Good nutrition and food safety are important consumer issues of the 1990's. Nutrition, food safety, and health are integrally related because no food is nutritious if it's not handled properly.

Overall, Americans enjoy a very safe food supply. USDA, the Food and Drug Administration, the Environmental Protection Agency, State and local Health Departments, and others are all working together to ensure that food is safe, wholesome, and accurately labeled.

Then why should consumers be concerned about food safety? Because even though food is inspected, it can contain bacteria that can cause illness if it is not handled properly. Meat, poultry, fish, eggs, fruits, and vegetables may contain bacteria. These bacteria are present throughout our environment.

At the right temperature, in just a few hours, small amounts of bacteria that you can't see, smell, or taste can multiply to dangerous levels on food and cause foodborne illness, sometimes called food poisoning. Common symptoms of many foodborne illnesses are flu-like and include diarrhea, which prevents the body's absorption of the nutrients in food.

Everyone in the food chain plays a role in food safety. Most of us eat foods grown and packaged many miles away, yet safe handling of food is as critical in the home as it is in a processing plant, retail store, or restaurant. The food preparer—in homes, restaurants, and institutions—has the final control over the safety of the food on the family table.

The consumer's role in food safety starts at the point of purchase and ends with the disposal of leftovers. By following these basic rules and handling food safely, most food-borne illness can be prevented.

Shopping

Food safety in the home actually starts at the grocery store.

Plan your purchases so that perishables (meat, poultry, seafood, and dairy products) are selected last. These foods should be refrigerated within 2 hours of purchase (1 hour in hot weather) so that food poisoning bacteria do not multiply.

Bag meat and poultry products to prevent juices from dripping onto other foods and keep them separated from other foods, especially foods that will not be cooked such as fruits and vegetables.

Buy packaged precooked foods only if packaging is sound, and buy products labeled "keep refrigerated" only if they are stored in a refrigerated case.

Storing Food

Proper storage of food prolongs its shelf-life and preserves nutrients as well as safety. Foods stored too long gradually spoil and also will lose nutritional value.

Make sure your refrigerator is kept clean and maintains a temperature no higher than 40°F.

Your frozen foods will maintain top flavor and nutritional value if the freezer is kept at 0°F or below.

Be sure to keep raw meat and poultry separate from other foods, especially those that will be eaten without further cooking. Poultry and ground meat will keep 1-2 days in the refrigerator; other meat items, 3-4 days.

Canned goods and other shelf-stable items should be stored in a cool, dry place. The temperature should stay above freezing and below 85°F.

Preparing Food

Cleanliness is the first critical step in safe food preparation. Wash hands thoroughly with soap and water before handling food. Wash hands, utensils, cutting boards, and work areas after handling raw products.

Frozen foods should never be thawed at room temperature. Instead, thaw them safely in the refrigerator. Thaw in the microwave only immediately before cooking.

It is essential that raw products of animal origin be cooked to an internal temperature of 160°F (180°F for poultry). Use a meat thermometer to check the temperature of meat and poultry. To check visually, juices should run clear and meat should not be pink.

Do not partially cook food. Have a constant heat source, and don't set the oven temperature under 325°F for cooking meat, poultry, seafood, or dairy-based foods. Microwave food in a covered dish and turn the dish frequently.

Serving Food

Food safety errors can be made during the serving and handling of cooked food.

When serving foods be sure to wash hands thoroughly with hot soapy water. Serve cooked products on clean plates and with clean utensils.

Foods should never sit at room temperature longer than 2 hours, 1 hour in hot weather. During serving, hot foods should be held above 140°F and cold foods should be kept cold.

Leftovers

When handling leftovers, cleanliness and temperature control are critical.

Wash hands before handling leftovers and use clean utensils and surfaces.

Refrigerate or freeze cooked leftovers in small, covered shallow containers within 2 hours after cooking. Leave airspace around containers in the refrigerator to ensure rapid, even cooling.

When reheating leftovers, cover and reheat thoroughly. Sauces, soups, and gravies should be heated to a rolling boil; all other products should be heated to 165°F.

