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Point/Counterpoint: Should food writers alert readers to health risks?

fava

Warning: this dish may contain fava beans (Credit: Wikimedia)

I recently got into a thought-provoking discussion on this blog with reader Kenneth Braunstein, who took umbrage with my many reviews of unhealthy, fat-laden hamburgers. Braunstein used this forum to raise the issue of responsibility in food writing. Namely, he asks if  critics should, as a matter of course, alert readers to health dangers lurking in restaurant food.

I asked Braunstein, who is a physician, to write an editorial. I responded.

Please let us know what you think about this issue in the comments section, and — please, please, please — keep it civil.

POINT: FOOD WRITERS BEAR A RESPONSIBILITY

By Kenneth Braunstein

Unfortunately, restaurant reviewers will usually cover how well the wait staff performed, the execution by the kitchen staff (i.e., was the food flavorful and properly prepared in a reasonable amount of time and as described in the menu), and was the meal worth the expense, but only occasionally use their bully pulpits to encourage serving healthful food.

Does the chef use hidden ingredients that may cause harm to his guests? Trans fats in the oils, high sodium loads, excessive carbohydrates, raw meats or fish, MSG, or fava beans are frequently never revealed on the menu. Gently or lightly seared has come to me as cold and raw in the center. Undercooked meats, fish, eggs, and shellfish may convey food borne infectious illnesses, such as E. Coli and Salmonella. MSG in susceptible people causes great discomfort. Fava beans can lead to severe and even lethal hemolytic anemia in persons of Mediterranean ancestry. The unexpected addition of diary products to a recipe needs to be cited so that lactose intolerant diners are forewarned.

Is the use of fats overly done? Their amount in meat products must be appropriate for the recipe. Greasy vegetables or worse vegetables with pork added as a surprise seasoning should be noted. Numerous reviewers admire how much bacon enhances certain dishes’ appeal. Besides upsetting vegetarians and violating several religions’ dietary laws, pork contributes saturated fat calories. These are issues, which deserve to be included in the overall evaluation of its application.

Is the restaurant sensitive to and knowledgeable about food allergies? Do they ask if you have any or must you bring it up? Will the chef have a clue about what you are talking? Shellfish, particularly tiny Pacific shrimp in Chinese “vegetarian” entrées, and nuts may not be mentioned by servers despite many of their customers having had allergic reactions to them including anaphylaxis. Gluten from grains is ubiquitous in Western cuisine and can cause serious diarrhea.

To accomplish this survey, a questionnaire could be sent to the restaurant prior to publishing the opinion. In addition, fat content, carbohydrate level, sodium load, and total caloric intake for the items ordered by the critic and his or her guests should be included. Finally, the sanitation rating of the establishment at time of visit would be mentioned. While these results are probably too awkward to be included in critiques proper, they maybe easily incorporated onto the website of reviewers.

COUNTERPOINT: DINERS SHOULD MONITOR THEIR OWN HEALTH RISKS

By John Kessler

Food writers are, by profession, omnivores. They eat and comment on any kind of food served in restaurants, even those items they personally don’t like. Readers are looking for advice on how to spend their money, whether on a $4.95 hamburger or a $175 meal for two in that new spot that everyone is talking about. As with chefs, the lifestyle can catch up with them. Some are overweight, others practice moderation and maintain a good exercise regime to keep the weight off. Few follow dietary restrictions, suffer from gluten insensitivity or have severe allergies that would prevent them from trying a variety of foods. If you don’t eat pork, pasta or peanuts in this business, you might as well look for a new line of work.

As some food writers joke, “We eat everything so you don’t have to.” This quip gets to the heart of the matter: Everyone is responsible for his or her own food choices.

Do food writers have a responsibility to point out that some dishes are rich, caloric and laden with fat? Absolutely. Should they balance their coverage of  all-American burgers and french fries with more healthful cuisines, such as Mediterranean and Japanese? Of course. Most professional eaters love these kinds of food and do more than pay lip service to them.

