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Chapter 19 – Consumer Concerns about Foods and Water
Learning Objectives
After completing Chapter 19, the student will be able to:
19.1 Describe how foodborne illnesses can be prevented.
19.3 Explain how environmental contaminants get into foods and how people can protect themselves against
contamination.
19.4 Identify natural toxicants and determine whether they are hazardous.
19.5 Debate the risks and benefits of using pesticides.
a. Discuss the health hazards associated with pesticides, pesticide monitoring techniques, and the risks
and benefits of organic foods.
19.6 List common food additives, their purposes, and examples.
19.7 Discuss consumer concerns about water.
a. Describe sources of drinking water, harmful contaminants, and methods to ensure water safety.
19.8 Debate the pros and cons surrounding genetically engineered foods.
Assignments and Other Instructional Materials
The following ready-to–use assignments are available in this chapter of the instructor’s manual:
• Case Study 19: Foodborne Illness
Other instructional materials in this chapter of the instructor’s manual include:
• Answer keys for How To (pp. 628-629) activity and study card questions
Visit the book’s instructor companion website to download:
• Handout 19-3: How to Detect and Avoid Spoiled Foods
Lecture Presentation Outline
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Key to instructor resource annotations (shown to the right of or below outline topics):
TRA = Transparency acetates: 13e = 13th edition, 12e = 12th edition, 11e = 11th edition, 10e = 10th edition
1
Worksheets 19-1 and 19-2 contributed by Daryle Wane.
2
Contributed by Carrie King.
3
Handouts 19-1 and 19-2 contributed by Sharon Rady Rolfes.
4
Contributed by Melissa Langone.
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I. Foodborne Illnesses (also known as food poisoning) 12e TRA 27; IM CS 19, HN 19-1
A. Foodborne Infections and Food Intoxications (Table 19–1) IM WS 19-1
1. Foodborne Infections
2. Food Intoxications
1. Industry Controls 12e TRA 27
2. Consumer Awareness (Figure 19–1)
C. Food Safety in the Kitchen (Figure 19-2) IM WS 19–2, HN 19–2; Website HN 19-3
1. Guidelines
a. Keep a clean, safe kitchen
2. Safe Handling of Meats and Poultry (Figure 19-4) 10e TRA 175
3. Safe Handling of Seafood
a. Undercooked or raw seafood can cause illnesses
4. Other Precautions and Procedures
a. Abnormal odors
b. Be mindful of safe refrigeration temperatures (Table 19-2)
D. Food Safety While Traveling
1. Traveler’s diarrhea
a. Different microbes
b. Different standards for food and water
2. How to achieve food safety while traveling
a. Wash hands; use antiseptic wipes or hand gels
E. Advances in Food Safety
1. Irradiation
a. Protection
1. Controlling molds in grains
2. Sterilizing spices and teas for storage at room temperature
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c. Supported by FAO, WHO, and AMA
d. Foods approved
II. Nutritional Adequacy of Foods and Diets
A. Obtaining Nutrient Information
1. Nutritional labeling regulations
III. Environmental Contaminants
A. Harmfulness of Environmental Contaminants (Figure 19-5)
1. Depends on its persistence
2. Bioaccumulation 10e TRA 177
B. Guidelines for Consumers
1. Hazards appear to be small
IV. Natural Toxicants in Foods
A. Poisonous mushrooms
B. Goitrogens in some vegetables
C. Cyanogens that produce cyanide
D. Solanine in potatoes
V. Pesticides
A. Hazards and Regulation of Pesticides
1. Hazards of Pesticides
a. Tolerance level set by government
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b. Imported foods contaminated with our banned pesticides
B. Monitoring Pesticides
1. Food in the Fields
b. The Total Diet Study estimates pesticide consumption
C. Consumer Concerns
1. Minimizing Risks (Table 19-3)
2. Alternatives to Pesticides
a. Natural pesticides
3. Organically Grown Crops
a. Producers market organic crops
b. USDA labeling for organic foods (Figure 19-6)
VI. Food Additives
A. Regulations Governing Additives
1. The GRAS (generally recognized as safe) List
2. The Delaney Clause
3. Margin of Safety
4. Risks versus Benefits
a. Use the lowest amount needed to get the effect
B. Intentional Food Additives IM CA 19-4
1. Antimicrobials
a. Salt and sugar
2. Antioxidants
1. Prevent oxidation in many processed foods
2. Adverse reactions in people
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3. Colors
4. Flavors
5. Sugar Alternatives
a. One of the most widely used flavor additives
6. Texture and Stability
7. Nutrients
C. Indirect Food Additives (Table 19-5)
1. Acrylamide
2. Food Packaging
1. If hot, do not use
2. If warm, it is safe for short-term heating
