It’s a busy morning – getting ready, eating breakfast, fixing lunch, checking email, grabbing homework. Then you notice something out of place. A carton of milk is sitting on the counter.

We’ve probably all had this happen and, at that point, three questions run through our minds: How long has the milk been out? Is it still safe? And who left it out?

Our very own registered dietitian Sarah Downs stepped in to help us find some answers.

Okay, Sarah, bottom line: How long can milk be kept out of the refrigerator before it starts to spoil?

Sarah Downs, RD: “Milk should never be left out at room temperature.

Refrigeration is the single most important factor in maintaining the safety of milk. Milk should be stored at 40° F or below. If stored above 40° F, milk will begin to develop signs of spoilage, including sour odor, off-flavor and curdled consistency.”

What if you’re not sure how long the milk has been left out? Is there a way to tell if it’s still safe to use?

Sarah Downs, RD: “When in doubt, throw it out. The general rule of thumb is to discard any perishables that have been stored above the “Danger Zone” of 40° F for more than two hours, no matter what their appearance or odor (and never taste the food to try and determine whether it’s still safe).”

What about ultra-pasteurized milk?

Sarah Downs, RD: “Ultra-pasteurized milk is heated to 280° F for a minimum of two seconds. This temperature and time combination is much more lethal to bacteria, killing virtually all of concern in milk. Ultra-pasteurized milk is also packaged under near sterile conditions, which makes recontamination with spoilage bacteria unlikely and rare. The average shelf-life of ultra-pasteurized milk products is 30 to 90 days when held under refrigeration, but only until the product is opened. Then it should be consumed within seven to 10 days to avoid spoilage.”

What’s different about the milk you see sitting at room temperature on the grocery store shelves?

Sarah Downs, RD: “Shelf stable milk has been ultra-pasteurized (UHT) and is packaged in aseptic cartons. This allows the milk to sit at room temperature in the grocery stores. However, it must be refrigerated after being opened and consumed within seven to 10 days to maintain quality and food safety.”

What advice do you have for parents to safely pack milk for their little ones in a sippy cup or lunch box?

Sarah Downs, RD: “For parents on the go, I would recommend the following options:

1. Pack milk in a lunch box or cooler with an ice pack to ensure it stays cool.
2. Purchase shelf-safe milk (make sure it has the UHT label on the package too!). Also, remember that after this milk is opened it should be treated like regular milk and kept cool at 40° F or cooler.
3. It’s important to remember that opened milk, regardless of the type, should never be left in temperatures above 40° F for more than two hours.”

Although we may not figure out who was responsible for leaving the milk on the counter, these guidelines will help us stay safe and enjoy nutritious milk!

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Dr. Sean O’Keefe recommends looking at total calories, calories from fat, and sodium content. For each of these, lower is better. Fast food chains don’t typically disclose ingredient information, but Dr. O’Keefe was able to shed some light on what we might find in various kids meal options such as hamburgers, chicken nuggets, French fries, etc. While ingredients vary depending on product and manufacturer, Dr. O’Keefe shares that sodium chloride, natural antioxidants and phosphates are additives you would normally expect to find in meat products. In reformed meat products such as chicken nuggets, you might find starches, gums, etc., used as a binding agent to keep the meat from falling apart. These are used in the same way you might use bread crumbs, flour, starch or eggs at home in a meat loaf. The phosphates found in meats are added for quality, water binding and retention, and can also act as antimicrobial agents, but this may not make much of an impact if burgers are made from frozen patties.

With regard to preservatives, propionic acid might be found in baked goods as a means of preventing mold. Aside from salt and flavorings, Dr. O’Keefe doesn’t expect to find many additives in French fries found on most fast food menus.

Below we’ve highlighted the best (lowest calorie) and worst (highest calorie) kids meal options from five different popular fast food chains.

