As we enjoy our most food-oriented holiday tomorrow, nutritionists and food safety experts recommend that particular care be taken to ensure that leftovers -- whether kept for later meals or dispatched home with guests -- don't become a catalyst for the pain, vomiting, and diarrhea that afflicts some 400,000 Americans annually on Thanksgiving.
The horrifying foodborne illnesses that struck Europe in the spring of 2011 served as a reminder that even the most "healthy" foods can sicken and potentially be lethal. In Europe, the culprit ultimately was identified as bean sprouts.
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The Center for Science in the Public Interest has offered a simple formula "2 hours -- 2 inches -- 4 days" for ensuring Thanksgiving food safety:
Two hours: You may be tempted to stay at the table chatting and digesting, but all leftovers need to be in the refrigerator within two hours.
Two inches: Don't overload food containers. Fill them only to a depth of two inches, which will allow rapid chilling of the contents.
Four days: Eat refrigerated leftovers within three to four days, or freeze if keeping longer.
The two-hour rule is critical, experts said. "Improper cooling is one of the major causes of foodborne illness," explained Suzanne Driessen, a food safety educator at the University of Minnesota in St. Cloud.
Most bacteria associated with foodborne illness, such as Salmonella, Clostridium perfringens, Escherichia coli, and Campylobacter jejuni, can grow at temperatures between 40° F and 140° F.
"Leaving food in the temperature danger zone of 40° F to 140° F for more than two hours is a dangerous practice. However, bacteria can grow and multiply every 10 minutes in the 'super danger zone' between 70° F and 130° F, making cooling quickly an important ingredient in preventing foodborne illness," Driessen told MedPage Today and ABC News in an email.
If the centerpiece of the meal is a turkey, most experts advise that the meat be removed from the bone before storage and placed in meal-sized containers. Stuffing should be stored separately, and is generally considered safer when cooked outside the bird.
"Stuffing cooked inside the turkey may not attain a cooking temperature sufficient to kill bacteria that may be present, or that may contaminate it from the inner walls of the turkey itself," advised Pascal J. Imperato, MD, of the State University of New York Downstate Medical Center in New York City.
The turkey must be cooked to a temperature of 165° F. "Stuffing inside a turkey that does not attain a high enough temperature to kill all bacteria may become a perfect incubator medium for their rapid growth," Imperato said in an email.
Desserts vary in how long they can be kept. Connie Diekman, RD, of Washington University in St. Louis told MedPage Today and ABC News in an email: "Leftover pie depends on the type. Custard pies such as pumpkin last two to three days, but fruit pies will be good for three to five days."
Another hazard arises when a food item that has been properly cooked ends up sharing space with an uncooked item. Wash cutting boards, kitchen surfaces, and your hands between tasks.
An important factor in safe food storage is the temperature of the refrigerator. One out of four home refrigerators are not sufficiently cold, according to Driessen. Setting the temperature control at 36° to 38º will ensure that contents are kept below 40°, and a refrigerator thermometer can be helpful.
A final note of caution was offered by David L. Katz, MD, of Yale University in New Haven: "When it doubt, throw it out."