Eating healthy can also mean eating safe. In North Carolina, three food borne diseases are at the top of health inspectors’ list of things to prevent — norovirus, salmonella and listeria.

• Norovirus, commonly known as the winter vomiting disease, is a short-lived but intestinally violent disease that results in diarrhea and vomiting. It can be mistaken for a stomach bug or flu-like sickness. Development of the disease generally takes 48 hours.

• Salmonella is characterized by the sudden onset of nausea, abdominal cramping and diarrhea with mucous. Salmonella is not typically a serious disease. There is no cure, but symptoms may be treated. Dehydration is the primary concern. Onset is usually 6 to 72 hours after ingesting bacteria.

• Listeria is a rare, but serious disease.

“Almost everyone that acquires a listeria infection is hospitalized, and about 20 percent die,” said Susan Grayson, head of the Dairy and Food Protection Branch of the Department of Environmental Health in the N.C. Department of Environmental and Natural Resources.

There are about 2,500 cases of listeria reported in the U.S. each year. Those who have weakened immune systems, such as those undergoing chemotherapy or those on immunosuppressants, are more susceptible to the disease.

While health inspections and restaurant ratings help arm customers with the information to make smart decisions about where they choose to eat out, it is up to the customer to note those ratings and pay attention to their environment.

“The best thing they can do is to probably pay attention to the grades that are posted,” Grayson said.

However, a grade does not necessarily reflect a restaurant’s day-to-day operations.

“Recognize that the grades are a snapshot in time,” Grayson said.

Donna Stephens — a certified food manager and former attorney who routinely scores more than 100 on inspections of her bed-and-breakfast inn, The Yellow House in Waynesville — recommends that diners take it a step further.

“Ask to have a peek in the kitchen,” Stephens said.

While the tactic may seem intrusive to some, diners can make it less so by casually asking for a look on the way to or from the bathroom, which is often located near the kitchen doors. Such is the case at WildFire restaurant on Main Street in Waynesville — one of few local restaurants Stephens said meets her criteria.

“I look everywhere I go,” Stephen said, referring to health inspection ratings. “Below a 95, there’s no excuse for that.”

Inspection score sheets allow for full or half deductions for problems, and a score may not reflect the full spectrum of reported problems. For example, having live pests or animals in the kitchen may be a two or four point deduction. However, having a pest breeding ground is only one to one-half a point off. Food being improperly stored, cooked, handled, etc, can be from a five to a two and a half point deduction.

Aside from ratings, look to see how servers handle food and utensils. Do they put their fingers on the rim of drinking glasses? If you ask for an extra fork or knife, do they touch the prongs or blade rather than the handle? A sense of professionalism and care goes a long way in helping to determine what’s going on behind the scenes.

— By Sarah Kucharski