MCDONALD’S

Best option: Chicken McNuggets (190), Apple Slices (15), Go-GURT (50), Apple Juice (80) = 335 calories

Worst option: Cheeseburger (290), French Fries (110), Go-GURT (50), Chocolate Milk (130) = 580 calories

Source:http://www.mcdonalds.com/us/en/food/meal_bundles/happy_meals.html

BURGER KING

Best option: 4 pc Chicken Nuggets (190), Apple Slices (30), Apple Juice (80) = 300 calories

Worst options: Cheeseburger (270), French Fries (190), Chocolate Milk (160) = 620 calories

Source: http://www.bk.com/menu/kids_meals

KFC

Best option: Grilled Drumstick (90), Green Beans (25), GoGo Squeeze Applesauce (60), Capri Sun Roarin Waters (30) = 205 calories

Worst option: Chicken Little (160), Mac and Cheese (170), GoGo Squeeze Applesauce (60), Milk (110) = 500 calories

Source: http://www.kfc.com/food/lilbucket/

WENDY’S

Best option: 4 pc Chicken Nuggets (180), Apple Slices (40), White Milk (80) = 310 calories

Worst option: Cheeseburger (280), French Fries (220), Jr. Frosty (200) = 690 calories

Source: https://www.wendys.com/en-us/kids-meals

SONIC

Best option: Chicken Strips (220), Apple Slices (35), Apple Juice (90) = 315 calories

Worst option: Grilled Cheese (410), French Fries (280), Chocolate Milk  (180) = 870 calories

Source: https://www.sonicdrivein.com/menu/178-kids-meals

For more information on healthy menu options for kids, check out the Kids LiveWell program from the National Restaurant Association.

_{“Laptop Lunches – puzzle pieces for autism awareness month” by Melissa is licensed under CC BY.}

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Response to Dr. Oz’s “Secrets of the Fast Food Industry” segment

By Dr. Sean O’Keefe

First, an introduction: I am a Food Scientist. I have a Masters in Food Science and Technology and a Ph.D. in Food Technology. I have been working as an academic in Universities for 24 years. I have conducted paid research for the food industry, but I am no mouthpiece for them.

I grew up in Antigonish, Nova Scotia, a small town (~5,000 at that time) in a house where my mom was a homemaker until we were all off to school. Growing up, the only fast food restaurant in Antigonish was KFC. We ate at McDonald’s twice a year when we visited Halifax for our dental exams. We only ate KFC once a year, and that was when they had BOGO coupons. So growing up, I ate at fast food restaurants three times per year. In my opinion, this is the right number of times per year to eat fast food.

I don’t eat fast food often because I don’t like it. It has too much fat, too much salt, too much sugar and is unappetizing to me. I would MUCH rather eat a peanut butter sandwich than fast food. The only fast food restaurant I regularly eat at is Subway, and only if my kids are hungry and want to eat something when we’re on the road. I have eaten at other fast food restaurants, but I honestly don’t remember my last visit.

I’m not a huge fan of fast food restaurants, and I am no apologist for the fast food industry, but I have to correct some errors in Dr. Oz’s recent segment that focused on the secrets being hidden in fast food.

First of all, the people interviewed were not fast food insiders. Not one of them works in the fast food industry. One is a chef – somebody competing with fast food. The second has a book saying the food industry is selling unhealthy food – by scaring people, she could increase book sales. The third, a public health commissioner, was the only one of the three who is competent to make comments on the fast food industry; but again, he was not an insider. “Insider” sounds compelling, but to be an insider, you’d have to actually work inside the fast food industry.

A study was discussed which examines the “link” between fast food and asthma; this was an epidemiological study. Epidemiological studies do NOT determine cause-and-effect. They can only determine whether something should be studied further. For example, epidemiological studies show that electric razor use is associated with heart disease, because countries with higher use of electric razors have higher incidence of heart disease. True, but upon further investigation, there is no cause-and-effect relationship between an electric razor and heart disease – other factors are at play. This is an example of the questionable results that epidemiological work may uncover.

