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There is great variability in food safety practices among older adults

Thaivalappil A, Young I, Paco C, Jeyapalan A, Papadopoulos A. Food safety and the older consumer: A systematic review and meta-regression of their knowledge and practices at home Food Control. 2019; 106782.

Review question

•      How knowledgeable are older adults about safe practices to handle food? To what extent do they engage in risky food consumption behaviours?

Background

•      Foodborne illnesses can have a tremendous impact on society through direct healthcare costs and indirect costs like lost productivity. In the United States alone, major foodborne illnesses are estimated to result in $14 billion in losses annually.

•      In addition to their financial costs, foodborne illnesses contribute to significant morbidity and mortality worldwide.

•      Older adults, along with young children and pregnant women, are especially susceptible to foodborne illnesses and often experience more severe symptoms.

•      Older adults are considered a high-risk population for foodborne illnesses because of their weakened immune system, which result in greater likelihood of complications resulting from illnesses. Older adults are more likely to practise unsafe food storage, handling, food consumption, and cooking behaviours, which also contribute to their risk profile.

•      This systematic review aims to identify, characterize, and summarize the literature examining older consumers’ safe food handling knowledge and behaviours, risky food consumption behaviours, and availability and preparedness of kitchen resources.

How the review was done

•      Review authors conducted a detailed search of eight research databases for eligible studies in June of 2018.

•      A complimentary search for unpublished grey literature was conducted on two additional databases.

•      The search strategy was based on previous studies in the field and included keywords such as food safety, elderly, knowledge, and behaviours.

•      A total of 1,452 articles were retrieved from the initial search, of which 57 were included in this review.

•      No conflicts of interest were declared.

What the researchers found

•      Results of this systematic review were categorized into four topics: consumer knowledge, food safety behaviours, risky food consumption behaviours, and preparedness and availability of kitchen resources.

•      Wide variability was found in the extent of consumer knowledge across all three areas of analysis, including a) understanding of best-before and use-by dates; b) awareness of Listeria; and c) awareness of safe operating temperature of refrigerators.

•      Great variability was also found in food safety behaviours. While most older adults reported refrigerating leftovers within two hours, mixed answers were reported for handwashing before food preparation, handwashing after food preparation or handling raw meat, performing the unsafe behaviour of washing raw meat, and safely storing raw meats in the refrigerator. Participants generally did not monitor the temperature of their refrigerators but reported generally positive outcomes for defrosting foods using methods other than leaving it out at room temperature.

•      In terms of risky food consumption behaviours, consumption of undercooked eggs fell between 8% and 50% prevalence across studies. Consumption of undercooked meat was reported less often, ranging from 9% to 24%.

•      Finally, preparedness and availability of kitchen resources also saw mixed results. Sixty-six percent of older adults reported owning a food thermometer across three studies. Only a small number of participants reported having a thermometer in their refrigerators (24%).

Conclusion

•      This systematic review synthesized the current research on older consumers' food safety knowledge, behaviours, and risky food consumption.

•      Analysis showed great variability of most outcomes and highlights a need for further research in these areas.

•      Key research gaps in the current literature included awareness and eating habits of many high-risk foods; storage practises like duration of storing leftovers in the refrigerator; and in-person observations of older consumers.