Five percent of American consumers have some form of food allergy, according to online dining guide AllergyEats. It might seem like a relatively negligible amount, but that 5 percent translates to 16 million restaurant patrons.

The rising awareness around nut allergies, gluten intolerance, and other dietary sensitivities has led many restaurants to create special dishes free of the offending ingredients. Operators have also systemized food-handling processes, which in some ways are just as regimented as food-safety procedures.

Here, the founder of AllergyEats and two restaurant leaders discuss the measures the limited-service sector has made to address food allergies—and where there’s still room to grow.

Elliot Schiffer / CEO, Mici Handcrafted Italian

Across the families of our five operating partners, we have children with allergies or intolerances to gluten, dairy, and nuts. We’ve designed our menu to easily exclude some of these items—we use a nut-free pesto as an example—and have added items to help accommodate restrictions, such as gluten-free pizza crusts.

By far our largest request is for gluten-free pizza. We’ve been serving a locally made gluten-free crust for years, and it now represents more than one in 10 pizzas we serve. We are working to finalize our allergen menu in January 2019.

Our biggest challenge is handling severe allergies. The presence of gluten, nuts, dairy, etc. in our restaurant creates an inherent danger. We do our best by using new gloves and utensils to cook an “allergy alert” item and taking a product directly out of its manufacturers container rather than from the cooking line. Limited service has the advantage of condensed menus and fewer ingredients to navigate, but our small kitchen size creates an obstacle when trying to carve out space to take special care of allergy-free dishes.

Paul Antico / Founder & CEO, AllergyEats

Since AllergyEats’ launch in 2010, the restaurant landscape has changed dramatically. More restaurateurs are understanding the importance of keeping food-allergic diners safe, as well as the profit opportunity from properly accommodating this very loyal customer base. Making the necessary changes to do this right is actually quite minimal. The biggest investment is commitment.

According to our annual list, the majority of the most allergy-friendly restaurant chains in America are sit-down, casual-dining restaurants like Mellow Mushroom and Burtons Grill. Only Chipotle regularly makes the list from the fast-casual category, and In-N-Out Burger made the list in 2017 from the fast-food space—the only time a fast-food outlet made it. In general, it is very hard for fast food to be accommodating. Making food quickly means that cleaning equipment for an allergy meal in the middle of the day is often not possible, making cross-contact risk high.

I do expect other fast-casual chains, particularly in the pizza space, to challenge some of the casual-dining restaurants in the future, given their ability to customize meals for individual customers just as Chipotle does. Pei Wei is also making major changes in this regard.

Restaurants need to not only have a more educated staff, but they also need to put procedures in place for how to handle a food-allergic diner’s order.

Robin Hamm / Vice President of Culinary, MOD Pizza

One of the common questions we receive from our customers is whether we will be able to accommodate multiple food allergies. With our variety of toppings, sauces, dressings, and crusts, fortunately the answer is that MOD can accommodate a lot of requests.

Since we flour and press our pizza dough in the same area of the kitchen where our pizzas and salads are created, we must be most mindful of wheat and gluten. And because we cook our pizzas in the same oven and build them on the same preparation line, cross-contact is a consideration.

Food allergens are synonymous with food safety. While the food industry continues to make great strides in food safety, there are still improvements to be made. It’s widely known that chicken must be cooked to at least 165 degrees Fahrenheit, but it’s not yet as broadly known that food allergens can’t be cooked away from a hot cooking surface (hint: It requires a wash, rinse, sanitize process). Rounding out the knowledge base of food allergens is an important next step.

Restaurants must realize that food allergies are a way of life. It’s our collective responsibility to share best practices and be innovative in our approach. When we work together, we’ll all rise to a higher level of customer safety and satisfaction.

Business Advice, Health & Wellness, Menu Innovations, Story, Mici Handcrafted Italian, MOD Pizza