But when it comes to the hidden dangers of fava beans and gluten cross-contamination, diners should get this information directly from the restaurant rather than from a media source, one who could be held liable if the recipe were to change.

If people have dietary restrictions, they need to go right to the horse’s mouth and ask the restaurant.

67 comments Add your comment

Kenneth Braunstein

May 17th, 2010
1:09 pm

To Cekker: I wouldn’t say nobody. Bibi does. I don’t think she is a relative, either. It is clear that JK’s bloggers expect less from a food review than they do from a Consumer Reports review. You would expect their experts to comment on the safety of cars, tires, cosmetics, home tools, baby cribs, baby food, etc.

1164mgc

May 17th, 2010
2:06 pm

To Kenneth Braunstein: I would welcome any designation on the menu that says a dish is CERTIFIED vegetarian. Some actually do that, and I appreciate it. But by reading some of the comments here, I realize that if I were to happen to eat a piece of bacon or a little bit of anchovy paste in a dish, while I’d suffer for it, it is not going to kill me – however, if I were allergic to something (like peanuts) I’d have to go that extra mile and question anything that sounds suspicious. In those cases where they may certify that something is peanut-free (for example), you might get into the danger of having the restaurant/chef legally responsible if a stray ingredient got in there. I would think most, if not all, people with such allergies carry epi-pens, yet it is as they say – an ounce of prevention is worth a pund of cure.

Getting back to the original question, though – whether or not a food writer should alert the public to food risks – I think it’s nice if they do mention that there are a lot of vegetarian options available, whether or not peanuts are served at the table, etc. but I don’t think they should be required to do so. I do think that the codes you mention for menus would help in the food writers’ columns as well, yet if I were truly an issue of life and death I think people would ask at the restaurant even if they were given any kind of guidelines on the menu or reviews, etc.

Kenneth Braunstein

May 17th, 2010
3:38 pm

To 1164: The wife of a doctor acquaintance of mine was told by a chef the day before going to the restaurant that an item was made nut free. On the day she got there, he had decided to make it with nuts. She had to use her EpiPen that day. She does not go out to eat in restaurants anymore due to her severe nut allergy. Your point about being vigilant is well taken. I just think that it would simplify dining out to have some formal means of letting people in advance know whether a particular restaurant is appropriate for them. Take for instance the great ethnic restaurants along Buford Highway. Many of the employees and the chefs there don’t speak conversational English very well. There must be a way for people with dietary restrictions to be able to eat safely at those restaurants. The convention business is vital to the economic health of our metropolitan area. To maintain our competitive edge, the restaurants must be user friendly to our guests with food allergies and dietary restrictions. Clearly, for them restaurant guides are an important source of information about where they will dine. Knowing that an item’s recipe does not include a forbidden ingredient will make dining out a lot more convenient. It takes the guess work out of ordering. One would always remind the server that the menu claims it is free of the forbidden ingredient and ask him/her to remind the kitchen of that fact. That is much more convenient than having to drag the chef out of a busy kitchen to be sure you and the kitchen staff are in sync, which unfortunately you may still have to do in establishments with amateur wait staffs (kids making extra money for college, etc.) and not true professionals.

As for liability, they are already liable if a customer drops dead from a food allergy. It becomes an impossible thing to defend. You have to prove that the now dead customer failed to warn you about their allergy. In the example I gave earlier, the restaurant lost $750,000.

The Nerve

May 17th, 2010
4:30 pm

I’m still amazed by the “death from Fava Beans” thing. And glad that I don’t have any food allergies. Whew.

