George has been living alone since his wife recently passed. She did all the cooking, so George’s culinary skills are limited to reheating food on the stove or in the microwave. His daughter June worried about her 81-year-old dad having enough to eat, so she always brought him heat-and-eat meals when she visited. June arranged for weekly grocery delivery and encouraged her dad to order takeout food several times a week. June worked in a hospital kitchen and was well trained in food safety. Recently, while visiting her dad in his home, she observed numerous food safety concerns as George reheated his foods. George has had a few mild “stomach bugs” recently, and June was concerned that he might have had foodborne illnesses.
The Centers for Disease Control and Prevention estimates that, each year, 48 million people get sick from a foodborne illness, 128,000 are hospitalized, and 3,000 die. High-risk foods are defined by the FDA’s 2017 Food Code as those that require “time/temperature control for safety (TCS) to limit pathogenic microorganism growth or toxin formation.” The list of TCS foods is extensive and includes but isn’t limited to raw or heat-treated animal foods, cut melons, and leafy greens. Most foodborne illnesses are caused by bacteria, but viruses and parasites also can be the culprits. In 2016, the most common confirmed cases of foodborne illness were caused by norovirus and Salmonella. Symptoms of foodborne illness vary depending on the origin of the illness, but nausea, vomiting, stomach cramps, and diarrhea are common.
Preventing foodborne illness is important for everyone, but especially for older adults, whose aging immune systems and/or comorbidities may result in more severe consequences than those seen in a younger, healthier person. Because they’re more vulnerable physically, older adults are more likely to die from bacterial gastroenteritis than the general population. Factors that could contribute to foodborne illness in older adults include lack of awareness of the risks of unsafe food handling or an aging sense of vision, smell, or taste that could prevent older adults from recognizing food spoilage. In addition, aging can result in changes in an individual’s ability to perform instrumental activities of daily living or activities of daily living, both of which could affect their ability to follow basic food safety guidelines during food shopping, storage, or preparation.
Taking the following steps during food preparation is key to preventing foodborne illness:
- Clean: Always wash fruits and vegetables (but not meat, poultry, or eggs), hands, counters, and cooking utensils.
- Separate: Keep meat, poultry, and seafood separate from other foods during food shopping, storage, and preparation.
- Cook: Heat foods to proper temperatures, as recommended by the USDA.
- Chill: Refrigerate and freeze foods promptly and correctly.
Although the steps are simple, their nuances can be complicated for a food safety rookie. More details on each step are available here.
A few basic guidelines can help George keep his convenience and delivered foods safe. Microwave meals always should be cooked according to package directions. If hot food is delivered, a general guideline is to eat it within two hours. If it isn’t consumed within a couple of hours, it’s best to refrigerate it for later consumption and reheat to 165° F before eating it.
If food is delivered cold (for example, grocery store home delivery of perishable items), it should be eaten or refrigerated at 40° F or colder) immediately. If left out for more than two hours, it should be discarded. If the ambient temperature is above 90° F (for example, a picnic in a hot climate), food should be discarded within one hour.
June realized that George had much to learn about food safety. She located some food safety videos that she and her dad could watch together, bought him a food thermometer, and helped him practice taking food temperatures. Most importantly, she continues to keep an eye out for food safety issues at each visit with her dad.
Becky Dorner & Associates offers several continuing professional education courses on food safety including one based on the 2017 Food Code. For more information, visit www.beckydorner.com/product/food-code-2017-course.
— Becky Dorner, RDN, LD, FAND, is widely known as one of the nation’s leading experts on nutrition and long term health care. Her company, Becky Dorner & Associates, Inc, is a trusted source of valuable continuing education, nutrition resources, and creative solutions. Visit www.beckydorner.com to sign up for free news and information.