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Background Frozen foods have rarely been linked to Listeria monocytogenes illness. We describe an outbreak investigation prompted by both hospital clustering of illnesses and product testing. Methods We identified outbreak-associated listeriosis cases using whole-genome sequencing (WGS), product testing results, and epidemiologic linkage to cases in the same Kansas hospital. We reviewed hospital medical and dietary records, product invoices, and molecular subtyping results. Federal and state officials tested product and environmental samples for L. monocytogenes. Results Kansas officials were investigating 5 cases of listeriosis at a single hospital when, simultaneously, unrelated sampling for a study in South Carolina identified L. monocytogenes in Company A ice cream products made in Texas. Isolates from 4 patients and Company A products were closely related by WGS, and the 4 patients with known exposures had consumed milkshakes made with Company A ice cream while hospitalized. Further testing identified L. monocytogenes in ice cream produced in a second Company A production facility in Oklahoma; these isolates were closely related by WGS to those from 5 patients in 3 other states. These 10 illnesses, involving 3 deaths, occurred from 2010 through 2015. Company A ultimately recalled all products. Conclusions In this US outbreak of listeriosis linked to a widely distributed brand of ice cream, WGS and product sampling helped link cases spanning 5 years to 2 production facilities, indicating longstanding contamination. Comprehensive sanitation controls and environmental and product testing for L. monocytogenes with regulatory oversight should be implemented for ice cream production. [ABSTRACT FROM AUTHOR]

Milk protein is recognised as one of the eight most common food allergens in the United States, and one of the most common causes of fatal or near-fatal food-induced anaphylactic reactions globally. Undeclared allergens in food products are the leading cause of the U.S. Food and Drug Administration (FDA) requests for food recalls, with undeclared milk protein as the most frequently cited allergen. The purpose of this study was to evaluate the prevalence of milk protein contamination in milk-alternative ice cream products sold as frozen dessert in the U.S. and labelled as 'non-dairy', 'dairy-free', and/or 'vegan', and to characterise the potential risk for allergic individuals consuming these products. Thirty-two unique milk-alternative frozen dessert products, including flavours with and without inclusions, from 16 different brands, were tested for the presence of milk proteins using enzyme-linked immunosorbent assay. Milk protein was detected in three of the tested products: two contained solid inclusions, and one did not have inclusions. One of the three products with detectable milk protein had an advisory statement indicating the product was made in a facility that processed milk. Although no consensus exists as to the minimal dose of milk protein necessary to elicit an adverse effect in a milk-sensitised individual, the milk protein quantities in one serving of each of the three products exceeded some of the published thresholds. These results suggest that one serving of certain milk-alternative frozen dessert products could potentially elicit an allergic response in highly sensitive individuals. [ABSTRACT FROM AUTHOR]

Listeria monocytogenes was linked to an outbreak of foodborne illness associated with in-process contaminated ice cream in the United States from 2010 to 2015 that sickened 10 individuals and led to 3 deaths. Ice cream obtained from the outbreak was used in this study to examine the population dynamics of L. monocytogenes as in-process contaminants compared with artificially inoculated cells. Because challenge studies of food products generally use artificial contamination, it is necessary to understand the differences in survival, if any, between these 2 types of contaminants. We hypothesized that laboratory-grown cultures of the pathogen that were not exposed to the environmental stresses of the manufacturing facility would show different population dynamics in an ice cream challenge study compared with in-process contaminants. In this study, half of the outbreak-associated ice cream samples were artificially inoculated with a 10 cfu/g cocktail of L. monocytogenes ; the other half contained only the in-process contaminants. All samples were stored at −20°C and tested for pathogen levels (n = 10 for each contaminant type at each time point) by the most probable number method at 3-mo intervals for 36 mo. Generally, population levels between the 2 contamination states in the ice cream were not significantly different and L. monocytogenes survived for at least 36 mo, regardless of contamination state. Overall, our results suggest that the use of L. monocytogenes as an artificial contaminant in challenge studies and risk assessment of ice cream during frozen storage give results similar to those shown by in-process contaminants. [ABSTRACT FROM AUTHOR]

The relationship between the number of ingested Listeria monocytogenes cells in food and the likelihood of developing listeriosis is not well understood. Data from an outbreak of listeriosis linked to milkshakes made from ice cream produced in 1 factory showed that contaminated products were distributed widely to the public without any reported cases, except for 4 cases of severe illness in persons who were highly susceptible. The ingestion of high doses of L. monocytogenes by these patients infected through milkshakes was unlikely if possible additional contamination associated with the preparation of the milkshake is ruled out. This outbreak illustrated that the vast majority of the population did not become ill after ingesting a low level of L. monocytogenes but raises the question of listeriosis cases in highly susceptible persons after distribution of low-level contaminated products that did not support the growth of this pathogen. [ABSTRACT FROM AUTHOR]

