You probably lost one today. Maybe more than one.
A shopper pushed her cart through your store, read a label on one of your private-brand products, found the allergen information vague or missing, and quietly put it back. No complaint, no manager conversation. Just a decision – made in about four seconds – that your store was no longer safe. She left with a smaller basket than she planned, and she’s already texting her food allergy parent group about it.
That family spends 5% more on groceries every month than the average household. They plan every trip. They buy the same trusted SKUs over and over. They are among the most loyal shoppers in food retail – until the moment they’re not. And when you lose them, you don’t just lose a transaction. You lose a household. You lose the friends and relatives they warn. You lose every future trip from a shopper who will now drive past your store to go to one that’s earned her trust.
There are 85 million of these shoppers in America. They collectively influence $19 billion in annual grocery spending. And most of them feel underserved by the stores they’re currently using.
That is not a niche problem. That is a growth opportunity hiding in plain sight.
The data coming out of Food Allergy Research & Education (FARE), McKinsey, and new economic research should be a wake-up call for every food retailer. This is not just a health issue; it is a growth, loyalty, and risk-management issue.
The Size of the Opportunity
Let’s start with the marketplace. As I hinted earlier, FARE’s research collaboration with McKinsey estimated that 85 million Americans in an estimated 35 million households now avoid one or more of the top nine allergens for themselves, or someone in their home, and that they collectively influence about $19 billion in annual grocery spending.
That’s not including the “halo” effect: friends, extended family, and workplaces that change what they buy because of the person with food allergy in their lives.
FARE’s National Indicator Report and related analyses suggest that roughly 33 million Americans live with convincing, clinician-diagnosed food allergy, with prevalence around 4.7% for children and 5.1% for adults (that’s the conservative, physician-diagnosed rate; 10.8% is the broader estimate).
The report found that those numbers are higher than many clinicians and policymakers realized, and they confirm what many of us have seen anecdotally in stores for years: allergy is not rare, and it isn’t only a pediatric problem.
Economically, the picture is even more striking. A new population-level model led by Christopher Warren and colleagues estimates that food allergy may cost U.S. society as much as $370.8 billion a year – about $22,000 per patient annually – when you add up lost productivity, medical care, specialty foods, and the daily work that patients and caregivers do to stay safe. 90%-plus of that burden is “indirect,” meaning time off work, lower productivity, and constant vigilance.
Grocery retailers sit at the center of where many of those dollars are spent and where much of that vigilance is exercised. You are not just selling food. In many cases, you are the front line of risk management for these families.
What Shopping Looks Like When a Mistake Can Send You to the ER
The FARE Food Allergy Consumer Journey work is sobering. Shopping with food allergy is slow, stressful, and unforgiving. Many households:
- Read every label, every time, even on “trusted” brands, because allergen statements are inconsistent and change without notice.
- Avoid entire departments – fresh bakery, service deli, bulk, salad bars – because the cross-contact risk feels too high and the information too thin.
- Narrow their baskets to a relatively small set of SKUs they have vetted and re-vetted, then buy them over and over to save time and reduce anxiety.
That behavior might look like lack of experimentation or low engagement in your category reports. In reality, it is a survival strategy. An unexpected use of an EpiPen (a lifesaving epinephrine injection for severe allergic reactions) and a trip to the ER isn’t something any family wants to risk.
One mis-labeled product, one uncommunicated formulation change, one cross-contact incident in your bakery, and that family (and the other food allergy customers who hear about it) may never come back.
From a retail strategy standpoint, this is a classic high-value, high-stakes customer: very deliberate, highly planned, and extraordinarily loyal once they trust you… but also permanently lost if you break that trust.
The New Public Health Lens
The National Indicator Report reframes food allergy as a major public health issue, not just a private medical condition. It highlights:
- Significant and growing prevalence across age groups, with substantial impact on quality of life, mental health, and food security.
- Disproportionate burden on lower-income and non-White households, who often face higher direct medical costs, less access to specialists, and fewer safe food options.
- Clear gaps in workforce training and systems—including in foodservice and retail—that leave families to manage most of the risk mitigation themselves.
For retailers, that means three things. First, regulators and advocates are paying closer attention; your policies and practices around allergens will increasingly be scrutinized. Second, what you do in your stores can either mitigate or exacerbate existing inequities. Third, there is real upside for retailers who step into this space with credible, transparent action rather than minimum-compliance behavior.
Five Moves Every Grocery Retailer Should Make Now
- Clean up how you communicate allergens.