This epidemiological study has been portrayed in the media as showing conclusive evidence of a link between fast food and asthma. The connection cannot be determined based on this epidemiological study alone. But I would argue that people would be healthier eating more fruit and less fast food, irrespective of any link to asthma.

Let’s review the “seven secrets” that were covered on the show.

 

1. The soda fountain is the dirtiest place in the fast food restaurant.

I believe this is true. We have known for a long time that ice can be a source of pathogenic bacteria. The soda fountain with sugar and air makes a very inviting place for mold and bacteria.

I don’t drink soda and don’t let my kids drink soda except for a special treat. In my opinion, sugared soda defines “empty calories.” In my opinion, you shouldn’t drink soda, not even diet soda; you should drink bottled water instead. Sure, you’re paying for something that comes out of your tap almost free, but that is better than drinking colored sugar water.

 

2. There are antifreeze chemicals in our food.

It is mentioned that “propylene glycol” is a chemical found in our food.

“Chemical” is a scary-sounding word, but what we need to step back and think about is the fact that everything we see, smell and touch contains chemicals. This includes our bodies.

Calling propylene glycol “antifreeze” is sensationalist and designed to scare people. Automotive antifreeze has traditionally been ethylene glycol, which is quite toxic to people and animals, and is why you should never leave car antifreeze where your pets may access it. Propylene glycol is not the same as ethylene glycol. Propylene glycol is sometimes labeled “non-toxic antifreeze” and is used where ethylene glycol would be a problem because of its toxicity. Propylene glycol is classified by the FDA as GRAS, generally regarded as safe. Other GRAS list ingredients include krill oil, which was advertised on The Dr. Oz show online. Since propylene glycol is a GRAS compound, it is safe to use in foods.

It was stated that we don’t know what the long-term effects (of eating propylene glycol in your food) might be. You could say the same thing about anything in our diet. How about soy products? Krill oil? Broccoli? Have any of these been studied in humans for long-term safety? Well…no. The best evidence available says that propylene glycol is safe.

I do agree that long-term safety is a question we need to look at when discussing food additives, but we also need to look at natural products as well. Comfrey tea, a favorite of natural food lovers, causes liver toxicity…100 percent naturally. Acetaminophen (Tylenol) is very toxic to the liver and is the main cause of acute liver failure in this country. Most people have it in their house and don’t think twice about using it. I hope the “insider” concerned about propylene glycol avoids acetaminophen like the plague, as it is much more dangerous than propylene glycol.

I found the comments about “cutting corners” to be quite funny. Chef Wilde said the fast food industry “wants to make money.” My response is that, OF COURSE that is the case. Certainly she, as a chef, wants to make money, right? No one is in business to lose money.

Fast food milkshakes were mentioned as being harmful, and it was said that old-fashioned milkshakes at home are a better choice. I agree that simpler is better. But, there are reasons why today’s milkshakes (and other foods) contain additives. Many of the ingredients discussed are for thickening, while some are for safety (mold prevention) and others are for stability, so the milk shake will be properly blended. Comparing a milkshake made at home and one made in restaurants that serve thousands of meals daily is silly.

Should there be labels on all fast food containers? Yes – I absolutely think there should be. Should companies strive for “clean labels” that contain whole products like milk, cream, sugar and vanilla? Absolutely. But please, let us keep these sensationalistic scare tactics out of the cup.

 

3. Grill marks are often fake.

I laughed out loud at this one. Consider this: Chefs in fancy, Michelin-starred restaurants may use propane torches to put the finishing touches on crème brûlée and other foods because it is easier than using a broiler and allows them to finish the dish in a way that meets their visual approval and high culinary standards.

While some restaurants actually grill their burgers, others may mark the patties with grill marks. About that, Dr. Oz asked, “Is it paint?” No! If it’s anything other than a grill making the mark, it is probably the same natural coloring used in soda to make cola dark. One of the guests said, “It can be toxic dyes…” Let’s be honest: at a high enough dose, anything can be toxic – including water. Everything used by the food industry has been tested and approved for use in foods.

