Which Will Make You Sicker: Four Star V. Fast Food

4 minute read

Americans love to eat out. Every day, 44% of us have at least one meal at a restaurant. All that convenience of not cooking at home, however, has a price. In a recent report from the Center for Science in the Public Interest (CSPI), researchers found that 44% of foodborne illness outbreaks were tied to restaurants, compared to 24% that occurred at home. That means that you’re twice as likely to get food poisoning eating at a restaurant than you are at home.

But are some types of restaurants that are “safer” than others when it comes to avoiding illness? The CSPI report didn’t analyze outbreaks by restaurant type, says Sarah Klein, senior attorney for food safety at CSPI, but other data suggests that you shouldn’t jump to the conclusion that the greasy diner and drive-thru are more likely to make you sick than a fine-dining spot. “One of the things that gives nutritionists palpations is that we’ve said at CSPI: That McDonald’s [and other fast food restaurants] may be the safest places to eat out,” says Klein.

MORE: When the World’s Top Restaurant Serves Up a Bug

Unwelcome critters like roaches and rats can certainly carry nasty bugs (and it goes without saying they’re health department no-nos) but they may not always be as bad as, say, using the same cutting board for raw and cooked foods, which can spread salmonella and E. coli, or employees neglecting to wash their hands after they use the rest room, which can introduce E. coli into the kitchen. “There’s a difference between quality and safety,” says Klein. “Things that are likely to gross you out are not necessarily the things that are likely to put you in the hospital.”

And it’s entirely possible that these violations may be more likely to occur in medium-priced or higher end restaurants, just because kitchen staff handle food more than they do fast food chains. Most fast food arrives frozen, in pre-packaged units, and cooking units can’t be turned off until the meat inside reaches the proper temperature.

Large corporations also use their purchasing power to ensure that manufacturers follow strict sanitation practices and provide reliably safe products: If an order for millions of dollars is on the line, growers and food makers are more likely to pay attention to keeping contaminants out.

MORE: How To Stop The Superbugs

At higher-priced restaurants or local facilities run by a family, however, there are more opportunities for contaminants to sneak into food. “Things are cooked to order and there are a lot of handling steps that go into that process,” says Klein of non fast food restaurants. Fresh ingredients are also more prone to contamination by bacteria since they aren’t processed or treated in order to retain their natural flavor. Once in the kitchen, they have to be stored at the appropriate temperature and washed, chopped, or cooked properly as well.

In a 2008 report on food safety, CSPI revealed that there was little difference in health department inspection reports — those letter grades you see in the windows of restaurants in cities like New York and Los Angeles — among lower-priced restaurants and higher-priced ones, suggesting that paying more doesn’t necessarily equal a cleaner kitchen. And across all restaurant types, the most common health department violations involved unclean food surfaces, followed by improper storing temperatures for raw and cooked foods. The third most common violation? Employees not washing their hands after handling raw meat or using the restroom.

For clues on how clean a restaurant is, check online reviews from recent diners (if they report getting sick after eating there, take heed), check the bathrooms for cleanliness, and if your food seems undercooked, don’t be shy about sending it back. Food poisoning is a bad way to end a nice night out.

More Must-Reads from TIME

Contact us at letters@time.com