Health reports keep coming along down the wires telling us about yet another fine fast food dining establishment killing children by serving up burgers rife with E.coli. Why children? Because their immune systems simply aren’t strong enough to fight this intruder. How is your immune system; and can it ward off E.coli? Do not try this at home! Why burgers? Stay tuned -- the answer will appear.

In other news, I recently read that cultures of movie theater seats revealed that they were swarming with E.coli -- all 100% of the seats. How many readers, do you imagine, have sat on those seats and eaten popcorn at the movies? What this can mean in real life, is that we have to start watching out for the small stuff in order to protect our bodies from this germ.

So, Modern Food Safety is the name of this not-so-funny article, but it’s about life: Quality of life and length of life; where can we get caught, and how we can survive!

Once Upon a Pasture

When animals are prepared for sale, external meat surfaces are exposed to intestinal contents, where E. coli lives. Does this mean that we shouldn’t eat meat? Don’t jump to hasty conclusions -- there are ways to defeat it’s omnipresence. For beef and other red meat, only the outside surfaces of a steak or roast have been exposed to bacteria. Remember the three-word food safety fight song: "Heat Kills Germs, tra la". We can take comfort in eating a steak, even if it does have a little line of pink running along the inside (call this medium-well in a restaurant), because the surfaces have gotten hot enough to kill off the e.coli, its cousins, and other germ strains

However, if you want a burger, you have to grind the whole chunk of meat up, which exposes all parts of the meat to the surface-resident E.coli. That’s why hamburgers are sometimes killers. The point is, If there is any pink, or any hint of the burger not being well heated enough, we must say no. This advice is as applicable to HIV-Negatives as well as Positives -- but the Negative will have diarrhea for a couple of days; the Positive could have the diarrhea for a very uncomfortably long time. Suggested Burger Behavior is as follows: Bite the burger, don’t chew. Look at it to see if there is any pink in the meat patty itself, and not until all tests are passed (use your glasses), chew your bite and enjoy the meal.

I was once with one of the nudgiest food safety people I've ever met -- he wouldn’t even allow parsley or other garnishes on his plate. At a really nice (expensive) restaurant, he ordered a fabulous burger well-done, took a bite, chewed and swallowed. Then he noticed the insides were totally pink! And then he asked me if he should send it back. I’m sure you can guess what my answer was. He was lucky; he didn’t develop a full-blown E.coli disease. But, because he did eat that one bite, he well could have! Had he downed the whole burger, well, there's a good chance I would have gone to visit him at the hospital. View before you chew! Diarrhea is so unpleasant.

Cooked poultry should be very tender with no trace of pink in the white meat, and fish must be flaky -- no runny or mushy flesh. Of course, raw fish (including sushi, oysters, cebiche, undercooked shrimp/lobster, raw clams, etc.), is always a risk. I’m often asked about smoked meat products. Since I’m not sure, I say no, not unless it was cooked well before it was smoked. It’s far better to avoid these uncertainties than to go to the hospital because you trusted what was unsure. Get special-tasting mesquite grilled steaks instead -- it’s a compromise, but it won’t make you sick.

Raw food facts, especially Sushi, were discussed when I gave the food safety portion of a nutrition education group I was teaching -- on a Tuesday night. The following Friday, a group member went for Sushi with her husband and another couple. The men had raw fish and the women, aware of my advice, made safer food choices. Both men were in the hospital by midnight. Neither was Positive. The women (naturally) were just fine and healthy enough to nurse their men back to health.

Egg protein is the so-called "gold standard" for measuring protein value. Eggs, however, represent a significant safety hazard. They are routinely exposed to salmonella, another AIDS-defining opportunist. We must expect that raw eggs have active salmonella.

Well cooked eggs are quite safe. Soft yolks and runny whites are out! Other egg risks include Caesar salad dressing, homemade egg nog, puddings, custards, hollandaise and bearnaise sauces, and some meringues. Egg substitutes are safe because the egg whites they contain have been pasteurized. Pasteurization uses the heat technique.

Like the whites in fake eggs, pasteurized milk products are the only safe ones. Avoid "raw" dairy products including cheeses and butter. Also avoid unpasteurized milk from non-cows, like goat milk. Cheeses can also be risky...read on.

