Deep Dive: Summer Food Safety

It’s prime season for barbecues, picnics, and al fresco dining! We teach patients to build balanced plates, but it’s just as important to keep food safety in mind. Warm weather can create the perfect conditions for growing bacteria, increasing the risk of foodborne illness. In today’s newsletter, we’re diving into simple, evidence-based tips to keep outdoor gatherings safe and enjoyable. 

What is foodborne illness?

Foodborne illness is just what it sounds like: an illness caused by food, mainly due to biological contaminants like bacteria, viruses, and parasites. Two key points to remember: it is common (USDA estimates 48 million illnesses and 3,000 deaths each year), and it is almost always preventable. 

Top Culprits of Foodborne Illness

Norovirus 

• Responsible for 56% of foodborne illnesses, 42% of related hospitalizations, and 26% of related deaths
• Common in: leafy greens, fresh fruits (like berries), shellfish (especially oysters), and ready-to-eat foods touched by infected handlers
• Avoid by: thorough handwashing with soap and water, cleaning fruits and veggies, avoiding raw or undercooked shellfish

Campylobacter

• Responsible for 19% of foodborne illnesses, 24% of related hospitalizations, 8% of related deaths
• Common in: raw or undercooked poultry, raw milk, untreated drinking water, fresh, uncooked produce
• Avoid by: cooking poultry to an internal temp of 165F, thoroughly washing kitchen tools that touch raw poultry, never reusing marinades, only drinking treated water and pasteurized milk

Salmonella (nontyphoidal)

•  Responsible for 13% of foodborne illnesses, 23% of related hospitalizations, 26% of related deaths
• Common in: raw or undercooked poultry, eggs, and meat, raw milk, raw produce and juice, nuts and nut butters
• Avoid by: cooking eggs and meats thoroughly, saying no to raw dough or batter, only drinking pasteurized milk, washing fruits and veggies under running water, refrigerating perishable items promptly  

Clostridium perfringens

• Responsible for 10% of foodborne illnesses, 12% of related hospitalizations, 3% of related deaths

• Common in: meat and poultry dishes (especially large batches or buffets), gravies, stews, and casseroles
• Avoid by: keeping hot foods at ≥140F and cold foods at ≤40F, refrigerating leftovers within 2 hours, reheating leftovers to at least 165F before eating

Summer Food Safety Red Flags

Dr. Leah Colucci, an emergency medicine physician at Yale University Hospital, notes that patients often come to the emergency department with symptoms that could be food poisoning — or another infection picked up at crowded events like barbecues, graduation parties, and other summer gatherings. Her advice? “You never really know what’s happening in someone else’s kitchen — whether there are pests, cross-contamination, or poor cleaning practices. Unlike restaurants, there are no safety standards for food at a potluck. Be mindful of what’s in the food you’re eating and where it came from. If you’re unsure, bring your own dish so you have a safe option.”

Here are some common issues that land al-fresco diners in the hospital:

🚩 Foodborne illness: 

From food left unrefrigerated for more than a few hours, cross-contamination with raw meat or dirty hands, and/or undercooked meat.

🚩 Poor hand hygeine and improperly washed fruits and vegetables

This can result in bacteria ingestion (including E. coli and shigella).

🚩 Alcohol-induced or other substance use impaired decision-making 

This includes increased risk of burns and grill accidents.

🚩 Dehydration

 Due to heat and under consumption of water or electrolyte-containing drinks.

🚩 Allergic reactions and anaphylaxis 

Caused by cross-contamination, lack of labeling, or lack of allergy awareness in potluck-style dishes.

🚩 Choking incidents 

Remember to cut hot dogs and quarter grapes for small children!

🚩 Insect- and pest-contaminated foods 

Caused by foods being left out uncovered.

What should you do if you do get sick?

If you are seriously injured or experiencing an allergic reaction, go to the emergency room right away. 

If you contract a foodborne illness, the symptoms may not show up until you’re back at home. 

