How Good Foods Can Go Bad: Juices

I love my morning orange juice. It is tasty. It is refreshing. I believe it is healthy.

American society is embracing juices by “juicing” nearly everything as evidenced by the rainbow colors of juices we see in grocery stores, food stands and specialty cafe’s. But there is a trend for consumers to drink commercial non-pasteurized juices and that carries an increasing risk of food borne illness.

What’s in Your Juice?

One of the largest hepatitis A outbreaks in the USA in 2016 was linked to strawberries used in smoothie products. The epidemic sickened 143 people in 9 states. The source was frozen fruit imported from Egypt and was found in multiple samples of strawberries.

Unpasteurized apple juice from “rotten apples” was the source of an E. Coli epidemic in 1996 that killed a 16 month old child and sickened 66 people, some of whom suffered from kidney and blood disorder diseases as a result. Odwalla Juice company had chosen not to pasteurize “claiming that the process of pasteurization alters the flavor and destroys at least 30% of nutrients and enzymes in fruit juice.”

Why Pasteurize?

Pasteurization is the process of heating the product to a high temperature for a short time. The goal of pasteurization is to kill bacteria and viruses that may be in the product. As it relates to juices, products naturally are likely to have germs from either the environment or from the harvesting process. Unless they are thoroughly washed and pasteurized there is a risk that the product and or/juice may become the host for the germ and the disease. Fortunately most juices in the United States are pasteurized to kill harmful germs.

Since November 1999, the US FDA requires that all unpasteurized juice display a warning label. The label has a warning:


Juice that is packaged by a processor, a food establishment such as a grocery store or health food store must be treated, under the FDA plan, or be stored under refrigeration and have the above warning label. For further information on Juice regulations.

Be Careful With Fresh Squeezed

Unfortunately fresh squeezed juice, served at a restaurant, juice bar, grocery or health food store, cider mill or farmers market etc. is not required to be treated, be processed under the FDA regulation plan, or have a warning label. This puts the vendor and the customer at risk of food borne illness. Strict use of thorough handwashing, cleaning the outside of the fruit with a specially formulated fruit cleanser, avoiding cross contamination on cutting boards and utensils and aggressive pre-service refrigeration certainly will reduce that risk.

Children, the elderly and people with weakened immune systems are advised by some governmental agencies not to consume or be served unpasteurized productsHerein lies another opportunity for the vendor and/or server to caution the customer on the risk of the unpasteurized product to shift responsibility of choice.

I still plan to enjoy my morning OJ but do so with a cautious eye.


Author: Dr. Harlan Stueven, MD

Harlan Stueven M.D. is a Board-Certified Emergency physician with sub-specialization in Environmental Toxicology and Board Certification in Medical Toxicology. Starting his career in the USAF, he served as a Flight Surgeon and Environmental Health Consultant Physician where one of his duties was monitoring food safety. In his nearly 40-year practice, he treated a range of medical, surgical and poisoning emergencies. He has been a Medical Director and/or Chairman of several hospital-based Emergency Medicine Departments, served as the President of Emergency and Environmental Medicine consulting group, a physician group Chief Financial Officer and sat on many national, state and local committees. Dr. Stueven founded Dining Grades and the Dining Safety Alliance to improve food safety by increasing awareness of food borne illness and the formation of partnerships within the food industry. He is a consultant to the Wisconsin Retail Food Establishment Grading Work Group; a Co-investigator in a CDC funded “Evaluation of Health Department Restaurant Inspection Programs” project. He has presented at several National, State and Regional conferences on restaurant grading and food safety. He is an accomplished leader, medical researcher, a champion of process improvement, author, and national and international speaker.

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