July 18, 2000 (Atlanta) -- Raw milk, runny eggs, and undercooked meat: For years, Americans have been getting pummeled with messages about the danger of eating these things. But a new survey finds many are doing it anyway -- particularly, and most distressingly, people with weakened immune systems who are at most risk of getting sick from such foods.
The seven-state survey was presented at a conference on infectious diseases here this week. The researchers called households in California, Connecticut, Georgia, Maryland, Minnesota, New York, and Oregon -- and asked whether any of 10 "risky" foods had been eaten in the preceding week. They included undercooked or "pink" chicken, turkey, burgers or ground pork; raw fish or shellfish; raw milk; runny eggs; alfalfa sprouts; and unpasteurized apple juice or cider.
More than 10,000 people were questioned, and close to 40% said they had eaten at least one of the risky foods. The risky food most likely eaten: runny eggs. Least likely was pink ground pork.
The researchers found that the most likely profile for a risky eater was a young adult male; almost 40% of those between 18 and 44 confessed they had eaten at least one of the forbidden foods. Among those 65 and up, that number dropped to just over 30%.
But it's the figures within the figures that caught the researchers' eyes. For reasons unknown, people with weakened immune systems -- those with AIDS, for example, or taking drugs that affect the immune system -- were found more likely to eat risky foods, whether young or old. The problem is, food poisonings can be extremely severe in those with weakened immune systems.
The survey's findings are no surprise to Menna Marcano, a registered dietician with Atlanta's Project Open Hand, which provides nutritional support to people with AIDS. "Unless they get some nutrition education, they don't know," she says. "In Atlanta, there are only two HIV dieticians, so there's not a lot of information going out to this large population. So this doesn't surprise me." Marcano suggests that at the very least, patients with weak immune systems, or immunocompromised, should be taught to cook food properly: meat to 165 degrees, chicken to 185 degrees.
"In so far as it represents a general truth about people not getting the message, it's a problem. They should be getting the message," says Richard Levinson, MD, DPA, associate executive director of the American Public Health Association. "Runny eggs and red meat -- especially in an immunocompromised patient, but for all of us -- are risky. And people need to be aware of how they cook their food."
Then again, it may be that people have gotten the message but are using their own method to assess risk, says psychologist Baruch Fischoff, PhD, who researches decision-making at Carnegie-Mellon University in Pittsburgh. "People hear about lots of things that may be risky," he says. "But they try to figure out how big is the risk. Then, people fall back on their experiences. So if you've never seen it ... that's information there, though that's only a limited kind of information." Fischoff suspects that when it comes to some risky foods, people may not go very far in considering the consequences for a simple reason: They want to eat them.
A risky food that's getting a lot of attention at this meeting is sprouts. One California survey of sprout food poisoning outbreaks concludes there's no reliable way to protect the public from the bacteria that can get on sprouts -- usually Salmonella or E. coli. Not that sprout farmers aren't trying. Many now pretreat sprout seeds with an antibacterial solution. But a Wisconsin study found an outbreak occurred even with this prevention method. Another study from Oregon suggested pretreatment of seeds might help, but perhaps not much.
The president of the International Sprout Growers Association says while there may have been problems with sprouts, the industry isn't getting credit for trying to make its product safe. "If we get through this, all the negativity, we're going to start educating the public about how great sprouts are for you," says Al Sullivan. "It's been real tough for the sprout industry. Somebody needs to look at what we've done and give us a pat on the back. I assure you, we're doing everything we possibly can to bring closure to this problem." Sullivan says that with the increased use of seed disinfectant and microbiological testing, he sees a day when sprouts will be the safest item in the produce section.