Alpha-gal syndrome changes how we socialize

COLUMBIA, Mo. — For some people, an invitation to dine out brings anxiety instead of anticipation. According to the nonprofit organization Food Allergy Research & Education, one in four Americans are affected by at least one of the top nine food allergies.

Karen Funkenbusch, health and safety state specialist with University of Missouri Extension, says the rising number of Missourians diagnosed with alpha-gal syndrome (AGS) is changing how individuals and families eat and socialize. Alpha-gal syndrome causes allergic reactions to red meat and other mammal-derived products.

A 2025 MU Extension survey of more than 1,000 respondents found that dining and social situations have a big effect on the mental health of people with AGS. Nearly two-thirds reported anxiety or depressive disorders, nearly half said the condition affected daily life, and 63% said they avoid eating out or attending social events because of fear of food contamination.

“Social isolation, loneliness, depression and anxiety are often hidden side effects of food allergies like AGS,” Funkenbusch said. “The fear of accidental exposure and misunderstandings from others can greatly affect quality of life.”

The challenges are often greater in rural areas, where social gatherings frequently center around food and restaurant options are limited. “Some rural communities may have only one fast-food restaurant and little variety,” Funkenbusch said. “Also, many social activities in rural communities center around sporting events where concession stand foods are the only choice.”

Dining out requires advance planning. Funkenbusch recommends calling restaurants ahead of time to discuss allergies and kitchen practices.

“It’s not just what’s on the menu,” she said. “Cross-contamination can occur when food is prepared on shared surfaces or with utensils that have contacted meat, dairy or other mammal-derived products.”

When eating away from home, she advises choosing simple foods with few ingredients or bringing prepared meals.

“Think ‘fins and feathers’ and whole foods,” aid Eden Stewart, who leads MU Extension’s interdisciplinary AGS team.

Grilled chicken or fish, steamed vegetables and salads are usually safer choices. Stewart cautions that dressings, desserts and processed foods may contain hidden mammal-derived ingredients such as gelatin or dairy.

MU Extension recently released a series of guides on understanding and managing alpha-gal syndrome. The publications are available for free download.

Open communication, self-advocacy and mental health support can help manage the social and emotional impacts of AGS. Funkenbusch urges people to disclose their condition, explain how to respond to an allergic reaction and always carry an epinephrine auto-injector.

Awareness of AGS remains limited, including among health care professionals. A Missouri Department of Health and Senior Services survey found that 78% of primary care physicians nationwide have little to no knowledge of the condition. Funkenbusch said the gap may be wider in rural areas, where outdoor exposure to ticks is more common.

But there is some progress. More Missouri restaurants are adapting menus and practices to accommodate AGS and other food allergies.

MU Extension continues to raise awareness through education and outreach. Funkenbusch encourages anyone experiencing stress, anxiety or depression related to chronic illness to seek support. “Reach out,” she said. “Call or chat with someone who will listen.”

In partnership with MU Extension’s Show-Me Strong Farm Families program, MU Psychological Services Clinic offers free, confidential telehealth counseling by licensed mental health counselors who understand agriculture and rural communities.

To learn more or request services, visit the Show Me Strong Farm Families webpage, email adpsc@missouri.edu or call 573-882-4677. For immediate help, call or text 988.