A most-probable-number (MPN) method was used to enumerate Listeria monocytogenes in 2,320 commercial ice cream scoops manufactured on a production line that was implicated in a 2015 listeriosis outbreak in the United States. The analyzed samples were collected from seven lots produced in November 2014, December 2014, January 2015, and March 2015. L. monocytogenes was detected in 99% (2,307 of 2,320) of the tested samples (lower limit of detection, 0.03 MPN/g), 92% of which were contaminated at <20 MPN/g. The levels of L. monocytogenes in these samples had a geometric mean per lot of 0.15 to 7.1 MPN/g. The prevalence and enumeration data from an unprecedented large number of naturally contaminated ice cream products linked to a listeriosis outbreak provided a unique data set for further understanding the risk associated with L. monocytogenes contamination for highly susceptible populations. [ABSTRACT FROM AUTHOR]

Descriptive analysis and consumer acceptance tests were conducted with 10 commercial vanilla ice creams. Aroma (vanilla/vanillin, cooked milk), taste (sweet, bitter), flavour (caramelised, oxidised, metallic) and mouthfeel/texture (astringent, scoopability/manual hardness, degree of ice, smoothness, mouthcoating) showed significant differences among the products. Of the ten ice creams examined in this study, BC (7.10) and EG (6.91) showed the highest overall quality ratings, and the majority of consumers were located around BC and EG by the principal component analysis. Drivers of liking (mouthcoating) and disliking (vanilla/vanillin, bitter, metallic, astringent and scoopability/manual hardness) were identified by partial least-square regression analysis for vanilla ice creams. [ABSTRACT FROM AUTHOR]

With the increasing popularity of ice cream in the nineteenth century, the incidence of foodborne illness attributed to this dessert exploded. Struggling to understand the causes of the mysterious and sometimes lethal ailment called "ice cream poisoning," Victorian doctors and scientists advanced theories including toxic vanilla, galvanism in ice cream freezers, and extreme indigestion. In the late 1880s Victor C. Vaughan's argument that ice cream poisoning could be attributed to the ptomaine "tyrotoxicon" received widespread acceptance. To date historians have neglected the role played by the ptomaine theory of food poisoning in shaping the evolution of both scientific thinking and public health in the late nineteenth century. The case of ice cream poisoning illustrates the emergence, impact, and decline of the ptomaine idea. [ABSTRACT FROM AUTHOR]

Abstract: The occurrences of Bacillus cereus group strains in 40 ice cream samples were investigated. Among 109 isolated B. cereus group strains confirmed by 16S rDNA sequence analysis only 50 were identified as B. cereus and one as B. thuringiensis by using FDA (U.S. Food and Drug Administration) standard, indicating the two identification standards were highly inconsistent. Furthermore, the psychrotolerant growth properties and the occurrence of specific psychrotolerant genes of the isolates were also studied. Both psychrotolerant 16S rDNA fragments and enterotoxic genes could be detected among mesophilic and psychrotolerant strains. No relationship among psychrotolerance, presence of psychrotolerant 16S rDNA fragments and enterotoxic genes were found and the specific cspA fragment was only detected in a small fraction (9.5%) of the psychrotolerant isolates. One psychrotolerant isolate Bw2-1 was identified as B. weihenstephanensis, but no clear distinguishing characteristics between B. weihenstephanensis and psychrotolerant B. cereus were found. These results might be of importance for gaining further understanding of the growth properties of B. weihenstephanensis and psychrotolerant B. cereus as well as their contribution to food poisoning. [Copyright &y& Elsevier]

Ice cream has been manufactured commercially in the United States since the middle of the 19th century. Ice cream and frozen dessert products comprise an important and relatively stable component of the United States dairy industry. As with many other dairy products, ice cream is differentiated in several dimensions. A censored translog demand system model was employed to analyze purchases of 3 ice cream product categories. The objective of this study was to determine the effect that changes in retail prices and consumer income have on at-home ice cream consumption. The analysis was based on Nielsen 2005 home scan retail data and used marital status, age, race, education, female employment status, and location in the estimations of aggregate demand elasticities. Results revealed that price and consumer income were the main determinants of demand for ice cream products. Calculated own-price elasticities indicated relatively elastic responses by consumers for all categories except for compensated bulk ice cream. All expenditure elasticities were inelastic except for bulk ice cream, and most of the ice cream categories were substitutes. Ongoing efforts to examine consumer demand for these products will assist milk producers, dairy processors and manufacturers, and dairy marketers as they face changing consumer responses to food and diet issues. [ABSTRACT FROM AUTHOR]

