Consumption of Raw Flour in the United States: Results from the 2019 U.S. Food and Drug Administration Food Safety and Nutrition Survey

Abstract: Several outbreaks of Shiga toxin-producing Escherichia coli infections in the past decade have been linked to flour and flour-associated products and have raised concerns that the consumption of raw flour represents a public health risk as a vehicle for foodborne pathogens. The extent to which consumers know and understand that they should not consume raw flour is unclear. In fall 2019, the U.S. Food and Drug Administration collected data on perceptions regarding uncooked flour and on self-reported consumption behaviors via the Food Safety and Nutrition Survey, a national probability survey of U.S. adults (≥18 years of age). Cross-tabulations and regressions were used to analyze the data (n = 2,171). Thirty-five percent of consumers reported having tasted or eaten something with uncooked flour in it in the previous 12 months. Responses differed significantly by sex, race, education, and age. On average, respondents indicated that uncooked flour is not likely to contain germs that can make people sick, with significant differences noted by demographic categories. Respondents rated raw homemade cookie dough as moderately likely to have germs that can make people sick, with significant demographic differences. These findings indicate that U.S. consumers are largely unaware that raw flour is risky to consume, and many people are consuming products that contain raw flour.