 

4. Chicken is not as healthy because it is doused in butter and margarine.

I haven’t conducted a study on those who eat fast food, but my guess is that people are not choosing fast food restaurants because of their extensive selection of healthy foods. As a part of a healthy diet, fast food is not bad for you. If you’re eating it once or more per day, that’s probably not healthy. But let’s take that one step further. If you’re eating out ANYWHERE – fast food restaurants, sit-down quick-service restaurants or a fine dining restaurant – once a day, it’s also probably not healthy, as the vast majority of restaurants are ultimately concerned with serving good-tasting food, and they won’t sacrifice taste for healthfulness.

They specifically mentioned that “60 percent of the previous fast food workers surveyed said they slathered fat… butter… on their chicken.” They estimated that the calories in that added fat (about 70 calories each time) could mean up to seven pounds gained annually. So, what is the solution?

Don’t eat empty calories. Don’t eat fast food so often. But let it be clear: my argument against eating fast food is not because of the extra butter, mold or the chemical additives Dr. Oz’s guests discussed. Let’s not tarnish the “fast food industry” because of these things; my argument is that there are healthier alternatives to fast food.

My advice: pack a lunch with foods bought fresh and prepared at home. Not only does this save money, it also controls your diet. If you want fast food once in a while, that’s fine if the rest of your diet is healthy.

 

5. French fries and milk shakes have ‘beef additives.’

Many years ago an Indian friend who is a strict vegetarian invited me to supper. We had dahl, among other things, and for dessert, she had Jell-O.

I looked at her:

“Shantha, I thought you were vegetarian,”

“I am.”

“Don’t you know where Jell-O comes from?”

She was shocked when I told her it was from beef collagen. Apparently in India, Jell-O is non-beef.

I think we’d be better off if fast food restaurants posted all ingredients on the boxes in which food is served. Perhaps we’d make better choices if that were the case.

For fries specifically, tallow improves the flavor tremendously. I am old enough to remember when the change from frying in tallow to frying in partially-hydrogenated vegetable oils took place. Consumers were not happy with the flavor although they believed that the new frying fat was healthier. I think ALL restaurants should disclose whether they are using animal-based ingredients in their products. “Beef in milk shakes” was mentioned, and I assume Dr. Oz’s guest is referring to gelatin. It is found in yogurt and many other places, but is noted on their labels.

The use of beef extract to flavor French fries is done to make consumers happy – the flavor is better with the beef flavorings. The fast food industry is not adding the flavoring to cut corners; it is adding it to improve the flavor, as determined by consumer product testing.

 

6. Fastest food is not the freshest food: seven day-old French fries

The chef stated, “Those are fries that are engineered for longevity.” This is ridiculous. Does she believe that McDonald’s expects consumers to eat their fries after a week?

Full disclosure: my wife loves McDonald’s. She says the fries are “the best ever.” She also says they are terrible after they get cold. Engineered for longevity? I don’t think so.

Let’s break down the science of why fast food French fries retain their appearance for days on end: the fries are high salt and low moisture.

10,000 years ago people knew low moisture and high salt kept food from going bad. That is why the fries do not get moldy. It is very simple science.

Heat lamps were also discussed. Sure, they warm the fries, which further reduces water and reduces the chance of mold. I would be shocked if fries are held “for hours” under the heat lamp before they are sold to customers. At that point, they would be dried up sticks and inedible.

 

Let’s remember that heat lamps are used in restaurants of all types – not exclusively in fast food restaurants. Most importantly, the heat lamps are used for our safety. Besides keeping food warm so it tastes good, the lamps retain heat so that foods don’t drop into cooler “danger zone” temperatures where bacteria may grow.

 

7. Best time to order

A claim was made that fast food restaurants “coat the place with industrial strength chemicals” at the end of the day.

