The promise of the American food supply is that you can eat anything and not get sick. You can usually assume that whatever you buy from a grocery store or fast-food joint won’t land you in a hospital.

But lately, foodborne-illness outbreaks seem to be distressingly regular. On Tuesday, the CDC reported 49 cases and one death linked to McDonald’s Quarter Pounders tainted with E. coli. In the past week, hundreds of waffle and pancake products were voluntarily recalled due to potential Listeria contamination. Listeria in particular has been a problem of late: Earlier in October, more than 11 million pounds of ready-to-eat meat and poultry products were recalled. And an especially bad Listeria outbreak involving Boar’s Head deli-meat products has led to 59 hospitalizations across 10 states and 10 deaths.

Many of this year’s outbreaks have occurred in foods that are preprepared—those that can be eaten as-is, without further cooking. Foods such as Quarter Pounders and waffles, yes, but also cold cuts, prepackaged salads, and jarred salsa are popular because they are convenient. That convenience comes at a cost. A rule of thumb in food safety is that “the more a food is handled prior to consumption, the higher the chances it can be contaminated,” Lawrence Goodridge, the director of the Canadian Research Institute for Food Safety, told me. Americans are left with a difficult choice: save time or risk getting sick.

Many bacteria that cause foodborne illness live among us. Listeria can be found in soil and water, and E. coli and Salmonella are normally found in human and animal digestive tracts. They become a problem when they get into food. Preprepared foods are particularly prone to contamination because they are usually processed in large, sometimes even multiple, facilities where microbes have lots of opportunities to spread. “Somebody, somewhere, or a company, has produced the food so that we don’t have to do it at home,” Goodridge said. A factory worker with mud on his shoe, or an employee who didn’t wash her hands after using the bathroom, can be all it takes to start an outbreak. Food-safety practices—such as regular cleaning, temperature control, and strict hygiene standards—are supposed to keep these factories pristine. But occasionally, they fail.

Refrigerated facilities keep most bacteria at bay—microbes grow more slowly at lower temperatures—but not Listeria, which thrives in cool conditions. Given enough time to grow, a Listeria colony forms a protective gel over itself, called a biofilm, which makes it especially difficult to get rid of. Meanwhile, E. coli typically gets into produce through water soiled with feces. Usually, contamination occurs at the farm level, but microbes can spread as fresh foods are processed into products such as precut fruit, bags of chopped lettuce, and even prewashed whole greens. When clean produce is washed together with a contaminated batch or sliced with the same equipment, bacteria can spread. Many foods are produced in a central location and then shipped cross-country, which is how a contamination event at a single farm can lead to illnesses nationwide.

This may be the reason for the ongoing Quarter Pounder debacle. According to McDonald’s, the E. coli outbreak may be linked to slivered onions, which were sourced from a single supplier that served certain McDonald’s locations in 10 states, as well as some Taco Bell, KFC, and Pizza Hut stores. Centralizing the slivering of onions no doubt increases efficiency at fast-food chains. But it also raises the risk of contamination.

In food safety, cooking is known as a “kill step,” because high heat kills most dangerous pathogens. Precut salads and fruit are usually eaten raw. Nobody cooks cold cuts, even though the CDC recommends heating them until they are steaming (who knew?). Even convenience products that are meant to be heated, such as frozen waffles and vegetables, aren’t always prepared properly at home. A toaster may not get a waffle hot enough—Listeria is killed at an internal temperature of 165 degrees Fahrenheit—and thawed frozen vegetables may be eaten without being boiled first, Barbara Kowalcyk, a food-safety expert at George Washington University, told me.

To be clear, there’s no need for Listeria hysteria. “On the surface, it looks like there are many more outbreaks,” but there are no data to prove that yet, Goodridge said. Still, some recent outbreaks demonstrate that precautions are working as they should. Listeria was identified in a regular sweep of the waffle factory and products were voluntarily recalled; no cases of illness have been reported. Tools for detecting outbreaks are becoming more sophisticated, Darin Detwiler, a food-safety expert at Northeastern University, told me. A technique called whole-genome sequencing can identify instances in which people have been sickened by the same bacteria, pinpointing the source of an outbreak. Earlier this year, it was used to investigate a Listeria outbreak in Canada that killed three people and hospitalized 15.

