Some people eat to live, but most of us live to eat. Meals are more than sustenance; they are how we celebrate milestones, connect with loved ones, and mark the passage of time. But for people living with food allergies, dining out can feel less like a joy and more like an exercise in survival.

Trust becomes the most important ingredient on the plate. Trust that an unfamiliar chef has taken precautions. Trust that the person taking your order understands cross-contact. Trust that someone on staff even knows all the ingredients in the dish. For food allergy families, these questions are not hypothetical. They are essential.

And yet, out of this fear has emerged something powerful: A movement. Advocacy led by people living with the disease, those who have lost loved ones to it, and the countless medical professionals who treat it is reshaping how we talk about food allergies. Their personal stories are not just emotional appeals; they are evidence of urgent gaps in our systems and the need for better safety measures.

I recently explored these issues on the KevinMD podcast, where I spoke about the risks food-allergic individuals face while flying, and how general understanding, medical guidance, and public policy must work together to keep people safe. Change often starts with people. Specifically, the people who simply refuse to accept that a meal should ever be a life-threatening event.

For most, dining out is something to look forward to. But for food-allergic individuals, it can be exhausting. Will the kitchen understand cross-contact? Is the staff trained on anaphylaxis? Does anyone even know what is actually in the dish being served?

Some restaurants step up. They see food-allergic patrons not as a liability but as a challenge worth rising to, using skill and creativity to craft inclusive, flavorful, and safe meals. For people used to eating the same safe options, these moments are extraordinary.

But far too many still close their doors. Some post disclaimers on menus discouraging allergic customers. Others clearly state they cannot ensure safety. This is not just exclusion; it is shortsighted business, because people often do not dine alone. In my own family, celebrations often involve a large group, and where we eat depends entirely on whether it is safe for my son. If a restaurant is not safe for him, it is not an option. Period.

This is why legislation like California’s ADDE Act (SB 68) is so important. The bill would require restaurants to list the top nine allergens directly on their menus, a level of transparency already required in the United Kingdom and European Union.

I would argue that even though this bill places requirements on restaurants, it should also be seen as a business opportunity. Many individuals and families currently avoid dining out due to a lack of transparency or trust in food safety. This legislation gives them a reason to return to the table. And they rarely dine alone. One food-allergic individual often brings an entire group—friends, family, or colleagues—along with them. In that light, this bill is not just a win for the food allergy community; it is a win for the restaurant industry as well.

As of today, an important step has been achieved as the California Senate has passed SB 68, the ADDE Act. This legislation is a vital move toward safer, more transparent dining experiences for millions of Californians living with food allergies.

The effort is being led by nine-year-old Addie Lao, who lives with multiple severe food allergies, alongside her mother Robyn Lao, a pediatric nurse practitioner (DNP, RN), and Senator Caroline Menjivar, who also lives with food allergies. Their lived experiences helped shape the bill, and their courage has galvanized a growing network of supporters.

I feel a deep kinship with Addie and her mom. When I founded No Nut Traveler, it was because I wanted to make the world safer for my son, specifically in the skies. For Robyn, it is the world of restaurants. Different settings, same mission: To make public spaces less dangerous and more inclusive for children like ours. My son was just eight years old when I began this journey. He is now nineteen, and as I look at the progress we have made and the change that is on the horizon, I see powerful parallels between our stories. It is a reminder that parent-driven advocacy, rooted in love and urgency, can help reshape the systems our children depend on.

I was honored to speak at a recent webinar hosted by the Asthma and Allergy Foundation of America (AAFA), which is leading advocacy efforts in support of the bill. We shared stories, strategies, and the urgent need for collective action. One of the leaders in that effort is Alexa Jordan, Advocacy and Policy Coordinator at AAFA, someone I first met years ago when she was a student who had experienced anaphylaxis on a flight. To see her now advocating on a national level, fighting for policy change that protects others, is both awe-inspiring and deeply personal. It is a testament to how those living with the disease are not only sharing their stories but reshaping the narrative and changing the landscape.

No one should die from food. Not a child at a birthday party. Not a teen out to dinner with friends. Not a mom simply enjoying dessert. These tragedies are not inevitable. They are preventable. And what we need is not more luck; it is better systems. Systems rooted in safety, clarity, and compassion.

I have often said that focusing solely on the allergic individual misses the bigger picture. When a group is planning a meal, whether it is an extended family gathering, a work dinner, or a team celebration, it is often the person with food allergies who determines where, or even if, the group dines.

In effect, that one individual can hold a silent veto vote. Because it is never just about one person. Families worry. Friends worry. Hosts worry. A single diagnosis quickly becomes a shared responsibility. This is not drama or overreaction; it is vigilance born out of necessity and a deep longing for a world where it does not have to be this way.

There is a better path forward, one that combines personal stories, medical insight, and public policy. One that treats safety not as a privilege, but as a standard.

We need to keep pushing for awareness, for transparency, and for systems that protect everyone at the table. Because one day my hope is that the table should be big enough and safe enough for us all.

Lianne Mandelbaum is a leading advocate for airline safety measures to protect food-allergic passengers. As president of No Nut Traveler and airline correspondent for Allergic Living, she drives policy change by collecting testimonials from food-allergic families to share with lawmakers, media, and advocacy groups. She can be reached on X @nonuttraveler, Facebook, and LinkedIn.

A sought-after speaker and media source, Lianne participated in a Medscape panel on emergency medical kits on planes and contributed global data on airline travel and food allergies at the GA²LEN Anacare Anaphylaxis & Food Allergy Forum. Her travel tips were also featured by Stanford’s Sean N. Parker Center for Allergy Research. She also appeared on Bloomberg to discuss the challenges faced by food-allergic travelers and advocate for policy changes.

Her advocacy led to a Department of Transportation ruling recognizing food allergy as a disability. She co-designed a global air travel and food allergy survey with Northwestern University’s CFAAR, which was presented at AAAAI and published in The Journal of Allergy & Clinical Immunology. She is the co-author of “Understanding Experiences, Barriers, and Facilitators of Safe Airline Travel—A Global Survey of Food Allergy Patients and Caregivers” (The Journal of Allergy & Clinical Immunology). She also contributed to “10 Practical Priorities to Prevent and Manage Serious Allergic Reactions: GA²LEN ANACare and EFA Anaphylaxis Manifesto” (Clinical and Translational Allergy) and “Ever Treat a Patient on a Plane? Why Med Kits Need an Update” (Medscape). Additionally, she collaborated with stakeholders to include anaphylaxis and necessary medications in the FAA Reauthorization Act of 2024.