Background: Modifiable risk factors such as diet may be important in both the etiology and progression of endometriosis as well as the prevalence of pain symptoms and infertility associated with this condition. In adults, higher intake of dairy has been associated with a lower risk of endometriosis diagnosis. There is currently no literature on whether dairy intake during adolescence, a potentially critical window of exposure, influences endometriosis risk.Objective: The objectige of the study was to evaluate the association between consumption of dairy foods in adolescence and the risk of laparoscopically confirmed endometriosis.Study Design: This was a prospective cohort study, the Nurses' Health Study II, which has prospectively collected data since 1989. In 1998, when participants were aged 34-51 years, they completed a 124 item food frequency questionnaire about their high school diet. Cases were defined as those who self-reported laparoscopically confirmed endometriosis. Cox proportional hazard models were used to calculate hazard ratios and 95% confidence intervals for the association between dairy foods and laparoscopically confirmed endometriosis.Results: Among women who completed the questionnaire about their high school diet in 1998, 581 cases of laparoscopically confirmed endometriosis were diagnosed among 32,868 premenopausal women from 1998 to 2013. Women who consumed more than 4 servings per day of dairy foods during adolescence had a 32% lower risk of laparoscopically confirmed endometriosis during adulthood (95% confidence interval, 0.47-0.96; Ptrend = .04) compared with women consuming 1 or fewer servings per day. The association was similar for low-fat and high-fat dairy foods. Yogurt and ice cream consumption, specifically, were associated with a lower risk of endometriosis. Those who consumed 2 or more servings of yogurt per week as an adolescent had a 29% lower risk of endometriosis diagnosis (95% confidence interval, 0.52-0.97; Ptrend = .02) compared with those consuming less than 1 serving per week. In addition, women who consumed 1 or more servings per day of ice cream per day during adolescence had a 38% lower risk of endometriosis diagnosis (95% confidence interval, 0.40-0.94; Ptrend = .20) compared with those consuming less than 1 serving per week.Conclusion: Our findings suggest that dairy consumption, specifically yogurt and ice cream intake, in adolescence may reduce the risk of subsequent endometriosis diagnosis. Future studies in adolescent populations are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Even though, to date, numerous studies in food advertising have considered the use of visual metaphors, their impact on consumers' responses in diverse cultures has been only narrowly investigated. The present study scrutinizes the conditional indirect effect of visual metaphors on the moderated by culture attitude toward the ad and the resulting attitude toward the brand. Two 2 × 2 full factorial between-subjects experiments with two levels of visual metaphor (presence and absence) and two levels of culture (India and the USA) were used to test our hypotheses. Participants, 417 (207 Indian, 210 US) for the first experiment and 181 (82 Indian, 99 US) for the second experiment were divided in four treatment groups (one for each condition). Two versions of two print advertisements for a novel coffee and a novel ice-cream brand were the experimental stimuli in experiments 1 and 2 respectively. SPSS macro (PROCESS tool) was used for data analysis. Both experiments provided evidence in support of the proposed framework. Visual metaphors in high context cultures (India) seem to have a significantly more positive effect on attitude toward the ad and eventually on attitude toward the brand compared to low context environments (USA)., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Health literacy has been defined as the ability to obtain, process, and understand the basic information needed to make appropriate health decisions. Half of adults lack the health literacy skills needed for our complex health care environment. In 2005, Weiss et al introduced the Newest Vital Sign (NVS), an instrument that can be used to quickly assess health literacy. The purpose of this study was to determine the acceptability and timeliness of using the NVS to measure the level of health literacy in various suburban, urban, and rural primary care settings. A secondary purpose was to determine the influence of taking a health class on one's level of health literacy., Methods: In this cross-sectional design, adults were recruited from 4 primary care settings and student athletes were recruited during preparticipation sports physicals. The NVS was administered and health literacy rates were compared with known trends. A subset of 50 patients was timed during test administration, and refusals were logged throughout. The adults and the athletes were analyzed separately., Results: One thousand fourteen patients (including athletes) agreed to participate (response rate, 97.5%). Average time needed to complete the NVS was 2.63 minutes. Of the adults tested, 48.1% demonstrated adequate health literacy. In logistic regression analysis, younger age, more formal education, health class participation, and body mass index were positive predictors of adequate health literacy among adults. An interaction term was used for gender/race, with white women used as the comparator. The gender/race odds ratio negatively affected literacy, with white men at 0.497 (95% CI, 0.328-0.753), non-white women at 0.177 (95% CI, 0.111-0.282), and non-white men at 0.210 (95% CI, 0.110-0.398). Among the participating middle- and high-school athletes, 59.7% had adequate health literacy. In logistic regression of this population, body mass index was a positive predictor whereas gender/race was a negative predictor., Conclusion: The NVS revealed health literacy status in less than 3 minutes, was widely accepted, and provided results comparable to more extensive literacy tests. Particularly, taking a health education class was associated with higher levels of health literacy among adults.