Virginia N. Hillers

Food safety education: what should we be teaching to consumers?

Food safety education is most effective when messages are targeted toward changing behaviors most likely to result in foodborne illness. The five major control factors for pathogens are personal hygiene, adequate cooking, avoiding cross-contamination, keeping food at safe temperatures, and avoiding foods from unsafe sources. Pathogens associated with poor personal hygiene have the highest incidence and costs. Inadequate cooking and cross-contamination have lower incidence. Keeping food at safe temperatures and unsafe food sources have the lowest incidence, although costs per case are sometimes very high. We recommend that consumer food safety educators primarily focus on hand washing, adequate cooking, and avoiding cross-contamination. Secondary messages should focus on keeping food at safe temperatures and avoiding food from an unsafe source. Evaluation tools are needed to evaluate self-reported behavior changes. The evaluation questions must focus on salient behaviors that are most likely to result in foodborne illnesses and must withstand rigorous standards of reliability and validity.

Influences of pesticide residue and environmental concerns on organic food preference among food cooperative members and non-members in Washington State

Abstract Although consumers express concerns about the health effects of pesticide residues, consumption of organic food is minimal. A survey was conducted to investigate the role of concerns about the health and environmental effects of pesticides on consumer preference for organically produced food, and the implications for nutrition educators and the organic food market. Members of a food cooperative that stocks organic foods and residents from the same geographical region were randomly selected to receive a mail questionnaire. Compared to the general population, members of the food cooperative had stronger attitudes and concerns about food and environmental issues, and a higher preference for and more frequent consumption of organic food. Pesticide residue concern was highly correlated with the food-related environmental concern variables and was a significant explanatory variable for organic food preference in both groups. However, environmental concerns were not significant explanatory variables for either group. In both study groups, a positive attitude toward cooking and shopping was correlated with food-related environmental concerns and was a significant explanatory variable for organic food preference. The results support the hypothesis that concern about pesticide residues is a significant factor in preference for organic food. However, the connections between food choices and environmental effects are unclear to many consumers.

Benefits and barriers to fruit and vegetable intake: relationship between attitudes and consumption

Abstract Consumption of fruits and vegetables is suggested to be beneficial in cancer prevention. However, surveys indicate that a large percentage of the population does not consume the recommended intake of fruits and vegetables. A mail survey was conducted in 1990 to examine attitudes toward nutrition and reported fruit and vegetable intake among randomly sampled Washington state residents (n = 1069; age range = 20–88 years). Individuals in low-income and low-education categories and males had significantly higher scores measuring barriers to fruit and vegetable intake compared to the highest income and education groups or females. All respondents had high nutrition concern despite income or education level. Nutrition behavior scores were significantly higher for individuals with high income. Results of the multiple regression analysis indicated that 16% of the variance in fruit and vegetable intake was accounted for by attitude variables. Barriers to fruit and vegetable intake were the largest component of variability in actual fruit and vegetable consumption. Results suggest a relationship between attitudes about barriers to fruit and vegetable intake and nutrition behaviors. Additionally, males and individuals with limited education and lower income may benefit from education directed toward reducing barriers to fruit and vegetable intake.

Evaluation of Food Safety Education for Consumers

Traditionally, nutrition educators have used a fairly global approach to teach food safety by teaching a broad range of safe food handling behaviors in the expectation that this will lead to the avoidance of foodborne illness. This approach can be confusing and lead to evaluation data that are difficult to interpret. This article suggests that food safety education and evaluation in the future be organized around five behavioral constructs: practice personal hygiene, cook foods adequately, avoid cross-contamination, keep foods at safe temperatures, and avoid food from unsafe sources. These five constructs are derived from data on actual outbreaks and estimated incidences of foodborne illness. Research is needed to establish reliable and valid evaluation measures for these five behavioral constructs. Evaluation instruments can be tailored to fit specific education programs. If evaluation instruments focus on these five behavior areas, the result will be meaningful evaluation data that can be more easily summarized across food safety education programs for consumers.