Food spoilage bacteria will grow in the refrigerator, so discard any outdated foods. Most foods will remain safe in the refrigerator for about 4 days, but use highly perishable foods such as stuffing or gravy within 1-2 days.

When in doubt, throw it out!

Kids for Safe Microwaving:

• Read the package instructions carefully.
• Use only microwave-safe cookware.
• Turn food in the microwave during cooking.
• Use potholders to take items from the oven.
• Take covers off food or open packages away from the face.

Special tips for favorite foods:

Hotdogs: Pierce the skin before cooking.

Jelly donuts: Break open before eating. Let the jelly cool.

Popcorn: Let the bag sit for a minute or so. Hold bag away from face to open.

Food Safety for Children

Spend some time in a roomful of kids—no matter what their ages—and you're likely to emerge exhausted. Yet, food safety experts classify children as a group at high risk for foodborne illness! Safe food handling practices can prevent food poisoning among children.

Infants

Infants are at high risk for foodborne illness: even a small amount of food poisoning bacteria can cause a serious illness in an infant. Caregivers must keep scrupulously clean all items used in feeding an infant.

Frequent handwashing is essential. Cases of foodborne illness in infants have been linked to the lack of handwashing by caregivers after handling raw meat or poultry or changing diapers.

Never leave baby food or formula out for more than 2 hours. Discard any unused milk left in a bottle.

Do not feed a baby food directly from a jar—bacteria from baby's mouth may contaminate the food left in the jar.

Expressed breast milk can be stored in the refrigerator for 5 days, formula for 2 days, and whole milk for 5 days. Leftover homemade baby foods may be safely refrigerated for 1 to 2 days. Strained fruits and vegetables in jars will keep 2 to 3 days, meats and eggs one day, meat and vegetable combinations 1 to 2 days.

Toddlers

Toddlers are "grown up" enough to be eating table foods and drinking from a cup. Cleanliness in still essential. Remember to clean off those little hands!

Finger foods are popular with toddlers, but remember that meat and dairy products require refrigeration and should never be left at room temperature for more than 2 hours.

When traveling, choose shelf-stable snacks such as dry cereals, crackers, raisins or prunes, fruit pieces, or vegetable sticks. Avoid meat or cheese sticks unless you carry them in an insulated cooler.

E. coli Foodborne Illness Outbreak: A Devastating Case Study

In early 1993, reports of a major outbreak of foodborne illness due to a rare strain of E coli bacteria shocked the Nation. The outbreak was linked to undercooked hamburger patties purchased from a West Coast fast food chain.

Recognized as a pathogen in 1982, E. coli 0157:H7 has been associated with several food-borne illness outbreaks in recent years. A number of cases have been linked to undercooked ground beef and, to a lesser extent, impure water, unpasteurized milk, and low-acid apple cider.

Symptoms of E coli foodborne illness include severe abdominal cramps, followed by watery diarrhea that often becomes bloody. Victims may also suffer vomiting and nausea, accompanied by low- grade fever. In some persons, particularly children and the elderly, the infection can lead to severe complications, including kidney failure.

While E. coli 0157:H7 can cause serious illness, it can be controlled by thorough cooking. Consumers should cook ground meat and poultry until the meat is no longer pink and juices run clear. When ordering hamburgers in a restaurant, ask that they be served medium or well-done.

In the wake of the outbreak, USDA has embarked on a number of new initiatives at the farm, meat plant, supermarket, and consumer levels to protect the public. For example, USDA is sponsoring research aimed at keeping food animals from harboring the 0157 bacteria in their systems, which includes efforts to develop a vaccine against the illness. USDA is working on improving detection methods to keep the bacteria out of meat plants, and instituting more stringent time and temperature controls in meat processing plants. It is also working closely with State and local public health agencies to increase effectiveness in avoiding and containing outbreaks.

Another important initiative is to require that all raw and partially-cooked meat and poultry products carry safe handling instructions on the package label. These instructions will guide consumers to steps they can take to ensure proper sanitation, cooling, and cooking when preparing meat and poultry products.

Preschoolers

This is an ideal time to teach food safety principles to your children.

Teach them to wash their hands after using the toilet and before and after handling foods.