Kenneth Braunstein

May 17th, 2010
5:03 pm

To The Nerve: I’m delighted that you now are beginning to appreciated the complexity of this issue. As more and more different cuisines with their own unique ingredients become available in the metro area, food allergies and dietary restrictions become an increasingly important issue. It ain’t fried chicken and bisquits anymore. It is my thought that food critics who are usually experts on food would expand their role and assist in guiding individuals who do care about their nutrition into good eating that is healthful. For those of you in the blogosphere who think I am nuts (and by your response that is the overwhelming majority of you), I suggest you take a look at the Culinary Institute of America’s Professional Chef’s® Techniques of Healthy Cooking or some of Alice Waters cookbooks. It is possible to have “good eats” and good nutrition. It is possible to go out to a restaurant and eat well and healthful. If Americans change their evil ways in their diets, hopefully we will be able to keep Big Brother out of our kitchens and restaurants.

Carrie Neal Walden

May 18th, 2010
11:00 am

Kenneth is an intelligent person, clearly. However, it seems he and I fundamentally disagree on where the *burden* of responsibility on this- or likely, any- issue is – and that, for me, is on the individual.

I am responsible for my own eating. McDonald’s doesn’t “make” me fat. If I choose to eat there, or eat there to excess and also choose other unhealthy lifestyle activities like no exercise, etc, then I will face the consequences. It is not McDonald’s responsibilty to “choose” my choices. Nor is it the job of a server to quiz me about my health – how annoying and actually rude would that seem?!- as I am perfectly capable and responsible of coming to any restaurant (nice, casual, fast-food or other) and asking discreetly the questions appropriate to discern dietary or health-related/nutrition-based info I need to order as I like. Or to order that ginormous cheeseburger and fries I really want.

Excellent response, JK. You do your job well, written enjoyably and with skill, and I believe- with a level of attention to nutrition and food “issues” of different sorts that are noteworthy. So, if this were a high school debate and I a judge, you win!

Carrie Neal Walden

May 18th, 2010
11:00 am

PS – I was using McDonald’s as a general example, just for the “record”!

Kenneth Braunstein

May 18th, 2010
12:35 pm

Personal responsibility has become a very complex topic since the new health care reform bill was signed. Within that bill are provisions for the Federal Government to expand its oversight of the American diet. Some of what JK Blogers are objecting to is not an abstract concept but Federal law now. The FDA sees a mandate from that law to lower sodium, fat, carbohydrates, and calories within the American food supply and, hence, diet. My issue is not whether you go to a particular restaurant. My issue is that you should have the data base to decide if that restaurant is appropriate for you. If you have heart failure, you have no business going to a Mexican restaurant that has 2 days worth of sodium in each dish. You need to know that if you have salt restrictions. If the chef at that same Mexican restaurant can do a no salt or low salt version of his menu, you also need to know that in your decision making process. The government now has rules in place that McDonalds and other chains will have to prominently display the nutritional content of each of the items you order. You won’t be given the option to discreetly ask for that. With regards to food allergies, it will not take most restaurants liabiity insurance companies very long to require that the servers document that they asked about food allergies. Look up the case from July 2008 where the basic argument was what the server knew. In medicine we are already required to ask for drug allergies when we prescribe medication. Look up my earlier comment on food allergies to see the number of deaths each year in people with food allegies who eat outside of their homes. I assure you, any restaurant that has someone drop dead in their dining room will be asking you if you have any food allergies. The reason for making this an issue is to be sure that the 8% of children and somewhat less than 5% of adults with true food allergies are able to communicate with servers and chefs who know what they are talking about. Peanuts are technically not nuts since they are not from trees. A chef who adds peanuts or peanut oil to a dish is technically correct if he states there are no nuts in it. The diner is dead because of a miscommunication.

Cekker

May 18th, 2010
3:22 pm

To sum the debate:

Braunstein thinks personal resposibility is complex. He thinks that it’s fine and dandy that the feds now want to control what we eat through Big Brother health care rules and that litigation is a perfectly reasonable route to take to ensure that the consumer’s choices are limited and we are protected from ourselves. He wants restaurants and critics and the public to submit to what the Feds (and presumably himself) deem sensible for us to eat. If you have heart trouble the government should dictate what you eat. Because, you know, personal responsibility is complex. And he has a lot of statistics and analogies to back up his view.