3. If cool, it is safe for long-term cooking
3. Dioxins
4. Decaffeinated Coffee
5. Hormones
a. Bovine growth hormone (BGH)
6. Antibiotics
a. Given to animals and residues remain in meat and milk
b. People with sensitivities may suffer allergic reactions
c. Antibiotic resistance is a problem
VII. Consumer Concerns about Water
A. Sources of Drinking Water (potable water)
1. Surface water
2. Ground water
B. Water Systems and Regulations
1. Home Water Treatments
2. Bottled Water
a. FDA has quality and safety standards
b. Expensive
c. Water source must be identified
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d. Refrigerate after opening
e. May contain contaminants
VIII. Highlight: Food Biotechnology IM CA 19-5
A. The Promises of Genetic Engineering
1. Extended Shelf Life
B. The Potential Problems and Concerns (Table H19-1)
1. Disruption of natural ecosystems
2. Introduction of diseases
C. FDA Regulations
1. Many foods are already genetically altered through selective breeding
2. Many foods are not substantially different
Case Study 19: Foodborne Illness
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Erin C. is a 27-year-old professional woman who describes a recent bout of “the 24-hour flu” she experienced after
eating out with friends over the weekend. She reports feeling an upset stomach at work on Monday with an increase
in symptoms that developed into severe abdominal cramps, nausea, vomiting, and some bloody diarrhea, continuing
into the evening. She called her doctor the next morning and reported what she had eaten the day before she
developed symptoms: 2 glasses of wine, broiled rare steak with mushroom sauce, baked potato with sour cream and
butter, and an assorted greens salad with oil and vinegar dressing from the salad bar where she was dining with
friends. Earlier on that same day, she had eaten leftovers from her refrigerator—a small pork chop, spinach salad,
and a glass of milk from a local organic dairy.
1. Based on information in Table 19-1, which of Erin’s symptoms would cause you to suspect that she had a food-
borne illness rather than the flu?
2. What foods that Erin ingested are frequent sources of food-borne illness?
3. Based on the information in this chapter, what questions would help you identify the likely cause of Erin’s
food-borne illness?
4. Besides calling her doctor for persistent symptoms, what dietary measures are important for Erin’s recovery?
5. Knowing that she prefers to eat rare-cooked meat, what precautionary advice could you offer Erin in reference
to Figure 19-4?
6. Based on this experience, suggest one practical action from each of the four simple rules outlined in the “How
To” section on page 628 that may protect Erin from food-borne illness in the future.
Answer Key
1. Severe gastrointestinal symptoms such as upset stomach, diarrhea—including bloody diarrhea—nausea,
vomiting, and abdominal pain that lasts 1 or 2 days.
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Suggested Classroom Activities
This chapter may be a good time to explore students’ concerns about foods. You may ask students to present their
concerns either verbally or in writing. Many of their concerns may be covered in the chapter.
Classroom Activity 19-1: Observing Hand-Washing Behaviors of Foodservice Restaurant Personnel
Key concept: Food safety in the marketplace Class size: Any
Instructions: Divide the class into groups, assigning each group to a different restaurant. Have students take turns
spending time in the restrooms and observing hand-washing behaviors of foodservice restaurant personnel. Instruct
them to report if hand washing occurred and, if so, whether it was correctly performed. Discuss the students’
experiences and their implications.
Classroom Activity 19-2: Comparing Different Foods
Key concept: Effects of food processing techniques on nutrients Class size: Any
Instructions: Have students make a table of values of selected nutrients for several foods that compares fresh, frozen,
canned, dried, or other processed forms. Have students draw conclusions about how processing affects the
contributions a food makes to a day’s nutrient requirements.
Classroom Activity 19-3: Estimate Vitamin Losses
Key concept: Vitamin losses due to storage/preparation Class size: Any
Instructions: Using a 24-hour recall, have students calculate the percent of daily requirement of the B vitamins and
vitamin C that they consume if typical vitamin losses occur. For example, if a student consumes foods that normally
would provide 85% of the daily requirement for vitamin C but there is a 10% loss from poor food storage, she only
consumed 76.5% of the requirement for that day.