You may not write the federal labeling rules, but you do control how clear and consistent you are.
Start with your own brands. Standardize precautionary statements so “may contain,” “processed in a facility with,” and “shared equipment” are used intentionally and consistently, backed by real risk assessment – not as legal boilerplate. Make sure recipe changes and plant changes trigger proactive communication in digital and loyalty channels.
Digitally, place allergen information prominently in your app and on your website. Make top-nine allergens, cross-contact statements, and “free from” claims filterable and searchable, and keep them synced with what is on pack.
At shelf, consider simple, carefully governed iconography to help time-pressed shoppers quickly identify rigorously validated “gluten-free,” “nut-free facility,” or “top-nine-free” products within a set. Avoid the temptation to over-claim; this is a place where over-promising will hurt you and could hurt your shoppers!
- Treat allergy-friendly as a core strategy, not a tiny section.
The FARE/McKinsey work makes it clear: households managing allergy over-index on grocery spending and are eager for credible innovation. Yet in many stores, allergen-friendly offerings are either scattered randomly or buried in an ill-defined “health” section.
Instead, integrate allergy-friendly items into the main sets where they make sense – snacks, center-store baking, frozen, dairy alternatives – but support them with clear signage and digital tools. These families want to shop like everyone else, not be sent on a scavenger hunt.
Where it matters most:
- Top-nine-free staples like breads, pastas, snacks, and frozen entrees.
- Kid-friendly, school-safe items for lunchboxes and parties.
- Safe seasonal items for holidays (think Halloween, Easter, winter celebrations) that are allergen minefields for these families.
Your private brands are the biggest lever you control. A nut-free granola bar that is truly school-safe or an egg-free refrigerated dough line can anchor entire trips. If shoppers can’t find those items with you, they will go wherever they can – and they will take the rest of their basket with them according to the McKinsey study.
- Redesign high-risk fresh and prepared departments.
Fresh bakery, deli, and prepared foods are where a grocer’s differentiation lives – but they are also where the allergy risk and anxiety are highest. The Consumer Journey research calls out these departments as major friction points.
The playbook here is about procedure and transparency:
- Implement strict allergen-handling SOPs: dedicated utensils, color-coded boards, cleaning protocols, and clearly separated production runs for high-risk allergens like peanuts and tree nuts.
- Where you can, develop at least a small set of SKUs produced in a nut-free environment (either in-house or via a dedicated facility), then label and market that clearly.
- On service cases, hot bars, and salad bars, make allergen and ingredient information unavoidable—on case tags, overhead signage, and your digital menu boards.
For families living with allergy, clarity and consistency are almost as important as the product itself.
- Invest in training as a core capability.
In my conversations with allergy families, one thing comes up again and again: front-line employees who say, “I think it’s fine…” when they don’t know – or who point the shopper to the package and walk away.
Every associate doesn’t need to be an allergist, but they do need basic literacy: what the top nine allergens are, what “cross-contact” means, and why off-the-cuff reassurance is dangerous. They should know exactly whom to call and which systems to check when a shopper asks about ingredients or facility practices.
Make this real with periodic refreshers in the highest-risk departments and with simple, accessible job aids. The National Indicator Report makes clear that workforce training is a systemic gap; retailers who close that gap in their own four walls will win disproportionate trust.
- Market to the allergy community with substance, not slogans.
Food allergy households are used to being ignored – and, when they are noticed, to being disappointed. They have seen “free from” claims that didn’t hold up and “allergy-friendly” store sets that were afterthoughts.
If you want to become their preferred food-allergy-friendly retailer, you have to earn it:
- Bring credible partners to the table. Work with organizations like FARE and with local allergists or parent groups to vet your private-label policies, your in-store signage, and your digital communication.
- Build dedicated allergy-friendly content and tools: curated shopping lists, classroom-safe party ideas, and clear explanations of how you source and verify “free from” items.
- Show up when the stress is highest – back-to-school, Halloween, major holidays – with specific, practical solutions: pre-vetted candy assortments, nut-free bakery items, and ready-to-go “allergy-aware” kits.
If you follow through, this is a community that will do your marketing for you. Parents talk to other parents. Online support groups trade lists of “safe stores.” Advocates notice which grocers walk the talk. Word of mouth in this space is powerful – and it cuts both ways.
The only real question is whether your store will be seen as part of the problem or do you want to be one of the first retailers that truly designed its experience for this food allergy era?
(Full disclosure: Phil Lempert serves as an unpaid adviser on FARE’s PACT Alliance CPG/Retail Board)