Observation versus self-report: validation of a consumer food behavior questionnaire

A reliable and validated set of food safety behavior questions that could be used with confidence when evaluating food safety education programs was identified in this study. A list of 29 food-handling and consumption behaviors rank-ordered within five pathogen control factors by nationally recognized food safety experts was the basis for the development of the behavior questions. Questions were evaluated for reliability and several forms of validity. During a kitchen activity session, 70 graduates of a nutrition education program completed four food preparation tasks while being observed and videotaped. The individuals also participated in an in-depth interview to validate behaviors that could not be observed during the food preparation activity, e.g., refraining from preparing food for others when experiencing diarrhea. Criterion validity was established by comparing questionnaire responses to observed behavior and interview responses. Twenty-eight questions met the validity criterion (> or = 70% agreement between observed and interviewed responses and self-reported responses), with three or more questions from each of five pathogen control factor areas. Observation assessments revealed that hand washing was more likely to be performed prior to beginning food preparation than between working with raw meats and fresh produce. Errors in methods of washing hands, utensils, and preparation surfaces between food preparation tasks were common. Most participants did not use thermometers to evaluate doneness but still cooked to safe internal temperatures. The results provide a tool that educators can use to evaluate food safety programs and will help guide the development of more effective food safety education programs targeting needed improvements in behavioral skills.

Consumer food-handling behaviors associated with prevention of 13 foodborne illnesses.

To be effective in reducing the incidence of foodborne illness, consumers and food safety educators need information about behaviors that will decrease exposure to foodborne pathogens. A four-round Delphi technique was used to survey nationally recognized experts in food microbiology, epidemiology, food safety education, and food safety policy with the aim of identifying and ranking food-handling and consumption behaviors associated with 13 major foodborne pathogens. The food safety experts ranked behaviors related to keeping foods at safe temperatures as of primary importance in preventing illness caused by Bacillus cereus and Clostridium perfringens and of secondary importance in preventing illness caused by Staphylococcus aureus. The use of a thermometer to cook foods adequately was ranked as of primary importance for the prevention of illness caused by Campylobacter jejuni, Salmonella species, Escherichia coli O157:H7, Toxoplasma gondii, and Yersinia enterocolitica, with the avoidance of cross-contamination being ranked as of secondary importance for most of these pathogens. Hand washing was the top-ranked behavior for the prevention of shigellosis. The avoidance of certain foods that are likely to be contaminated was the top-ranked behavior for the prevention of illnesses caused by Listeria monocytogenes, Noroviruses, and Vibrio species. The expert panels ranking of behaviors for the reduction of the risk of illness caused by major foodborne pathogens can enable consumers to make informed choices about food consumption and handling behaviors and can guide food safety educators in prioritizing their educational efforts.

Identification and Classification of Consumer Food-Handling Behaviors for Food Safety Education

OBJECTIVE To identify key behaviors associated with major food safety pathogen control factors. DESIGN World Wide Web-based descriptive study with 4 tasks: compile a list of food-handling behaviors from the literature; use Delphi process to build consensus, rank order, and edit lists of behaviors; assess content and construct validity; and review results of Delphi process at a summit meeting of selected experts to make final recommendations for a food safety behavior list. SUBJECTS/SETTING A convenience sample of 10 epidemiologists, 11 food microbiologists, 10 food safety educators, and 10 food safety policy makers was recruited from lists of nationally known experts. Twenty-four experts completed 4 rounds of surveys presented to them via a Web site. Six experts attended a face-to-face meeting to finalize behavior lists. Statistical analyses performed Descriptive statistics and sum of observation data were used to determine rank order and validity. RESULTS Twenty-nine key food-handling behaviors for maintaining the safety of food and reducing the number of cases and outbreaks of foodborne illness were identified. These were rank-ordered within 5 pathogen control factors: practice personal hygiene, cook foods adequately, avoid cross-contamination, keep foods at safe temperatures, and avoid foods from unsafe sources. APPLICATIONS/CONCLUSIONS This list of rank-ordered behaviors grouped by pathogen control factor should help dietitians and educators confidently teach food safety guidance that will be most effective in preventing illness.

Evaluation of consumer-style cooking methods for reduction of Escherichia coli O157:H7 in ground beef.