I’ll always remember my mother just peeling the mold off of a hunk of cheese going bad, and eating it! Ugh! is still how I feel about that behavior, but if she did it, maybe other readers had mothers that did it too, even perhaps continue doing it -- after all, it was Mom. Stop. Ms. Food Safety says NO. If it’s already going bad, i.e., rotting, spend the extra drachma and get a new slab of cheese. By the way, cheese can be kept in the freezer very safely, allowing us to buy sale slabs or large bags of shredded cheese and still enjoy the convenience of having it around -- rather than having to go get it. Other cheese concerns: I have to issue a NEVER (and I don't like to issues NEVERs) on soft and/or moldy varieties such as Brie, Camembert, Bleu and Roquefort. Don’t eat moldy food.

Supermarket Behavior

Reports of germ-laden burgers and meats are enough to inspire vegetarianism, but if you still eat meat, fish or poultry, remember that they have juices that drip! The evil juices exuding from flimsy meat wrappers are always a risk for cross-contaminating other foods. Wrap the meat in a plastic bag or two before putting it in your cart -- put it on the bottom so as not to get unhealthy juices on vulnerable foods like fresh fruits and vegetables.

Other supermarket cautions include checking the "sell-by" date. Canned meat, fish and poultry products are OK because the canning process uses high heat and heat kills germs -- they are safe. Look at your canned foods, while most dents are OK, any bulges may signal killers like botulism. As the microbes flourish, they increase the volume held in the can -- this causes the bulge. Even persons with totally competent immune systems need to avoid bulging cans.

In the kitchen, after shopping, refrigerate perishables as quickly as possible. Wash/scrub produce ASAP. Use a stiff brush and/or a teflon scrubbie. When possible, peel produce. You'll not only lose the germs, you'll also avoid the fiber from skins of veggies and fruits that can often make diarrhea worse if you’re unlucky enough to have it.

Example: All green-leafy veggies are difficult to wash thoroughly. Since there is almost no nutrient value in lettuce, even Romaine, and it has very few calories but lots of diarrhea-causing fiber, it's wise to avoid salads. Spinach greens are especially hard to clean well, and again, they contain that fiber to give you a good case of diarrhea, or make the case you might already have much worse! If you want green power, go to the collard greens. They are big, flat leaves that wash easily, are delicious when cooked, and offer a more broad nutrient delivery than practically any other green. Again, be sure to not let meat droplets contaminate your produce.

Cutting Board Update

Long-ago cutting-board advisories called for plastic (rather than wood) cutting boards, but, based on 1993 research, a warning was issued that plastic is probably worse than wood - it seems to hang onto bacteria more aggressively! But later on, it was revealed that actually the plastic was better as long as it is well cleaned. I’d recommend marble, but I’m not even sure if we can trust it. But Nutrition Power has a great cutting board substitution trick: Buy a stack of those really really cheap paper plates to use for cutting surfaces. The plates are disposable, so you can't get into trouble unless you re-use them. Change plates (and even knives) between foods to avoid cross-contamination. Clean-up was never easier!

As tedious as it may be, adequate food safety even extends to defrosting frozen foods. Room temperature is the most pleasant environment for bacteria. Since frozen foods thaw unevenly, by the time the insides are defrosted, the outsides may be thriving with microbial growth. Safely defrost frozen food in the fridge or microwave. If you're in a hurry, run cold water over the food to be defrosted -- but avoid standing water where microbes could be doing a back-stroke into deep crevices of foods.

Freezing doesn't kill bacteria, they just stop multiplying. (Betcha didn't know that...unless you signed up for one of those cryogenic firms so you could thaw out in some future millenium). Once warm, the bugs start reproducing again; two for one, all day, every day. Cook all foods to an internal temperature -- the deepest part of the food -- of at least 165 degrees F. Use of a meat thermometer is a truly inspired idea, and I wish I'd thought of it -- but this particular advice came from the CDC (Centers for Disease Control). It's far better to invest in a thermometer than to spend a month in the hospital because you didn't.

