Runny eggs for all! The implications of changing advice on egg - PowerPoint PPT Presentation

Runny eggs for all! The implications of changing advice on egg safety for care homes June 2016

British Egg Industry Council • Formed in 1986 - representative body for egg industry • Administers the British Lion Code of practice • Funds the generic marketing of eggs through the British Egg Information Service

Eggs and salmonella

1988 1988

Sp Sprin ing 19 1998

Trends in human salmonellosis in England and Wales 35000 All S.E. PT4 30000 S.tm Other 25000 20000 15000 10000 5000 0 81 83 85 87 89 91 93 95 97 Year

Current advice on eggs • Current advice is that vulnerable groups (babies, pregnant women, elderly and infirm people) should only eat eggs if they are fully cooked until the white and yolk are solid • Advice dates from salmonella scare in 1988 • FSA currently reviewing the advice

Why review the advice now? • It’s no longer relevant or accurate – Salmonella has been effectively eradicated from British Lion eggs • It’s disproportionate – Risk of food poisoning from eggs is significantly lower than many other foods – Any remaining risk vastly outweighed by benefits to vulnerable groups • It’s having unintended consequences – People most in need of the nutritional benefits of eggs being discouraged from eating them – It may be contributing to increased egg allergy

FSA review • FSA instigated review of their advice in October 2014 • Advisory Committee on the Microbiological Safety of Food asked to review egg safety • ACMSF presented draft report in January 2016

ACMSF conclusion – January 2016 “The Food Standards Agency should now consider amending its long - standing advice – that vulnerable groups should avoid raw or lightly cooked eggs - for eggs produced under the British Lion scheme or a demonstrably- equivalent comprehensive scheme.”

ACMSF report – January 2016 • ‘There has been a major reduction in the microbiological risk from Salmonella in UK hen shell eggs since the 2001 ACMSF report. This is especially true for those eggs produced under the Lion Code.’ • ‘The very low risk level means that eggs produced under the Lion Code, or produced under demonstrably equivalent comprehensive schemes, can be served raw or lightly cooked to all groups in society, including those that are more vulnerable to infection, in both domestic and commercial settings, including care homes and hospitals.’

Why are Lion eggs recommended?

Lion Code of Practice – hens • All Lion hens guaranteed British • Hens vaccinated against Salmonella Enteritidis and Salmonella Typhimurium • Stringent feed controls, including production of feed to Universal Feed Assurance Scheme (UFAS) standards • Registration and a unique 'passport' system, ensuring complete traceability of hens, eggs and feed • Increased hygiene controls and salmonella testing on farm, in excess of the National Control Programme, including turnaround swabbing

Lion Code of Practice - eggs • Regular egg testing (not included in National Control Programme) • Lion Quality eggs stamped on farm with the farm code and production method • Increased hygiene controls, in excess of national and EU legislation, including packing centre hygiene swabbing • Cool chain from farm to packing centre to retailer • Best-before date and Lion logo printed on the shell of Lion Quality eggs as well as on the egg box

Lion Code of Practice - auditing • Independent auditing, including unannounced audits, of all producers and packers in the Lion scheme, in accordance with the ISO 17065 standard • 700 different audit points in Code

17 years…….and counting • More than 700 auditable criteria • More than 50,000 audits • 3m eggs tested • £100 million investment by Lion producers • 300 Lion eggs eaten every second in the UK ……One amazing success story!