No food is totally safe from contamination. Practically everything sold in stores or restaurants is handled in some way. Milk is pooled from any number of cows, then pasteurized and packaged. Hamburger patties are usually made with meat from many butchered cows that is then ground, seasoned, and formed. People get lulled into the idea that “the U.S. has the safest food supply in the world,” Kowalcyk said, “but that doesn’t mean that it’s safe.” People can reduce their risk of contracting a foodborne illness by buying whole foods and cooking from scratch when possible, Goodbridge said; it’s probably safer to clean and chop your own head of lettuce. Yet even that is not a guarantee. Foodborne illness also spreads in home kitchens, where cross-contamination of raw meat with other foods, unsafe storage, and food spoilage often occurs. The risks are lower for healthy people, who can usually get through foodborne illness without excessive discomfort. But for vulnerable groups—very young, very old, and pregnant people—foodborne illness can lead to hospitalization, and even death.

The recent spate of outbreaks highlights the dilemma plaguing the state of American eating. People are simply too busy and exhausted to cook from scratch. In the daily scramble to get dinner on the table, ready-to-eat food is a lifeline. But with every additional stage of preparation comes an extra helping of risk.

The Wegmans in Brooklyn’s Navy Yard is—sorry to be dramatic—paradise on Earth: 74,000 square feet of high ceilings and long aisles, stocked with nearly everything a person could conceivably want to eat or drink. It has tamarind and rambutan and malanga; pink pineapples and purplish, fresh-packed venison; a special cheese that is softly dusted with dried flowers and herbs collected in the German Alps. The milk options alone include beverages made from soy, almonds, oats, cashews, flaxseeds, bananas, pistachios, and hazelnuts, in addition, of course, to the lactational secretions of the American cow, all displayed prominently in well-stocked, brightly lit display cases.

One of the world’s most consumed, most convenient, and least wasteful types of dairy, in contrast, occupies a space about the size of a beach cooler, on the bottom shelf in an unglamorous and highly missable corner of aisle six. It’s shelf-stable milk, a miracle of food science—and a product that Americans just can’t learn to love.

Shelf-stable milk is, as you might imagine, milk that does not need refrigeration and can thus be stocked on shelves. It gets this way by being blasted to 280–302 degrees Fahrenheit for one to five seconds in a process that is hotter and faster—and much more effective at killing bacteria—than other types of pasteurization. It’s then poured into special packaging that is sterile and airtight, where it can last for months on end.

Shelf-stable milk (also known as ultrahigh-temperature, or UHT, milk) does not take up space in the refrigerator before it needs to; it does not need to be packed on ice when thrown into a picnic basket or a lunchbox; it does not begin, like a car, to lose value as soon as you drive it off the lot. Andrew Novaković, a professor emeritus of agricultural economics at Cornell, told me that it is “almost immortal.” It is safe, convenient, practical, and particularly useful in the many urban parts of this country where refrigerator space is at a premium, as well as in the many rural areas where grocery stores are spread out. More meaningfully, it doesn’t require participation in the resource-intensive, greenhouse-gas-spewing system of refrigeration that the industry calls the “cold chain.”

For all of these reasons, shelf-stable milk is wildly popular in many parts of the world. Hilton Deeth, a professor emeritus in the School of Agriculture and Sustainability at the University of Queensland, in Australia, told me that in some European countries, a good 90 percent of the commercial milk supply is UHT. In France, to be more precise, 19 out of every 20 liters of milk sold is UHT; in Spain, it’s 48 out of 50. The Chinese market is growing quickly, Deeth told me, as is the Central American one. In dairy sections around the globe, the default is rectangular, unrefrigerated, plastic-coated cartons of milk that lasts for months.

But in the United States—a market that is, at least theoretically, addicted to convenience, no stranger to processed foods, and more and more attuned to climate change—shelf-stable milk is unpopular. This is not for lack of trying: In the 1990s, Parmalat, the company that popularized UHT milk in Europe, attempted to introduce its product to the U.S. via a splashy marketing push that involved blanketing the airwaves in 30-second spots and throwing a free Pavarotti concert in Central Park. By 1995, after all that effort, shelf-stable milk still accounted for less than 1 percent of the U.S. milk market. As of 2020, it made for 3 percent, according to the analysis firm Verified Market Research.

To understand why, you have to understand just how weird, comparatively speaking, Americans are about milk. U.S. adults drink more milk than their counterparts in Europe, experts told me, and are much finickier about temperature. “We’re just trained to enjoy super-cold things,” Amy Bentley, a food-studies professor at NYU, told me. “Milk fits into that.” But Americans are also particularly enthralled by some enduring myths about milk. Here, milk is supposed to be fresh and natural. And for that reason, it also needs to be refrigerated—because it is so fresh that, like beef ribs or chicken cutlets or other animal products, it was recently a little bit alive.