Pretend you're on a visit to the Third World. If you're not sure about any food, ask. If your food seems undercooked, send it back. You may have to wait 5 or 10 minutes, but preventing avoidable opportunists is such a splendid idea, it’s worth the wait! And now here’s a new twist on the food safety nudge I mentioned earlier. Suppose you go to the movies, and don’t eat the popcorn because diarrhea is happening -- you’ll eat out later. You may have touched the E.coli-tainted seat rendering your hands infectious.

Later, at the restaurant, you pick up the menu that many other movie-goers have held; it has to be contaminated with E.coli, and your hands get riskier and riskier. Then you order your meal, and a fabulous basket of warm, homemade bread comes along. Naturally, you reach for a piece -- with a little butter or olive oil, you’ll be in food-pleasure heaven -- but we skipped a step or two. Your high-risk hands have to be dealt with to avoid getting an E.coli attack. One method is to get out the wet wipes you always have with you and thoroughly cleanse your hands, removing the movie seat, menu, and table-borne E.coli from them, or at least disturbing it.

And of course, washing your hands, with soap, and hot water, is always a good idea. Just don't re-contaminate them by touching the doorknob on the restroom door when you leave. Figure another way to get out.

Here's a convenient, newly invented safety step. There are now products that disinfect with almost no trouble. I use a product called Purell. It’s an instant sanitizer against E.coli and many other infectious bugs. It comes in convenient sizes, from purse/pocket size to pump dispenser-size. After rubbing a quantity on your hands, somehow the hands get dry again, and now they’ve been wet-wiped and sanitized, and thanks, I’ll enjoy my bread now. Call GOJO Industries, makers of Purell at toll-free (888) 478-7355, or check their web site: nogerms@voyager.gojo.com.

If you had no HIV to concern yourself with, this behavioral technique wouldn’t be so important. The Negative stomach has lots of natural stomach acid -- so much that germs ingested are instantly killed -- like heat, acid also kills germs. But sadly, Positive stomachs usually lack sufficient acid to kill off the germs you might deliver to it which would then allow that microbe to travel down the intestinal tract and promote the E.coli-related diarrhea you didn’t want to get.

Back at the restaurant, a few more cautions. The first is closely related to the theater-seat E.coli transmission. There’s a rag that is used to wipe down tables. Can you, in your wildest imagination, believe in your heart of hearts that a new, clean one is used for each table? Since I was a waitress many lifetimes ago, I’ll let you in on a little secret: The same rag is used over and over -- not necessarily even being changed from one day to another, and definitely not cleaned or even rinsed out with tap water in-between tables. This was back when there were still ashtrays on tables -- and yup, these were scrubbed out with that same bar rag. Now, are you sure you want to get hands-on with the table?

I have to mention salad bars. They’re everywhere -- even supermarket. The servings look so fresh and healthy, don’t they? Don’t. There is absolutely no way of knowing what is in those containers. We weren’t behind the closed doors in the kitchen where the serving dishes were filled. What if the person doing the filling just came back from the movies? And didn’t use gloves?? Who was there before you and did they use the appropriate retrieval utensils provided? Did they sneeze? Cough? Do you really want to know? The point is that you can’t know and that’s my advice -- when in doubt -- don’t! It simply isn’t worth the risk. Order from the menu.

When traveling, we’re at particular risk for food-borne infection. Observe all of the safety warnings you've ever heard, plus as many other neurotic behaviors as you can think up for yourself. Here’s an airplane hint: Probably, the food served on the plane is sufficiently awful that not eating it should be no problem. But if you're so hungry you're willing to tolerate the faulty taste, eat only the HOT foods served -- they've been well heated, and thus, germ-free. All together now... What's the Modern Food Safety fight song?

HEAT KILLS GERMS! (And dont't forget the "tra la" at the end...makes all the difference!)

_______________________________________

First do no harm. If any of this advice is, or seems to be, connected with adverse health consequences, contact your doctor, your nutritionist, or both.

_______________________________________

Nutrition Power is a Registered Trademark of Health and Nutrition Awareness. Copyright 1997 Jennifer Jensen, MS, MBA, RD.

All Rights Reserved.

Other versions of this article have appeared with permission in Being Alive Newsletter, Arts & Understanding Magazine,and other newsletters.