online daily.
At the beginning of the 2020-2021 school year, Romo participated in a “virtual fair” where she was able to hear from people from Dining Services and connect with other food allergy students. This year, Chen — who attended classes remotely last year — attended a kitchen tour of BD, which she described as “very informative.” The tour took place on August 20 and allowed students with food allergies and dietary restrictions who had previously reached out to Miller and Registered Dietitian Nutritionist Susan Caciano to meet Executive Chef Patrick McElroy and see the station and equipment where Top 8 Friendly dishes are prepared.
“I really appreciate how they made an effort to tell us what they do to make sure people with food allergies are safe,” Chen said. “At the same time, it was a little disheartening because I would say that half of the tour was like, ‘Oh okay, if you’re allergic to nuts and eggs, just don’t go to Cherry Tree Café.’”
Miller conducted FARE training for nearly every Dining Services employee for the first time this year to teach them about food allergy safety and protocol, and chefs working at the Top 8 Friendly station have been required to undergo additional training. Previously, Dining Services conducted its own internal training, but Miller said that the name recognition and reputation of FARE provides “a level of comfort and assurance” for students.
By the end of this semester, Goodwin said he hopes that every employee — from the cashiers to the servers — will have completed food allergy training.
Chen recalled one particular chef, Gerardo Peregrino, who made her feel particularly comfortable. When she told the staff she had dietary restrictions, “he came out and personally talked to me and just asked about my food allergies, and then he prepared a meal for me personally,” she said.
“He just always has such a positive attitude,” Chen added. “I really appreciate how comfortable he made me feel, and I didn’t feel like I was being a demanding customer and creating all this unnecessary hassle for him.”
“[Peregrino] is just who he is,” Goodwin said. “He takes a lot of pride in his work. If he has a student that needs extra help, he goes out of his way to make sure it is that way.”
“We’ve tried to really emphasize with our teams how we make sure that [each] student feels comfortable,” Goodwin continued. “I always [say], ‘This is your home. You’re here more than you are at your normal home, so we’ve got to make you feel like you’re at home as much as we possibly can.’”
In addition to the Top 8 Friendly station, students with food allergies can order from the Simply Made menu on GrubHub with approval from the Nutrition Team, which includes Miller and Caciano. The menu consists of allergy-friendly options and is available at the BD, the DUC and the Village. Over 100 students have access to this menu, according to Goodwin.
When a student clicks on the Simply Made menu in the GrubHub app, the following message pops up: “This menu is for students who have been approved through the WUSTL dietitian, any students placing orders without prior approval will have their orders canceled.”
When ordering, students with food allergies can either check off their allergens (at the Village and DUC stations) or put them in the pickup instructions. “I really, really love that,” Chen said. “I think that really made me feel safe about what I can eat.”
However, Chen noted that there are problems with the app that sometimes make her nervous. For example, the Simply Made menu does not list the ingredients. Because Chen is allergic to sesame, she has avoided ordering the burgers and chicken sandwiches. “I’m not completely sure whether or not the bun has sesame on it,” she said.
Despite Dining Services’ best attempts to make dining inclusive and safe for students with food allergies, there can be oversights.
Romo said that last year, while quarantining on campus, she was once given yogurt and a muffin that contained dairy. “They had me fill out a form, stating if I have any allergies or dietary preferences or restrictions. And so I did, and they were aware of my allergy, and they’d give me the vegan meal every day,” she explained. “But there was just one day they brought me breakfast and there was some sort of mix up.”
Thinking it would be safe, Romo ate the meal and ended up having an allergic reaction.
“It was pretty bad,” she said. “I had to go to the hospital. I reached out to them and they were really apologetic. It hasn’t happened since then.”
For students with food allergies, there exists an always-present fear that food may contain an allergen even when it is deemed allergy-safe.
For example, although Chen ordered a stir fry dish from the Simply Made menu, she became worried when she saw a seasoning that looked like sesame. “It ended up being safe; it was just some sort of seasoning,” she said. “But it’s just a lot of anxiety.”
To mitigate this anxiety, Caciano said the dietitians like to take a “personalized approach” so they can “support the whole body.”
“We guide not only around some of the practical — what food menu items are available — but then some of the strategic, which is, ‘How much time do we need to have to eat to feel calm? Where are we going to plan to eat this? And do we want to be by ourselves? Or do we want to plan to go with friends for a more positive, whole-body experience?’” Caciano said.
Beyond dining hall experiences, there are other considerations that students with food allergies must account for.
Because the Top 8 Friendly stations exist only at the DUC, BD and the Village, Chen said she has no options for food when she is on the East End of campus for art classes. “Part of me is just so used to always bring[ing] snacks and my two epinephrines, and so I kind of just used that to tide myself over,” Chen said. “But of course I wish I could go to a Top 8 station at every single dining place.”
Due to some of these underlying concerns, eating is never an impulsive activity. “I feel like I spend so much of my time just having to plan beforehand: ‘What am I going to eat tonight, where am I going to go?’ and you know, I’m kind of envious of people who are like, ‘Oh, we can just spontaneously decide where we want to go,’” Chen said.
In social contexts, it can be especially difficult for people to manage food allergies. “When it’s like, people inviting me to get dinner, get lunch… I feel bad telling them, ‘Okay I can only eat at XYZ places. These are the places I completely know are safe,’” Chen said. “I guess that’s one thing that I feel like makes my experience different from a lot of other people’s.”
There are other smaller ways in which food allergies affect students, too. Dairy-free milk, for example, costs more at Cafe Bergson. While this is not different from many off-campus cafes and coffee shops, the small charges add up over time.
However, Dining Services and the nutrition team are continually looking to improve the experience of students with allergies. According to Miller, some brands, such as Enjoy Life, were brought in due to student recommendations. “A lot of students bring up products to us and let us know, ‘Hey, I really like this brand, or I’m really used to this — can you bring it into campus and have it available?’” she said. “[We’re] just always looking to grow and expand and meet the students’ needs, wherever that may be.”
Goodwin said that, in addition to bringing in more product, his team is planning to finish the allergen kitchen in BD. Currently, the station is separate and has its own ventilation, “but [eventually] we’ll have the wall up, and it’ll be allergen-free, not allergen-friendly,” he said. They also hope to find a way to replicate this separation in the DUC, which has smaller kitchen facilities than BD.
Miller emphasized the importance of communication with the Nutrition Team for students with food allergies. “As much as I don’t want to hear about issues because I want everyone to have as great of an experience as possible, sometimes they do, and we just want to know about them so we can help to fix them and prevent them for that particular student and others as well,” she said.
“We always love hearing from students, no matter how small the question or concern is,” Caciano said.