Patients with a weakened immune system from chemotherapy, bone marrow or stem cell transplant, organ transplant, or human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) often are put on a neutropenic diet. Your doctor will let you know when to begin following this diet and when you can resume your normal eating habits.
Foods to avoid
Avoid the following foods while on the neutropenic diet:
- Raw or undercooked meat, fish, or poultry
- Cold meat or poultry
- Pickled fish, smoked salmon, and lox
- Undercooked eggs (no runny yolks)
- Yogurt with live and active cultures
- Frozen yogurt or soft ice cream from a machine
- Cold brewed tea or sun tea
- Unpasteurized tofu (must cut into 1″ cubes or smaller and then boil for a minimum of 5 minutes in water or broth before eating or using in recipes)
- Exception: It is not necessary to boil aseptically packaged, shelf-stable, and pasteurized tofu
- Unpasteurized dairy product
- Milk shakes made in a blender
- Deli meats, cheeses, and prepared salads
- Exception: Vacuum-packed lunch meats and hard cheeses are allowed, except for sharp cheddar cheese
- Hard salami in natural casing
- Soft cheeses, such as Brie or feta
- Cheese with mold, such as blue or Gorgonzola
- Mexican-style cheeses, such as queso fresco
- Cheeses containing peppers or other uncooked vegetables
- Unpasteurized honey
- Unrefrigerated cream-filled doughnuts or other pastries
- Unpasteurized fruit and vegetable juices, including cider
- Raw nuts or nuts roasted in their shells
- Unwashed herbs
- Fresh fruits and vegetables/sprouts
- Note: Some hospitals still recommend that patients do not consume fresh fruits and vegetables, while others state that as long as the fruit is washed thoroughly under cold running water before peeling and/or cutting, it is OK to consume
- Patients on the neutropenic diet should not peel or cut fruits or vegetables, but should have someone else do that for them
- Patients should avoid all raw vegetable sprouts, even if their physician has stated that washed produce is OK to consume
- Stir-fried vegetables
- Caesar salads with Caesar dressing
- Fresh sauerkraut
- Unpasteurized beer
- Cold soups and gazpacho
- Hollandaise sauce
- Uncooked brewer’s yeast
These tips and recommendations may help:
- Make sure to follow proper food safety techniques, including thoroughly washing your hands before touching any food.
- Take a multivitamin that does not contain iron each day following transplant.
- Boil well water for 1 minute before drinking. If using bottled water, make sure that the water was produced through reverse osmosis, distillation, or filtered through an absolute 1-micron or smaller filter by checking the label.
- Check all expiration dates before eating or preparing food.
- Discard any cooked food that was left at room temperature for 1 hour or longer.
- Do not prepare any salads with mayonnaise, unless you plan to eat them immediately.
- Eat all leftovers within 24 hours.
- Do not handle any bread dough that contains yeast.
- Do not wash or peel fresh fruit yourself.
References and recommended readings
Cedars-Sinai Medical Center. Cancer patient guidelines for a neutropenic diet. Available at: http://www.csmc.edu/pdf/CANCERNEUTROPENICDIET.pdf. Accessed February 12, 2010.
Dept of Food and Nutrition Services, University of Mississippi Medical Center. The neutropenic diet: for use during chemotherapy and bone marrow transplant. Available at: http://www.library.umc.edu/pe-db/Neutropenic-Diet.pdf. Accessed February 12, 2010.
McDowell D. Nutritional needs of the bone marrow transplant patient. Available at:
http://www.thedietchannel.com/nutritional-needs-bone-marrow-transplant-patient. Accessed February 12, 2010.
Non-Hodgkin’s Lymphoma Cyperfamily. The neutropenic diet. Available at: http://www.nhlcyberfamily.org/treatments/neutropenic.htm. Accessed February 12, 2010.
University of Pittsburgh Medical Center. Neutropenic diet. Available at: http://www.upmc.com/HealthAtoZ/patienteducation/Documents/NeutropenicDiet.pdf. Accessed February 12, 2010.
Review Date 2/12