• Stay hydrated!
• Replace fluids and electrolytes like sodium and potassium.
• Avoid anti-diarrheal medications unless advised by a doctor. Meds like Imodium can prolong certain infections. 
• Track hydration through urination. You should be peeing regularly, and your pee should be light and clear.
• If you can’t maintain hydration, seek a higher level of care at urgent care or the ED.

Safe Grilling 101

Grilled food is undeniably delicious! But without proper precautions, it can also pose some health risks. Here’s what the experts say about safe grilling:

Temperature matters

Raw meat should be kept out of the “danger zone” of 40F-140F. Poultry, meat, and seafood should be cooked to the minimum temperatures shown below.

You can wash your hands outside

Hands should be washed with soap and water before and after handling raw meat. If you’re outdoors, set up a handwashing station with bottled water and soap. Note: hand sanitizer or antibacterial wipes can be used in a pinch. However, these do not kill norovirus, the leading cause of foodborne illness.

You should never use a wire grill brush

Though popular for cleaning grill grates, these pose a serious safety risk. Wire pieces can break off of the brush while cleaning, stick to the grill grates, and end up in food such as hamburger patties. When consumed, these tiny razor-sharp wire pieces can puncture the throat and travel through the body.

Char, though tasty, can be a carcinogen 

When meat is cooked at high temperatures — especially over an open flame — heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) can form. These substances have been shown in laboratory studies to cause changes in DNA that may increase cancer risk. Some studies suggest a link between frequent consumption of heavily charred meats and certain types of cancer, including breast, colorectal, and pancreatic. Here’s what you can do:

• Reduce cooking time over high heat
• Avoid direct contact with flames/heat
• Consume charred meats in moderation
• Eat grilled vegetables instead!

No fridge, no problem: dishes that can handle the heat

We love this list of super-safe picnic foods from TastingTable. Next time you’re packing for an outdoor gathering with little-to-no refrigeration, try one of these:

• Bread/crackers with jam or jelly
• Nuts or trail mix
• Dried fruit
• Fresh fruit (especially whole fruit like apples, berries, and bananas)
• Pickled vegetables
• Fresh vegetable crudite
• Grain or leaf-based salads with dried cranberries, croutons, and vinegar-based dressing
• Firm cheeses (e.g. cheddar, gouda, swiss – for up to 4 hours)

In general, aim for cold, shelf-stable, or preserved items rather than hot or perishable foods!

Top Tips to Avoid Foodborne Illnesses

🖐️ Wash your hands often and with soap, especially if you’re preparing food. 

❄️ Keep cold foods cold. Salads, cut fruits, and dairy-based foods should be kept at or below 40F until they’re ready to serve. Clear up extra space in the fridge or cooler if guests will be bringing their own dishes to share!

♨️ Keep hot foods hot. Grilled meats and hot sides should be kept at or above 140°F (60°C) until served. Use warming trays or insulated containers when possible.

🌡️ Use thermometers. A meat thermometer will tell you when your proteins are safe to serve. A fridge thermometer will help you keep that cooler temp below 40F! 

⌛ Don’t leave food out for more than 2 hours (or one hour if it’s over 90F). 

⛱️ Set up snacks in the shade. Pro-tip: under-the-table is a great place for a cooler that is not yet in-use.

🧊 Coolers should stay closed whenever possible, especially if they contain raw meat or dairy.

🍽️ Pre-chill plates and serving dishes. This little touch makes a big difference!

🔪 Have extra cooking utensils, plates and trays at-the-ready to avoid cross-contamination. 

🙅 When in doubt, throw it out. If a food’s safety is questionable, it’s better to discard than risk illnesses (even if that coagulated potato salad looks really, really good to you). 

Work with a Culina Health Registered Dietitian

If you want to learn more about food safety and healthy eating without sacrificing flavor, the team of RDs at Culina Health is here for you! Book a session with a Culina Health dietitian today—we accept most major insurance plans!