The earliest American advertisements for milk, from the 1840s, emphasized its bucolic origins and uncontaminated contents, using imagery of rolling hills and words such as wholesome, fresh, and unadulterated. These ads, directed at city dwellers, sold milk as a small escape from urban life, which was chaotic, crowded, and artificial. Milk became one of America’s favorite beverages, and more than a century later, modern milk advertising still features rolling hills and words such as fresh. Even though our milk is now highly likely to come from gigantic, thousand-acre farms in the Southwest, where land is cheap, advertising still sells us on small, family-run dairies. The last time I bought conventionally pasteurized milk, the back of the plastic jug described its contents as “all-natural.”

E. Melanie DuPuis, a professor of environmental studies and science at Pace University, wrote a book about this; its title, taken from an early milk advertisement, is Nature’s Perfect Food. She calls the mythmaking around dairy “the imaginary of milk.” “The imaginary of milk is that it’s coming from the countryside,” she told me. It’s from a happy cow, and it’s bottled quickly, with minimal intervention. It’s old-fashioned Americana incarnate. It is, as Bentley put it, ”the epitome of wealth and health and freshness”—or, as the ads put it, “pure.”

[Read: Go ahead, try to explain milk]

UHT milk, with its initialized name and aseptic packaging, evokes something else. Its imaginary, DuPuis said, is that it is “a manufactured product that’s coming from far away.” When Deeth tells people about the work he does researching shelf-stable milk, he finds that many are completely misinformed about what it is. Based on the name and the packaging, they believe it to be full of preservatives, instead of just processed in a slightly more extreme way than the milk they drink all the time. “I think people are suspicious,” he said. (He and others have also noted a slightly “burnt” or “caramelized” taste to UHT milk, though obviously it’s not enough to turn off consumers all over the world.) Shelf-stable milk is an affront to the stories that Americans have been told by the dairy industry and pop culture about what milk should be.

Those stories are so powerful that Americans refrigerate all kinds of milk-adjacent products unnecessarily. Soy and nut milks are just shelf-stable ingredients blended into water, and as such do not require refrigeration before opening. But they are typically sold in the refrigerated section, often at a cost to manufacturers, who pay extra for the shelf space. To them, the symbolism associated with refrigeration is worth it. When Steve Demos launched the soy milk Silk, in the late 1970s, he paid supermarkets more to display it in the refrigerator, a canny marketing decision that some experts credit for the eventual widespread adoption of alternative milks.

“Milk in a bag, milk in [an aseptic container], just doesn’t feel right,” Bentley told me of American attitudes toward shelf-stable milk. It “feels substandard, subpar.” And in a rich country with relatively large refrigerators, she pointed out, people can afford to avoid it: “Because the U.S. is so wealthy and can devote the resources to a cold chain, we do.”

We do so at no small cost to the environment. As the writer Nicola Twilley outlines in Frostbite, her recent history of refrigeration, mechanical cooling requires tremendous amounts of power for warehouses—refrigeration accounts for about 8 percent of global electricity usage—as well as diesel for trucks. It also requires chemical refrigerants, small amounts of which leak into the air as part of the process; many of these refrigerants are “thousands of times more warming” than carbon dioxide, Twilley writes. Environmental scientists call them super-greenhouse gases.

[Read: The truth about organic milk]

That Americans do this in the service of natural is bizarre, because natural is a bizarre word to use for the process by which a substance meant for baby cows leaves their mothers’ bodies at 101.5 degrees and ends up hundreds or thousands of miles away, refrigerated in plastic, to be consumed at 40 degrees by a different species. Natural is an inappropriate descriptor for a drink that requires days in the massive vasculature of manufactured chill, which ships cold air around a warm country 24 hours a day, 365 days a year. The milk in your refrigerator is a small monument to industrial machinery, the result of centuries of human intervention. There’s basically nothing natural about it.

A strange paradox of American culture is that people want to understand food—but only to a point. We want to reap the spoils of a massively industrialized food system, but we do not want our food to feel industrial. Shelf-stable milk is a reminder of all that’s artificial about what we eat. It’s not a reminder that most Americans want.

The milk I bought at Wegmans cost $3.49 and was made by Parmalat, which is still holding on to its tiny U.S. market share. It sat in my pantry for a week or so—even after all this, I just couldn’t bring myself to peel back its silvery seal and take a big swig. But then life’s great motivator—desperation—intervened: I ran out of cold milk and forgot to buy more. So we opened the Parmalat. The primary milk-drinker in my household, who is 1 year old, declared it yummy. I let it sit for another day or two in the fridge before finally trying it myself. I really don’t know what I was expecting, but it tasted like milk: creamy, slightly sweet, as natural as anything else.

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