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Classroom Activity 19-5: Biotechnology Debate
7
Key concept: Biotechnology Class size: Small to medium
Instructions: The Highlight does a great job of outlining both the pros and cons of food biotechnology. Clearly, there
is much to consider, including the environment, shelf life of the product, enhanced nutrient composition in a fast–
paced world, etc. As students learn and grow into their positions as health care professionals, they will be confronted
with clients/patients with beliefs on both sides of the equation. It will be very important for students to fully
understand their beliefs in this debate and to develop a balanced approach to educating clients on the differing
perspectives in a manner such that clients may make their own decision—what is best for them, their beliefs, and
their value system. Ask each student to fully review Highlight 19 and pursue a literature search to determine where
they stand in the debate over food biotechnology. Then ask your students to write up an educational plan for clients
that want to learn about food biotechnology and really don’t have any issues with it and those that are skeptical or
oppose it.
Can the student describe how it feels to educate a client on something that they really do not fully support but they
understand is not harmful to their clients? Is the student beginning to see the importance of working with the client
from the client’s perspective? Ask the students how they plan to remove their own bias in their educational
programs with their clients.
How To “Try It!” Activities Answer Key
How to Prevent Foodborne Illnesses
No, rinsing the cutting board in warm water is inadequate to remove or destroy microbes transferred from the raw
pork to the board. The cutting board and knife should both be washed vigorously with hot, soapy water before they
are used for the vegetables. Sterilizing the cutting board with a bleach solution would also be a wise precaution.
Study Card 19 Answer Key
1. Foodborne illnesses may be classed as either foodborne infections—those caused by an infectious agent—or
food intoxications—those caused by a poisonous substance. Foodborne infections are caused by eating foods
2. Meats and poultry contain bacteria and provide a moist, nutrient-rich environment that favors microbial growth.
Ground meat is especially susceptible because it receives more handling than other kinds of meat and has more
surface exposed to bacterial contamination. Meat should be cooked thoroughly, using a thermometer to test the
10. GRAS (generally recognized as safe) substances are exempted from complying with the FDA’s approval
process based either on their extensive, long-term use in foods or on current scientific evidence, though they are
subject to ongoing review. Examples include salt, sugar, caffeine, and many spices. In contrast, to receive
11. d 12. a 13. a 14. a 15. c
Critical Thinking Questions
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1. Foodborne illnesses are a major concern for individuals and yet they continue to occur despite best practice
efforts in preventative methods. For this question, keep a food safety diary of your food safety behaviors for a
3-day period. Note all activities related to food selection, food preparation, food consumption, and food disposal
methods. Analyze your activities in observance of demonstrated food safety rules such as proper temperature/
storage, hand hygiene/clean surfaces, cooking foods thoroughly as directed, and proper disposal/storage of
prepared foods.
2. Discuss the process of bioaccumulation as it relates to mercury in the edible fish supply.
3. Describe methods that will prevent natural toxicants such as goitrogens, cyanogens, and solanine from causing
illness.
4. Food additives arrive in many of the foods we eat by either direct (intentional) or indirect (incidental) routes.
While consumers are likely to be aware of intentional food additives, associating them with enhanced color
and/or antioxidants, the potential for indirect food additives is often less clear. Discuss how the presence of
indirect food additives affects foods and how consumers can become more educated so as to make informed
choices relative to the food they consume.
5. The sales of bottled water have dramatically increased, as it is now viewed as having “designer” type qualities.
Bottled water as a food product has become a new fashion icon as it is marketed at both the national and
international level. Compare the advantages and disadvantages of using bottled water.
6. Genetically modified foods or genetically engineered foods are a part of our current food supply and yet many
consumers are unaware that they are eating these types of foods. Current federal legislation does not require
labeling specifying this process. Do you think that these types of foods should be required to be labeled as
genetically modified? What information do you think should be available to the public regarding these types of
food products?