The objective of this study was to evaluate the thermal inactivation of Escherichia coli O157:H7 in ground beef cooked to an internal temperature of 71.1 degrees C (160 degrees F) under conditions simulating consumer-style cooking methods. To compare a double-sided grill (DSG) with a single-sided grill (SSG), two different cooking methods were used for the SSG: for the one-turnover (OT-SSG) method, a patty was turned once when the internal temperature reached 40 degrees C, and for the multiturnover (MT-SSG) method, a patty was turned every 30 s. Patties (100 g, n = 9) inoculated with a five-strain mixture of E. coli O157: H7 at a concentration of 10(7) CFU/g were cooked until all three temperature readings (for two sides and the center) for a patty were 71.1 degrees C. The surviving E. coli O157:H7 cells were enumerated on sorbitol MacConkey (SMAC) agar and on phenol red agar base with 1% sorbitol (SPRAB). The order of the cooking methods with regard to the cooking time required for the patty to reach 71.1 degrees C was as follows: DSG (2.7 min) < MT-SSG (6.6 min) < OT-SSG (10.9 min). The more rapid, higher-temperature cooking method was more effective (P < 0.01) in destroying E. coli O157:H7 in ground beef. E. coli O157:H7 reduction levels were clearly differentiated among treatments as follows: OT-SSG (4.7 log10 CFU/g) < MT-SSG (5.6 log10 CFU/g) < DSG (6.9 log10 CFU/g). Significantly larger numbers of E. coil O157:H7 were observed on SPRAB than on SMAC agar. To confirm the safety of ground beef cooked to 71.1 degrees C, additional patties (100 g, n = 9) inoculated with lower concentrations of E. coli O157:H7 (10(3) to 10(4) CFU/g) were tested. The ground beef cooked by the OT-SSG method resulted in two (22%) of nine samples testing positive after enrichment, whereas no E. coli O157:H7 was found for samples cooked by the MT-SSG and DSG methods. Our findings suggest that consumers should be advised to either cook ground beef patties in a grill that cooks the top and the bottom of the patty at the same time or turn patties frequently (every 30 s) when cooking on a grill that cooks on only one side.

Use of Nonvitamin, Nonmineral Dietary Supplements Among College Students

Abstract The authors assessed the use of nonvitamin, nonmineral (NVNM) dietary supplements in a college population. They found that the use of NVNM dietary supplements among college students might be higher than that of other population groups and that the types of NVNM products they use differ from those used by an older population. Of the 272 students who completed the questionnaire, 48.5% reported they took an NVNM supplement during the past 12 months. The most frequently used NVNM products were echinacea, ginseng, and St Johns wort. Of the 27 students who took NVNM products to promote weight loss. 81.5% had body mass index (BMI) values in the acceptable range. Eleven of the 19 participants who reported an adverse reaction to an NVNM supplement continued to take the products despite negative effects. Users and nonusers of NVNM supplements did not differ significantly by age, ethnicity, gender, perceived dietary adequacy, or by exercise patterns.

Attitudes and behaviors about pesticide residues, susceptibility to cancer, and consumption of fruits and vegetables

Abstract Nutrition educators are encouraging increased consumption of fruits and vegetables as a source of fiber, nutrients and anti-carcinogens. However, media messages about the health effects of pesticide residues have created fear about consuming fresh produce. A survey was sent to 2,000 Washington state residents to assess attitudes and behaviors related to concern about pesticide residues, perceived susceptibility to cancer, and consumption of fruits and vegetables. The survey included questions that were developed to assess each of the attitude and behavior variables. Multiple regression analysis indicated that 41% of the residue-reducing behavior and 44% of the health concern about pesticides was explained by the variables. Individuals with health concerns regarding pesticides had higher scores for residue-reducing behaviors, environmental concern, and perceived susceptibility to cancer. Respondents with low concerns about pesticides had a higher trust in regulation and saw greater benefits for pesticide use. Concerns beyond personal health, such as environmental concern, appear to contribute to concerns about pesticide residues. Fear of pesticide residues does not appear to diminish nutrition behaviors related to fruit and vegetable consumption.