Diet Guidelines For Immunosuppressed Patients

Food safety is important during and after cancer treatments. The immune system is often weakened by cancer treatments, making the body more susceptible to foodborne illnesses.

Neutropenia is a condition where you have lower-than-normal levels of neutrophils (a type of white cell). If you have neutropenia, following food safety guidelines are especially important. Be sure to follow all food handling guidelines to help protect you from bacteria and other harmful organisms found in some mishandled food and beverages.

If you had a stem cell transplant, your diet may be stricter than that of a patient who had chemotherapy or radiation therapy and no transplant.

Diet guidelines published by institutions or doctors about handling food safely may also recommend avoiding foods that are more often associated with illness.

Basic Guidelines to Follow

  • Avoid raw or rare meat and fish and uncooked or undercooked eggs. Cook meat until it's well-done. Use a meat thermometer to check that foods reach a safe internal temperature. 
  • Thoroughly cook eggs (no runny yolks) and avoid foods containing raw eggs such as raw cookie dough or homemade mayonnaise.
  • Avoid unpasteurized beverages, such as fruit juice, milk and raw milk yogurt.
  • Avoid salad bars and buffets.
  • Refrigerate pate, cold hot dog or deli meat (including dry-cured salami and deli prepared salads containing these items), eggs or seafood.
  • Consume only pasteurized milk, yogurt, cheese and other dairy products.
  • Avoid soft cheeses made from unpasteurized milk such as blue-veined cheeses, Brie, Camembert,  feta, goat cheese, queso fresco/blanco. Pasteurized versions of these cheeses may be available and are safe to consume. Check the label to see if the cheese is pasteurized.  
  • Avoid raw sprouts, such as alfalfa sprouts.
  • Wash fresh fruits and vegetables before eating or peeling.
  • Avoid well water unless it has been tested, filtered, or boiled for one minute before drinking. At home, it's okay to drink tap water or bottled water.

Neutropenic Diet

Your healthcare team may refer to these guidelines as a “neutropenic diet” or you may have encountered the term on your own. This diet was supposed to help individuals with neutropenia learn how to decrease exposure to bacteria and other harmful organisms found in some foods. However, a universally-accepted definition of what foods should be included was never developed.

In a review of studies, the neutropenic diet was never proven to decrease exposure to bacteria in foods. This diet does not seem to benefit patients in any way. Safe preparation and handling of foods is more important than restricting intake of specific food groups, as balanced diet and nutrition is important for coping with chemotherapy and other treatments.

Food guidelines for immunosuppressed patients vary among cancer centers. Ask your doctor for any special instructions.

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