Explain why some of their favorite foods—milk, juice, cheese, eggs, and hot dogs—need to be refrigerated.

Caution children not to eat cookie dough or cake batter that contains raw eggs.

School-Age Children and Teens

The independent school-age child can quickly prepare his or her own breakfast or after-school snack. Make sure that food safety is on the menu!

Tell children to wash hands before preparing or eating food. Always use clean spoons, forks, and plates.

Don't place books or book bags on eating counters or the kitchen table.

Throw away leftover sandwiches or other "refrigerator type" foods left from lunchtime.

Do not leave perishable items at room temperature. Remind children to return them to the refrigerator as soon as they are finished with them.

Caution children not to eat bread, cheese, or soft fruits or vegetables that look bad or have even small spots of mold.

Microwave Safety Tips for Older Children

If you give your child permission to use the microwave, start by holding a Saturday morning training session. Only children who can read should be allowed to use the microwave.

Parents should know that severe burns can and do occur from improper microwave use. Special packaging for kids' favorite foods like popcorn, pizza, and french fries can get too hot for kids to handle. Steam from popcorn bags can burn the eyes, face, arms, and hands. Jelly donuts, pastries, hotdogs, and other foods can reach scalding temperatures in seconds.

Food Safety Tips

1. Keep it safe, refrigerate. Refrigerate foods you'll use quickly. Freeze raw meat or poultry you can't use in 1 or 2 days. Freezer should register 0°F; refrigerator, 40 °F.
2. Don't thaw food on the kitchen counter. Bacteria multiply rapidly at room temperature.
3. Wash hands before preparing food. Wash hands and utensils after contact with raw meat and poultry. Wash cutting boards or other work surfaces too. Bacteria, often present on raw foods, can spread to other foods if you don't.
4. Never leave perishable food out over 2 hours. This includes marinating. No need to bring foods to room temperature before cooking.
5. Thoroughly cook raw meat, poultry, and fish to at least 160°F internal temperature. Juices should run clear and meat should not be pink. Do not partially cook food. Have a constant heat source, and never set the oven under 325°F.
6. Promptly refrigerate or freeze leftovers. Divide large quantities into smaller containers for quick cooling. Reheat leftovers to at least 165°F.

Food Safety for At-Risk Individuals

Foodborne illness is a much more serious concern for some people than others. Today a growing number of people are vulnerable to severe and chronic foodborne diseases due to compromised (weakened) health status.

Food risks for health-compromised individuals result from depressed or weakened body defense (immune) systems that do not protect against microbial invasions well enough. Some diseases or health conditions cause dysfunctions of the immune system, while immunity can be immature in infants and waning in the elderly. Without adequate immune system protection, extensive and life-threatening diseases can occur from bacteria and viruses on mishandled foods. As a result, these people must practice special precautions when buying, handling, preparing and storing food.

Persons With Weakened Immune Systems

Immunocompromising conditions can be caused by genetic disorders, chemotherapy, surgery, medications, and infectious diseases. For example, in persons with the HIV infection that leads to AIDS, certain cells called the T-helpers—which would normally stimulate the body's defenses and limit the invasion of unwanted microbes—have been destroyed. As a result, persons with AIDS are 20 to 30 times more likely to acquire salmonella infections, and 300 times more likely to be infected by Listeria monocytogenes. In addition, this leads to chronic diarrhea, malabsorption of nutrients, and undesirable weight loss.

Chronically Ill People

Chronic diseases also can damage organ systems involved in the body's defense and increase the risk of foodborne infections. For example, a person with a diseased liver, the body's primary filtering organ, is more susceptible to blood and other tissue infections. Other chronic and compromising diseases include diabetes, nonalcoholic cirrhosis of the liver, and cancer. Reduction of stomach acid associated with aging or surgical procedures has also been associated with food-borne disease.

Infants and Children

An immune system that hasn't finished developing, small body mass, and increased exposure mean greater risk and severity of foodborne disease for infants and children.

Infants have little natural immunity when born. In addition, premature babies may not even receive normal maternal protection through nursing, increasing their vulnerability to infection.