Answer Key
1. This question combined with an interactive observation and analysis of the student’s food selection, preparation,
and disposal will serve to highlight awareness of potential areas that may increase the likelihood of spread of
foodborne illnesses. Even though there are demonstrated causal relationships between food preparation, storage,
2. The presence of contaminants in the food supply is a substantial concern. Mercury is a significant contaminant
because it undergoes the process of bioaccumulation. Mercury does not degrade or break down and as such will
accumulate in the environment with repeated exposure. Factors that affect the amount of mercury present in the
3. Goitrogens are commonly occurring substances found in certain food products (cabbage, bok choy, kale,
mustard greens, etc.) that can interfere with thyroid hormone production. Individuals who are taking thyroid
replacement therapy and/or have clinical issues related to thyroid disease and/or presence of goiter should
monitor the consumption of these food items, especially in the raw state. Cooking does deactivate enzyme
4. Indirect food additives occur in foods as a result of the manufacturing process. They are an unexpected
consequence of food preparation, processing, and/or packaging often arising from chemicals /solvents that are
used. While the argument may be made that some of these potential additives could be eliminated from foods as
a result of stricter and/or alternative manufacturing methods, one must consider that in order to generate an
adequate food supply for a population, a certain amount of processing is needed.
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5. The major constituent of bottled water is water. As such, the main advantage of bottled water is its convenience
in that it has portability. Tap water originates from the public water supply and undergoes treatment in
accordance with regulations to ensure safety and removal of possible contaminants so that they are “under
acceptable levels.” Additionally, consumers can utilize home water treatment systems to further purify their
6. At the present time, FDA regulations only require labeling if the food product is substantially different (or
altered) as compared to the conventional food product. Even though the premise behind genetic engineering
IM Worksheet Answer Key
Worksheet 19-1: Foodborne Illness Trends (Internet Exercise)
Worksheet 19-2: Safe Food Practices – Answers will vary; worksheet indicates which practices are safe.
Worksheet 19-3: Chapter 19 Crossword Puzzle
1. artificial sweeteners
4. hand washing
7. two
10. Organic
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Worksheet 19-1: Foodborne Illness Trends (Internet Exercise)
1. Which of the following statements is true concerning FoodNet?
a. It is run by a system of computers.
b. The FoodNet sites work with approximately 15% of the U.S. population.
c. The FoodNet site started tracking food safety information in 2000.
d. The FoodNet site tracks five different pathogens.
2. E. coli O157 infection was the most common problem spread by contaminated foods in the year 2007.
3. Salmonella is a common bacterial germ.
4. There is only one way to transmit Salmonella from animals to humans.
5. Food contamination with E. coli O157 can cause diarrhea in humans.
a. True
b. False
6. In order to minimize the risk for transfer of organisms, it is advised that you wash your hands the
amount of time it takes to sing the “Happy Birthday” song once.
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Worksheet 19-2: Safe Food Practices
Answer the following questions based on your understanding of food safety and see how you
rank in terms of being a “Food Safety Advocate.” (Circle “Yes” or “No.”)
1. I use a meat thermometer when I cook foods in the oven.
Yes
No
3. I rinse cutting boards with water after using them for food preparation.
Yes
No
5. When thawing meats or poultry, I leave the food product out on the counter
to make the process quicker.
Yes
No
6. If a food smells funny, I taste it just to make sure that there is a problem.
Yes
No
7. I only purchase foods from a grocery store freezer that feel solidly frozen.
Yes
No
8. I use the extra marinade used in food preparation as a sauce when serving
Yes
No
9. I change my sponge in the kitchen when it looks dirty.
Yes
No
10. I check expiration dates of food products prior to purchasing them from a
grocery store.
Yes
No
Scoring:
• If you have answered “Yes” to questions 1, 2, 4, 7 and 10 give yourself 2 points for each
question, and if you have answered “No” then deduct 2 points for each question.
• If you have answered “No” to questions 3, 5, 6, 8 and 9 give yourself 2 points for each
question, and if you have answered “Yes” then deduct 2 points for each question.
Grading:
2. I wash my hands before I start meal preparation.
Yes
No
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Worksheet 19-3: Chapter 19 Crossword Puzzle
1
2
3
4
5
6
7
8
9
10
11
12
Across:
Down:
6. Agricultural technique that could be used to reverse
nutrient deficiencies such as vitamin A deficiency
10. _____ foods are an alternative to foods grown with
pesticides.
12. Food additives designed to extend the life of foods
3. _____ water is safe for human consumption.
4. One of the most important ways to improve food
than 6 ounces per week.
7. To prevent foodborne illness, refrigerate take-home
the levels of pesticides in the U.S. food supply.
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Handout 19-1: Increases in Imported Foods
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Handout 19-2: Prevention of H1N1 Infection
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash
after you use it.
• Wash your hands often with soap and warm water for 20 seconds, especially after you cough or
sneeze. Alternatively, clean hands with alcohol-based wipes or gel sanitizers.