It’s an interesting point, but I know of no evidence that this is actually true. Carryover of sanitizing agents may occur, but normally at levels so low that they are difficult or impossible to measure. The fact that the restaurants have aggressive sanitation procedures to keep food safe is now being turned 180 degrees to be something that is a problem. I would challenge Dr. Oz to show one study where fast food cooked first thing in the morning absorbs sanitizers at levels that are unsafe. I can smell chlorine in my tap water, but the level is regulated and the level is safe – despite the fact that I can smell it. I would rather have a slight chlorine smell than unsafe water.\

Dr. Oz seemed to be serious about wanting a discussion about fast food products. I just wish he would have picked a group of food experts who could address the myths the chef and author were perpetuating.

Fast food can be part of a healthy diet, but eating fast food every day is not part of a healthy diet. At the end of the day, I think Americans need to make better food choices.

_{“California Whopper” by Joey is licensed under CC BY.}

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How about the YouTube video showing a cheeseburger that’s four years old?

We reached out to Dr. Sean O’Keefe, a food science professor at Virginia Tech, and asked him why fast food doesn’t spoil.

Why doesn’t fast food spoil? Shouldn’t the bun and burger get moldy? Why don’t the fries spoil?

Dr. O’Keefe:

Fast food spoils the same as any other food. A couple of things about the fast foods in question make them less susceptible to spoilage. The high salt and low moisture contents in the fries and burgers keep them from mold growth. The bun, like most bread, has propionic acid added (a natural product from microbial action), which prevents mold for a long enough time until the moisture in the bun decreases to a point where mold will not grow. The burger patty has high salt and is dried during the cooking process. The fries have low moisture and high salt contents. So the combination of high salt and low moisture prevents spoilage.

It may not look like it, but #fastfood spoils just the same as any other food.
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If I cook a burger at home, will it spoil? Won’t the bun spoil?

Dr. O’Keefe:

Let’s define spoil. Foods deteriorate via a number of different mechanisms. Mold growth is one obvious way foods can spoil. I guarantee I can measure things like oxidation and lipolysis in the fries and burgers in those pictures and show that they are spoiled even though there is no obvious mold growth. If you cook a high fat, high salt burger at home in a thin patty and then leave it where it will dry out, I do not expect that it will get moldy quickly. That is not to say it is not spoiled – probably, pathogenic bacteria may have grown or other chemical reactions have occurred, resulting in spoilage.

The people aging these fast food products are doing so to try and paint fast food as unhealthy because they are full of preservatives. This is not correct. They are looking for mold growth as a measure of spoilage and mold does not grow at very low levels of available water.  Peanut butter does not get moldy because it has low available water, but it will definitely spoil if stored at room temperature in presence of oxygen (via oxidation reactions). Are these people spazzing out about peanut butter? I didn’t think so. If I let a hamburger bun dry out, it will never get moldy, as long as the available water level is low.

Should we be concerned about the food we eat from fast food restaurants?

Dr. O’Keefe:

Fast food can be part of a healthy diet, but you should not be eating fast food three times a day, seven times a week. Once in a while, as a treat, it is perfectly fine to eat fast food. But many fast food choices have high sodium and fat contents, and some fast food choices have extremely high levels of calories and fat. You should look at the caloric content information available at the restaurants and make menu choices based on that. Your normal diet should have plenty of fresh fruit and vegetables.

Does fast food contain a lot of preservatives?

Dr. O’Keefe:

Fast food is consumed almost immediately after cooking, so there is no logical need for preservatives. The reason the burger, fries and buns do not mold in those cases is that they have low available moisture and high salt (the fries and burger). Drying and salting have been used to preserve foods for many thousands of years. The fact that drying and salting prevent or delay mold growth is no surprise at all. Buns would probably have the same mold growth inhibitor used in most commercial bread, propionic acid. Propionic acid delays mold growth and is found naturally in things like Swiss cheese. So the short answer is no: fast food does not have more preservatives than any other processed food.

How long does fast food keep before it should be thrown out?

