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Food Safety in Chronic Illness

Updated: Nov 16, 2022

Foodborne illnesses are common, affecting nearly 48 million people each year. 1 in 6 Americans contract food poisoning each year which can result in serious repercussions. Individuals with weakened immune systems are put at even greater risk when exposed to foodborne illnesses. Conditions such as cancer, HIV, or kidney disease are more likely to increase the length of illness, risk of hospitalization, and risk of fatality.

Many chronic illnesses result in a weakened immune system, meaning that the body can’t fight off infection as well as a healthy body could. This is often the result of a reduction in white blood cells (WBCs). WBCs help fight infections and disease. In the presence of chronic diseases, these cells decrease from being killed off and the body's inability to produce new ones.

In the case of cancer, this reduction in immune strength can occur as a result of chemotherapy, radiation treatment, and/or through the spread of cancer to the bone marrow where WBCs are produced.

Other chronic illnesses like HIV/AIDS, invade the immune system, decreasing its function. Autoimmune diseases, on the other hand, mistakenly cause the immune system to attack the body. Therefore most autoimmune diseases have to be treated with immunosuppressants, which intentionally reduce immune function, resulting in an overall weakened immune system.

Food safety is an extremely important aspect of chronic disease management. Food is a prime environment for bacteria to grow and people with chronic conditions are much more susceptible to these foodborne pathogens. Luckily, understanding and utilizing proper food safety procedures will severely limit the risk of contracting food poisoning. Learning how to safely handle foods until they reach your table is a great tool to have when you or a loved one is battling a chronic illness.

Shopping for Food

Proper food safety starts at the grocery store. It’s important to shop for nonperishable foods first followed by perishable items to ensure these items stay at the proper temperature. The “use by” dates should also be checked on each product to ensure the best quality. Here’s a list of some other tips to remember when you visit the grocery store:

  • Use plastic bags to separate items (i.e. fruits in one bag, meat in another)

  • Do not buy any products with tampered packaging

  • Do not eat samples

  • Do not buy pre-cut melons

  • Check eggs to ensure they are clean and uncracked

  • If going to a farmers market, go early to ensure food has not been sitting out all day

  • Be selective when purchasing fish or other seafood products

  • Check all milk, dairy products, and juices to make sure they are pasteurized

Foods should be taken home to be stored at proper temperatures as soon as possible. If traveling long distances to store, consider using a cooler with ice to transport perishable food items. Frozen foods and refrigerated items should be put away first, followed by the non-perishables.

Handling and Storing Foods

Before handling foods, ensure that hands are adequately washed. All fruits and vegetables should be thoroughly washed until all dirt is removed from their surfaces. Even bagged “pre-washed” vegetables like salad mix should be washed prior to use. The same goes for canned goods. The tops of cans should always be cleaned and sanitized before opening because of the potential risk of cross-contamination from the production and shipment process.

When storing foods, it’s important to keep them at the appropriate temperature. Cold foods should be stored at 40° F or lower. Hot foods should be kept at 135° F or higher. Non-perishables need to stay out of the “temperature danger zone,” which is anywhere from 41° F to 135° F — It’s within this temperature range that disease causing bacteria grows best.

Here are some more tips for safe food storage:

  • Keep food items at least 6 inches above the ground

  • Store raw meats away from ready-to-eat foods

  • Store garbage cans away from prep areas

  • Keep food in sealed containers, bags, or packaging

  • Keep food away from chemicals and other cleaning supplies

  • Store ready-to-eat foods on top shelves of the fridge

  • Store meats and poultry at bottom of the fridge

Food Preparation

When preparing food, it’s important to avoid cross-contamination. All preparation surfaces should be wiped down and sanitized between each use. Hands should also be washed when switching from one task to another. Different utensils should be used for each food unless they have been washed in between uses.

For example:

  • Use one knife for cutting chicken and another for cutting vegetables

  • Don’t cut meats and vegetables on the same cutting board

  • Do not put raw meat and raw produce on the same tray

It’s also important during preparation that no foods are thawed at room temperature. If a food needs to thaw from being in the freezer, it should be placed in the fridge overnight to avoid the development of bacteria.

Food Cooking Procedures

Foods need to be heated to certain temperatures to be deemed as safe for consumption. Poultry should be cooked to at least 165° F and other meats and fish should be cooked to at least 145° F. The American Cancer Society recommends heating poultry to at least 180° F and other meats to at least 160° F as an extra precaution for those with weakened immune systems.

When meats are cooked, there should be no pink left in them whatsoever before serving. They should be cooked until the juices run a clear color. This ensures that all disease causing bacteria has been killed, minimizing the risk of infection.

When cooking foods in the microwave, they should reach a minimum temperature of 165° F. During the process, rotate or stir the dish accordingly to ensure that all parts of the food reach the required temperature. Use a calibrated thermometer and clean between uses.

Eating Out

Over half of the foodborne illnesses contracted each year come from restaurant food. Similar to having a food allergy, it’s important to be aware of your surroundings while dining out when you or a loved one has a weakened immune system.

Here are some tips to better ensure food safety while eating out:

  • Eat earlier in the day to avoid large crowds

  • Ask for single-serve condiments

  • Don’t set utensils directly on the table

  • Order all meats well done

  • Don’t order raw fruits or vegetables

  • Avoid “fresh squeezed” juice

  • Don’t eat from high-risk sources (i.e. buffet, salad bar, potluck)

For individuals with chronic illnesses, putting health as a top priority is crucial. Avoiding extra factors that pose risks, such as foodborne illnesses, is one step toward living a happier and longer life. Adequate food safety not only decreases the risk for foodborne illnesses but also ensures that food is able to promote recovery and overall health improvement. It starts at the grocery store/restaurant and doesn't stop until our food is in your mouth. Whether you are battling a chronic illness, someone you love is, or you’re hosting an individual with a compromised immune system, following safety precautions in your kitchen can make the world of difference.


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