✈️ Navigating Air Travel with Food Allergies: Recognizing Risks, Addressing Misunderstandings, and Promoting Safer Skies

Air travel can be daunting for anyone, but for those with food allergies, it presents a distinct array of obstacles. Even as awareness of food allergies grows—especially among children and adults developing new allergies—airline policies and societal comprehension still fall significantly short of what is needed for secure and inclusive travel.

In an engaging episode of the KevinMD Podcast, physical therapist and food allergy advocate Lianne Mandelbaum discusses these pressing matters. Drawing on her advocacy experiences and personal insights, she exposes the hidden threats, systemic lapses, and widespread myths that individuals with food allergies encounter when flying commercially.

🛑 The Present Situation: Myths and Mismanagement

Lianne Mandelbaum’s piece, “Flying with food allergies: Addressing misconceptions and promoting safety,” emphasizes the urgent need for education and reform—within the medical community, general public, and airline authorities themselves.

Key findings from a study by Northwestern University she cites reveal concerning statistics:

– 31% of travelers with food allergies refrain from informing airline personnel due to fears of retaliation or embarrassment.
– Over 33% experience unprofessional behavior or outright dismissal from airline staff upon revealing their allergies.
– A troubling 70% reported that promised accommodations were not provided.
– 12% faced denial of boarding or were removed from flights due to their disclosures about allergies.

This data illustrates a distressing reality: food-allergic travelers frequently encounter prejudice, doubt, and a troubling absence of institutional backing.

⚠️ Discrepant Airline Policies

In the U.S., there is no standardized allergy protocol across domestic airlines. Some maintain thorough and considerate allergy protocols, while others still serve high-risk allergens such as peanuts and tree nuts without offering alternative options or seating changes. Even when airlines establish procedures, flight crews often overlook them without facing repercussions.

One account shared by Mandelbaum recounted a mother being instructed to stand at the airplane’s rear with her allergic child during a snack service involving tree nuts. Far too often, travelers confront apathy, miscommunication, or unwelcoming attitudes merely for requesting basic safety measures.

⛑️ Systemic Medical and Regulatory Deficiencies

One of the most startling findings emphasized in Mandelbaum’s advocacy is that as of 2025:

– U.S. airlines are not legally bound to carry epinephrine auto-injectors or nasal sprays on board.
– Most are only required to have epinephrine in vial-and-syringe format—a method that is nearly impossible for untrained, or even many trained, individuals to administer safely amid turbulent emergencies.

Further exacerbating the risk is inadequate allergen labeling on in-flight meals. The U.S. FDA does not mandate complete allergen visibility for airline food, resulting in situations where significant allergens like tree nuts may be present but not specified on packaging—leading to airborne anaphylactic episodes.

🏥 Actions for Physicians and the Medical Community

Healthcare providers—particularly general practitioners who may see food-allergic patients but are not allergists—have a crucial role in promoting safer travel for their patients.

Mandelbaum urges doctors to:

– Bring up travel proactively during consultations.
– Write letters for patients outlining their medical needs and rights.
– Advise patients to avoid consuming airline meals.
– Equip patients with strategies such as carrying medications, self-prepared food, and familiarizing themselves with airline policies ahead of time.

Even brief discussions can yield life-saving impacts.

👥 Public Misunderstandings

Education transcends just medical or aviation concerns—it’s a societal challenge. The public’s understanding of food allergies is often marred by humor, misinformation, and incredulity.

Common misconceptions held by the public include:

– The notion that individuals choose their food allergies or are overly cautious.
– The misguided belief that medications like epinephrine work like magic wands, whereas they require timely administration and may not always be effective.
– Stigmas labeling food-allergic passengers as troublesome for seeking accommodations.

Mandelbaum emphasizes the necessity of recognizing food allergies as a serious medical issue rather than a mere lifestyle choice.

📢 Pushing for Systemic Change

Organizations such as No Nut Traveler, initiated by Mandelbaum, are advocating for legislative and policy changes. A promising update is the incorporation of language in the FAA Reauthorization Act of 2023, which establishes a pathway for requiring that epinephrine auto-injectors be available on all commercial flights shortly.

However, advancements are gradual, and until changes occur, passengers must champion their own cause—and they require support from healthcare professionals, lawmakers, and fellow travelers in this endeavor.

🎓 Essential Takeaways for Safer Flying

For the Food-Allergic Traveler:
– Always carry multiple doses of epinephrine and safe snacks.
– Notify airline personnel as soon as possible—and request