Older children are exposed to high rates of illness in schools and daycare facilities. There is less control of personal hygiene and more chance of spreading infections. Proven practices that limit the spread of foodborne illness in schools include monitoring hand-washing by both staff and children and discouraging children from bringing home-cooked meals to school.

The Elderly

The elderly make up an increasingly large portion of the population, with many persons suffering from chronic and immunocompromising diseases. Studies show that as people age, their protective immune systems weaken. Medications and treatments, such as diuretics, antacids, and chemotherapy, can further limit resistance to food-borne infection. These high-risk factors can result in serious problems when the elderly eat foods with disease-causing bacteria or viruses. For example, Salmonellosis from improperly handled foods has caused severe illness and even death in elderly consumers.

Food Handling Recommendations for Persons at Risk

The rules for safe food handling are especially important for at-risk individuals. Some deserve extra emphasis for those with special needs, and a few additional precautions are recommended for avoiding listeriosis.

• Never eat raw meat, poultry, or seafood, such as steak tartare or raw oysters or clams. In fact, meat, poultry, and fish should be well-cooked for persons at risk.
• Avoid foods with raw or undercooked eggs.
• Food should be served piping hot; if it's not, it should be sent back for further heating.

Avoiding Listeriosis

Pregnant women, the elderly, the very young, those with immune-compromising conditions, and those preparing foods for these individuals can decrease risk by:

Avoiding raw or unpasteurized milk.

Avoiding soft cheeses such as Mexican style, feta, Brie, Camembert, and blue cheese. There is no need to avoid refrigerated hard cheese, processed slices, cottage cheese, or yogurt.

Reheating leftover foods or ready-to-eat foods such as hot dogs thoroughly until steaming hot before eating.

Although the risk with deli foods is low, persons may choose to avoid these foods or thoroughly reheat cold cuts before eating.

The Interesting Case of Listeria Monocytogenes

Listeriosis is a rare but potentially fatal disease for those at risk. Persons over 60 years old and newborns have the highest incidence. The Listeria bacteria rarely causes illness in healthy people, but pregnant women are at risk for listeriosis, because of risk to the fetus. Listeria monocytogenes bacteria can grow—very slowly—at refrigerator temperatures on foods, and illnesses have been linked with ethnic soft cheeses, raw chicken, deli-prepared luncheon meats, and salads.

Symptoms vary and depend on the individual's susceptibility. Symptoms may be limited to fever, fatigue, nausea, vomiting, add diarrhea. More serious forms can result in brain infection and blood poisoning.

Where to Go for Food Safety Information

The Meat and Poultry Hotline

USDA's Food Safety and Inspection Service operates a toll-free hotline to answer questions about food safety and nutrition. The Hotline, staffed by home economists and registered dietitians, handled 100,000 calls in 1992. Callers can also hear food safety information by using the Hotline's Food Safety Information System, a series of recorded messages that can be accessed with touch-tone telephones. Over 50 food safety and nutrition messages are available 24 hours a day.

USDA offers and promotes food safety education. The Hotline staff works closely with the USDA Extension Service and other groups to advance this mission.

While many of today's consumers are extremely knowledgeable, people are routinely exposed to a tremendous amount of nutrition and food safety misinformation. By combining food safety advice with nutrition information, the Hotline has proved a boon for callers. The complexity of today's food marketplace and the ever-increasing number of new foods on the market has compelled more consumers to call the Hotline than ever before. A consumer calling about the safety of a meat or other product stored in his or her refrigerator can now find out how it fits into a balanced diet.

The Hotline can be reached at:
1-800-535-4555
In the local Washington, DC, area:
(202) 720-3333
FSIS Public Awareness Office:
(202) 690-0351

The Cooperative Extension System

Nutrition and food safety educational programs have been a cornerstone of the Cooperative Extension System (CES), a partnership of the Extension Service-USDA with State and county educators. The CES links the education and research resources and activities of the USDA, 74 Land-Grant Universities, and almost 3,150 county administrative units. The CES has an ongoing Food Safety and Quality national initiative which has resulted in a variety of program approaches to producing and maintaining a safe, wholesome food supply. You can also contact your local Cooperative Extension Service office for information and educational programs about the safe handling of food. Consult local government listings for the office nearest you.