The rest of us, except for Bibi(maybe?), disagree.

Kenneth Braunstein

May 18th, 2010
5:25 pm

To Cekker: I never said what I agreed with in the personal responsibility debate that you ascribe to me. I have tried to be neutral on the politics that you seem to think I have advocated. What I state without judgement are the facts. The law has these regulations in it and liability in Georgia is back to the way it used to be due to the State Supreme Court overturning the tort reform of the past few years. If you don’t like the Feds interfering with your diet, you’re too late unless you can figure out a way to overturn the law as our Governor is trying to do. The editorial page of today’s AJC has a debate about this. Give him some suggestions. If you don’t like the fact that trial lawyers dictate how you live by filing lawsuits directly on individuals and their employers and indirectly on the corporations that insure them, then talk to your state representative and senator. No insurance company is going to pay for a negligence lawsuit without putting the screws on the insured after all is said and done. One of the unfortunate aspects of living in our country is having to pay for settlements and verdicts in liability lawsuits. Look at all of the legal papers you have to sign these days to cover liability for renting a car, sending your kid on a field trip for school, any after school sport activity, or having a minor procedure done to you at a hospital or outpatient facility. From how you worded your comment, it appears that you personally do not have to pay for liability insurance for your job. If you did, you know that what I have described that the hospitality industry is going to face in the future is going to happen. The Mom and Pop restaurant is being squeezed by the franchise, chain, or megagroup corporations. They will all have liability policies. Their underwriters will try to minimize the risk by requiring documentation of such things as denial or affirmation of food allergies. Google E. Coli induced hemolytic uremic syndrome or salmonella and see the lawsuits they create. Call or email any restaurant chain’s risk management department and see what their policies are. Go to Five Guys and see all the disclaimers about peanuts they have placed very prominently in their restaurants. Do you think their lawyer had some say in the wording and placement of those signs? They won’t even let you walk out of one of their sites with a single peanut they give out free. Talk to restaurant managers, like I have, and see how they are trying to cope with the issue. Finally, if you don’t think personal responsibility is complex, go to a law library and read up on informed consent. If you are harmed by a restaurant, how much is their responsibility and how much is yours? How much research do you have to do on your allergy before you can place blame on a restaurant; i.e., did you personally do due dilligence? Can a person with a known milk allergy sue an ice cream palor? (I know that sounds ridiculous, but remember the woman who successfully sued McDonalds for its hot coffee being too hot.) Do you wear a MediAlert of its equivalent on your person to warn others of your allergies? How clear do you have to be about your allergies with the restaurant’s staff? With whom are you ultimately responsible to discuss your allergies? Is a server adequate or does the manager or chef need to be told personally by you if you have a potentially lethal allergy? If you knowingly order and eat undercooked food that you assume is bacteria free but it isn’t, have you waved your rights because the restaurant had a sign somewhere in it or a statement on the menu stating that the government does not deem that to be a safe eating choice? Who do you sue if your wife or kid is killed by a drunk driver who got plastered at a bar or restaurant and was allowed to leave the establishment to drive home on his own? The law states that the bar or restaurant is liable for that individuals’ “personal responsibility” not to drive drunk. You may not be aware that if you serve alcohol at your house you can be liable for the actions of anyone who leaves it intoxicated. Finally, remember the rule of gold. He who has the gold rules. Under the new health care act, the government has the gold and it rules, whether you, John Kessler, or I like it or not.

Kenneth Braunstein

May 18th, 2010
6:21 pm

To Cekker: The topic of this blog is whether restaurant reviewers who, because of the new regulations in the health care bill, will have access to nutritional information not previously available to them should include that data in their reviews to allow individuals to exercise their personal responsibility in a more informed fashion than they do now. In addition, should those same reviewers note the ease of interface with the restaurant or the lack of it when such issues as food allergies or dietary restrictions are raised. I have purposely tried to avoid showing my approval or disapproval of the Big Brother aspects of the current law. As for litigation, I’m a doctor. It’s a fact of life. Also, 1164 mgc should count for at least a half of an approval.