Dr. O’Keefe:

We separate foods into perishable, semi-perishable and non-perishable categories. Perishable would be things that require refrigeration. Semi-perishable are things like bread that are OK at room temperature but will get moldy eventually, and non-perishable are things like crackers that can stay many months at room temperature without spoiling. Fast food is a combination of perishable and semi-perishable items. You can store these at low humidity, allowing them to dry out, then leave them for months without growth of mold. But they would not be safe to eat.

You should treat fast food as any other food.  If you have a meat item, eat it immediately or refrigerate a day or two. Fries can be held longer because they have less free water than the burger patty (free water is needed for bacteria and mold growth), but they wouldn’t taste very good the next day, so why bother?

The people showing pictures of these burgers are trying to grind an axe and say fast food is full of preservatives and are therefore bad for you. The reason we don’t see mold is simply low moisture and high salt in the foods, something people knew would preserve foods many thousands of years ago – why should people be surprised at this today?

_{“Burger/Ink” by Christian Kadlubamizo is licensed under CC BY-SA.}

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After an inquiry regarding “pink slime” or mechanically separated chicken in chicken nuggets, we asked Dr. Casey Owens, Associate Professor in the Department of Food Science and member of the Center of Excellence for Poultry Science at the University of Arkansas for some clarification. She maintains that this is not the process used to make nuggets.

We received a question from a reader who wants to know what food products come from “mechanically separated chicken.” What can you tell us about this?

Dr. Owens:

Typically, mechanically separated chicken serves as an ingredent for products like hot dogs, bologna, and Vienna sausages – emulsified products. The processor he uses in the video is not what would be used in the industry, nor would this process be used for chicken nuggets as the video suggests.

Why is mechanically separated chicken used?

Dr. Owens:

Mechanically separated chicken (MSC) contains proteins that are useful for other products. It takes on a fine, pasty texture, so it can be formed into a desirable shape. Consumers should note that products using MSC typically have a higher fat content.

In this video, the people say that the pink in the meat is from blood, that eyeballs are mixed into the paste, etc. What is the truth?

Dr. Owens:

First and foremost – there is NO chance of eyeballs being in the chicken, because the head is removed much earlier in the process. In the Jamie Oliver video, you can see there is no head on the chicken he presents to the children – the same is true in processing facilities. Mechanically separated chicken is made using the meat left after the breast meat and legs are removed – meat found between the ribs, near vertebrae, around joints, etc. as well as some fat, connective tissue and skin (if there is any that remains on the carcass). There will also be trace amounts of bone, which provide calcium – but bone content is monitored closely as only so much calcium is allowed in MSC. Lastly, some of the meat will appear darker in color becasue it either came from legs (dark meat) or is bone marrow (if bones are broken in the process, some marrow can come out).

Take a look at the picture below. The video says this is mechanically separated chicken. What’s your take?

Dr. Owens:

Well, it would be great to know the source of that image, because without it, anyone can claim it is anything. If it is any type of meat, I would guess that it is a hot dog batter – not chicken – because of the coloring. When a meat emulsion is made (ie., hot dog, bologna), it becomes lighter in color because of the stable mixture between fat and water that is formed. Kind of similar to the reason mayonnaise is white. Because poultry meat is relatively light anyway, color (e.g., paprika) can be added. The nitrites generally found in cured products (i.e., hot dogs) also create a color reaction in the meat, causing it to have a reddish/pinkish color in meat.

Do you eat meat that has gone through mechanical separation?

Dr. Owens:

Yes – in fact, I happen to like hot dogs!

If consumers don’t want to eat MSC, how can they avoid it?

Dr. Owens:

If MSC (or MST – mechanically separated turkey) is used in a product, it has to be listed on the ingredient statement as “mechanically separated chicken” (or other species). It would not be listed as just “chicken.” Overall, I encourage people to read their ingredient statements before coming to any conclusions. If they are not satisfied with those ingredients, they can choose another product.

How about you… do you eat products like hot dogs and bologna that have been emulsified? Tell us in the comments section below.

_{“Fast Food Chicken Nuggets” by Walt Stoneburner is licensed under CC BY.}

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