Kids Love Dr. Barton

Just How Safe Is That Lunch?

by Dr. Douglas Barton, M.D., Pediatrician 08/09/2011

Millions of American children are sent to school with sack lunches more than one day a week for day care or school.  For many of these children, their parents believe that they are providing the best nutrition for their children as well as retaining some amount of control over what their children eat.  Little do they know that they may inadvertently be infecting  their children in the process.

A study published in the journal Pediatrics, the official publication of the American Academy of Pediatrics, was released last week that looked specifically at school lunches and the risk of infection.  The study specifically looked at whether foods sent in "sack" lunches were kept below 40 degrees Fahrenheit, the USDA recommended temperature for perishable foods.  The authors looked all the contents of 705 lunches at 9 different day care centers.  In those 705 lunches were 1306 perishable items.  Only 22 of those items remained below 40 degrees.  Surprisingly, adding ice packs did not increase the percentage of items that remained at acceptable temperatures.  Additionally, putting lunches in the refrigerator also did not increase the percentage remaining at acceptable temperatures.

Close evaluation suggested that very, very few foods remained at an acceptable temperature for more than an hour after being packed for the children!

Several hypotheses were given for the poor temperature maintenance.  Ice packs, by themselves, did not keep the lunches cool enough as the lunches were not insulated enough.  Alternatively, some things were placed in refrigerators, but were too well insulated against the cooling temperature the refrigerator provided.   The authors went on to say that their study actually presented more new questions than it actually answered.

Perishable foods left at temperatures above 40 degrees Fahrenheit for more than 1-2 hours allow the rapid growth of bacteria already present in food.  When food is kept below this temperature, these bacteria are unable to grow and make more bacteria, so their numbers remain low.  The more bacterial growth on food, the more likely people who eat that food are to get sick.  Children in particularly are prone to illness from food borne bacteria.  Food borne bacteria mostly cause "stomach flu" type symptoms with vomiting and diarrhea.  Some of these bacteria, like Salmonella and E. coli, can cause serious illness, especially in children.

So what should a parent do with this information?  What is very clear is that perishable food is a risk in a "sack" lunch.  Nuts, fruits, crackers and other non-perishable foods can provide an important source of nutrition in such lunches.  If you add perishable foods to your children's lunch, pack them with cool packs for the trip to school or day care.  Once you arrive, take the food out of the packing and place them in an appropriate refrigerator. 

Day care centers and schools can use this information to take a close look at their refrigerator policies.  Often times, students and staff are allowed free access to refrigerators, leading to doors that are frequently opened and shut.  Each time the door is opened, the temperature inside goes up a little until the refrigerator can lower the temperature back down.  Consideration should be given to limiting how often the refrigerator doors are opened.  Another possible strategy that has not been tested, would be to lower the temperature inside the refrigerator during the school's operating hours.



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