Soufflé Chef

May 19th, 2010
5:35 pm

Dr. Braunstein, perhaps you can explain why, if the problem of obesity is so important to the Obamas, how, in good conscious, he appointed an obese Surgeon General? There exists a certain perverse irony.

Kenneth Braunstein

May 19th, 2010
6:11 pm

Jenny Craig was not available.

Red

May 25th, 2010
9:36 am

It is not the food critic’s responsibility to give nutritional or health advice. It is the food critic’s responsibility to give a review of the food, the service, the ambiance. Then, when I get there, it’s my own responsibility to decide which items to order and how much. If I have concerns because I don’t eat this, that or whatever, then it’s on me to ask the server about it.

Given the health crisis in the US, I understand Dr. Braunstein’s desire that you use your column to address health and nutritional issues. However, unless you are a doctor or nutritionist, I’m going to be very wary about any such advice you give. And unless the AJC is going to hire a nutritionist to go with you,, I think you’d be getting into murky waters by holding forth on areas outside your expertise.

Then wait for the day where someone reads your column, orders something you thought was healthy but not, gets some health issue, then sues you and or the AJC for giving bad advice.

Kenneth Braunstein

May 26th, 2010
9:47 am

To Red: The food critic is not giving out nutritional or health advice when he/she describes what is in the dishes, the calories, the sodium content, the fat content, or the carbohydrate content. Nor is notifying the public as to the restaurant’s knowledge of food allergies or ability to adjust its recipes for dietary restrictions. Rather, the food critic is giving you the consumer the data you need to carry out your responsibility to decide which items to order and how much just as he/she does when describing how good or bad a dish tastes. I doubt that you would order something that a food critic describes as just awful tasting. For those individuals with significant health issues knowing in advance whether to try out a particular restaurant is important. Unless restaurants elect to do it on their own and either advertise what they do or place it on their website, where would the customer go to find out what is the real story about a restaurant and is it appropriate for their health needs?

[...] should be responsible for: calories, fat content, allergens, etc., etc., ad nauseum. The article is here. Go read it, I’ll [...]

Monica Ricci

July 17th, 2010
3:53 pm

FOOD ALLERGIES ASIDE…(that’s something I firmly believe is up to the individual to suss out, and the restaurant should have specific ingredient lists AVAILABLE in the back, for those with DEADLY allergies who want to put their minds at ease before dining. AND if you have a food allergy and you don’t carry an Epi-pen that’s just asking for trouble, because mistakes happen.)

Anyway… It’s not a food critic’s job to inform me of the “health rating” of the food they’re reviewing! Tell me if it was amazingly delicious or if it sucked. Give me the texture, the color, the flavors… tell me if you’d order it again. That’s all I want to know!

Listen people, it’s the year 2010… if you don’t know by now the difference between “healthy” food and unhealthy food, you’re an idiot. Here’s a hint: If you’re at a restaurant, there’s a good chance you’re getting more calories, fat, sugar, and salt than you really need. If I’m a restaurant critic, there’s your freakin’ disclaimer.

If you want to eat exactly 350 calories per meal and you’re on a sodium restricted diet you might have to come to terms with the fact that dining out might be a challenge.

Oh and by the way, some more food for thought… The government, through this b.s. stimulus bill and healthcare legislation is going to take so much more control of our bodies and small business that it will make your head spin.

I just heard today that as part of the “stimulus bill”, healthcare providers will be REQUIRED to include your BMI (body mass index) in your electronic medical records, or they will NOT get federal funding.

Hey Nutbar Congress and Clueless Pretend President! If I want to live on deep fried bacon and cheddar sandwiches, that’s MY business not yours. Grrrrrr… do NOT get me started.