Human cases of salmonella - England and Wales - 35000 S. Enteritidis 30000 S. Typhimurium 25000 Other Serotypes The ‘salmonella in eggs’ crisis Total salmonellas 20000 PT4 15000 10000 5000 0 Year 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Source: Public Health England, May 2014

Non-Lion eggs

Imported eggs • Other European countries have experienced continued outbreaks of salmonella – several outbreaks among humans in the UK directly linked with imported eggs over last decade • HPA tests on imported eggs in 2004 – nearly 7% tested positive for salmonella • FSA survey of imported eggs on sale in the UK, published in 2006 – egg shell and/or contents contamination in one in 30 boxes of six eggs sampled

Imported egg survey 2006

Salmonella outbreak – 2015

Identifying and using eggs

What to look for

Handling eggs • Store away from strong smelling foods - egg shells are porous. • Store eggs away from raw meat. • Wash hands before and after handling eggs. • Never use dirty, cracked, broken or washed eggs. • Growth of salmonella can be prevented or minimised by low temperature storage, particularly in the kitchen – temperature fluctuations can accelerate changes to yolk membrane permeability. • Eggs should be kept at a constant temperature below 20oC to – prevent deterioration in yolk membrane permeability – minimise growth of any micro-organisms that may be present • In the catering industry, where pooling of eggs is common, pasteurised egg products should be substituted for raw eggs

Good egg!

Nutritional benefits of eggs • Nutritionists and dietitians now actively encouraging egg consumption • Nutrient dense food – High quality protein - nutrient-rich alternative to red/processed meat – Naturally rich in vitamin D, B2 (riboflavin), vitamin B12, iodine, selenium and other essential dietary vitamins and minerals • Practical benefits, particularly for those on low incomes – Economic – one of cheapest protein foods – Quick/easy to cook

Limits? • Once thought that dietary cholesterol in eggs raised blood cholesterol • Subsequent research showed that saturated fat, not dietary cholesterol, is most influential in raising blood cholesterol • All UK heart and health organisations have removed limits “Although eggs contain "There’s no recommended cholesterol, the amount limit on how many eggs of saturated fat we eat has you should eat. Eggs can more effect on the amount be included in a healthy, of cholesterol in our blood balanced diet” than the cholesterol we get from eating eggs.”

Nutritional needs of older people Alison Smith, British Dietetic Association - Older People Specialist Group

Undernutrition • Residents in care homes at risk of malnutrition (undernutrition) – Recent UK studies have shown that 30 – 42% of those admitted to care homes are malnourished on admission – Prevalence of malnutrition in individual care homes commonly between 30 and 50% of all residents – Care home residents tend to be less well, less mobile and more dependent than people living in the wider community • Detecting and treating malnutrition is therefore essential, and treatment should focus on increasing intake of all nutrients, not just calories

Sarcopenia • Older people who are less physically active are also at high risk of developing sarcopenia (loss of body muscle and muscle strength), which can have a significant impact on mobility – Sarcopenia affects 14 – 33% of those living in long term care • Adequate intake of protein essential to help prevent/treat sarcopenia and malnutrition – 35% of older adults living in long term care fail to meet minimum recommended protein requirement – Recent evidence suggests that the current recommended protein requirement for older people may need to be increased • Current evidence also suggests that inclusion of a similar sized portion of protein containing food at each meal may help more in preventing/treating sarcopenia than a large portion of protein at 1 meal with smaller amounts at other meals • Adequate vitamin D intake is also implicated in prevention and treatment of sarcopenia

Where eggs fit in • One of the best food sources of high quality, easily digestible protein – 2 medium eggs contain 14g protein – Eggs are a good source of leucine, an essential component of protein which plays an important role in muscle repair/growth • Eggs are also a good dietary source of vitamin D • Eggs are a familiar food for many older adults, especially at breakfast time (fried, poached, scrambled, boiled) or as part of a snack meal (egg on toast, egg sandwich) • Eggs are soft and therefore easy to chew, even for those with few teeth • Eggs are small and therefore less likely to put off those with a small appetite • Eggs are quick and easy to prepare within busy care home kitchens

Summary

Summary • Nutritionists and dietitians now actively encouraging egg consumption – Nutrient-dense food – ‘Limits’ removed • Eggs particularly important for older ages – Easy to eat – Nutrient-dense – Most digestible form of protein • British Lion eggs have never been safer – Salmonella has been effectively eradicated through the Lion Code – Lion eggs can now be served ‘runny’ for vulnerable groups