About this topic
This diet may be needed before or after certain cancer treatments. This diet will help people who have poor immune systems. It limits the amount of germs that could make you sick. Germs are often found in raw or uncooked foods. Cooking foods to high temperature kills germs. Pasteurized foods or foods that are put under very high heat without cooking are safe to eat. These are foods like canned foods and commercially packaged foods. ‚
What will the results be?
You will lower your chance of getting sick from eating food while your immune system is down. ‚
What changes to diet are needed?
Talk to your doctor and dietitian if you need to follow this diet. Do not take any herbal products, vitamins, minerals, or other supplements without checking with your doctor. ‚
When is this diet used?
You need a low bacteria diet when your body is not able to fight infection well. Your white blood cells, especially your neutrophils, fight infections. If you do not have very many neutrophils, you may need to be on this diet. You will want to follow safe food handling habits. You may not want to eat certain foods. ‚
What foods are good to eat?
Milk products like: ‚
- Milk or milk products. They must be pasteurized and grade A.
- Cheese and cheese products made with pasteurized milk. These must be commercially packaged. This includes cheeses like mild or medium cheddar, mozzarella, parmesan, and cream cheese.
- Yogurts. They must be pasteurized. They may have fruit or live cultures in them.
- Whipped toppings that are pasteurized. It may be dry, refrigerated, or frozen.
- Ice cream, frozen yogurt, sherbet, ice cream bars, homemade milkshakes
- Eggnog that is commercially prepared
- Sour cream
Meat and meat substitutes like: ‚
- Meats that are fully cooked or canned. These include beef, pork, lamb, and poultry. Fish, shellfish, game, and ham are also included. So are sausage, bacon, and hot dogs.
- Eggs that are cooked with a firm white and fully cooked yolk
- Egg substitutes that are pasteurized and fully cooked
- Salami, bologna, and other luncheon meats that are commercially packed
- Hard smoked fish that are canned and commercially packed. Keep in the refrigerator after opening.
- Tofu that is cooked
- Peanut butter that is commercially packaged
Fruits and vegetables like: ‚
- Fruit juices that are canned or frozen
- Fruit that is dried, canned, or stewed
- Fruits and vegetables that are raw. Be sure to fully wash them first. Ask about the proper way to wash fruit.
- Vegetables and potatoes that are cooked. They may have been fresh, frozen, or canned.
- Herbs that are fresh and have been fully washed may be added to raw or cooked foods. So can dried herbs and spices.
Breads, grains, cereals, and desserts like: ‚
- All breads, bagels, rolls, muffins, pancakes, sweet rolls, waffles, French toast
- Potato chips, corn chips, tortilla chips, pretzels, popcorn
- Cooked pasta, rice, and other grains
- Cereals that are cooked or ready to eat
- Cakes, pies, pastries, and pudding that must be stored in the refrigerator. They can be commercially prepared or homemade.
- Cookies that are commercially made or homemade
- Cream-filled cupcakes, fruit pies, and canned pudding that is safe to be stored on the shelf
Drinks like: ‚
- Tap water and ice made from tap water
- Bottled water. It may be distilled, spring, or natural water, but must be commercially bottled.
- Drinks that are canned, bottled, or powdered
- Coffee or tea. This may be instant or brewed. Cold brewed tea must be made with boiling water.
- Herbal teas that are commercially packaged. These must be brewed.
- Nutritional supplements. They may be liquid or powdered, but must be commercially prepared.
Fats like: ‚
- Oil, shortening
- Margarine, butter, or refrigerated lard
- Mayonnaise or salad dressings that are commercially prepared and stable on the shelf. Cheese based dressings are OK too. Refrigerate these after opening.
- Gravy or sauce that has been cooked
Others like: ‚
- Ices, popsicle-like products
- Salt, granulated sugar, brown sugar
- Jam, jelly, syrups. These should be refrigerated after opening.
- Nuts. They may be canned or bottled. They may also be used in baking.
- Peanut butter that is commercially prepared
- Honey that has been heat treated or is commercially prepared
- Entrees or soups that have been cooked
- Catsup, mustard, BBQ sauce, soy sauce, other condiments, pickles, pickle relish, or olives. These should be refrigerated after opening.
- Candy, gum
What foods should be limited or avoided?
Milk products like: ‚
- Milk, cheese, yogurt, and other milk products
- Cheese sliced fresh from the deli
- Cheeses with chili peppers or other uncooked vegetables
- Cheeses with molds like blue, gorgonzola
- Other cheeses like sharp cheddar, brie, camembert, feta cheese, farmers cheese, goat cheese
- Soft serve ice cream from a restaurant
Meat and meat substitutes like: ‚
- Meat, poultry, fish, game, tofu, eggs, and egg substitutes that are raw or undercooked
- Meats and cold cuts from the deli
- Hard cured salami in natural wrap
- Cold smoked salmon, lox
- Pickled fish
- Tempe (tempeh) products
Fruits and vegetables like: ‚
- Fruits or vegetables that are raw and unwashed. This includes unwashed herbs.
- Fruit and vegetable juices that are not pasteurized
- Vegetable sprouts that are raw like alfalfa, radish, broccoli, or mung bean sprouts
- Salads from the deli
- Salsas that are stored in a refrigerated case, even if commercially prepared
Breads, grains, cereals, and desserts like: ‚
- Grain products that are raw
- Cream-filled pastry products that are not stable on the shelf
Drinks like: ‚
- Tea that is cold-brewed and made with warm or cold water
- Well water. All well water must be boiled for 1 minute before drinking.
- Mate tea
Fats like: ‚
- Salad dressings that are made fresh. This also includes those with aged cheese such as blue or Roquefort, raw eggs, and are stored in refrigerated case.
Other items like: ‚
- Honey that is raw or has not been treated by heat. This also includes honey in the comb.
- Nuts that are raw and unroasted or those that have been roasted in the shell
- Herbal and nutrient supplement preparations
- Brewer's yeast that has not been cooked
- All miso products
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.
- More than 6 loose stools in 24 hours
- If you have any concerns about your diet.
- Throwing up more than 3 times in the next 48 hours
- New onset pain
- Pain in the abdomen
- If you are losing weight, call your doctor or dietitian. They will help you increase your food intake safely. Commercial supplements may be used to maintain or gain weight.
- If you have any concerns about your diet.
Helpful tips
Prepare food safely: ‚
- Wash hands before cooking and eating, and as often as possible.
- Clean food set-up area very well with soap and water and dry to prevent germs from getting on the food.
- Separate raw, cooked, and ready-to-eat foods while shopping, making, and storing foods.
- Do not wash meat and poultry.
- Throw away cracked eggs.
- Use one cutting board for poultry, one more for meats, and one more for vegetables. This will stop germs from spreading from one food to some other.
Cook and eat food safely: ‚
- Do not cook or eat food from dented cans.
- Thaw frozen food in the refrigerator or in cold water. Do not thaw at room temperature.
- Cook foods to a safe temperature (beef: 160 ‚ °F/71 ‚ °C, pork: 160 ‚ °F/71 ‚ °C, poultry: 165 ‚ °F/74 ‚ °C).
- Reheat leftovers to 165 ‚ °F (74 ‚ °C).
- Do not drink straight out of cans. Wash the top of the can before opening and then pour into a cup.
Store food safely: ‚
- Store foods in a refrigerator at a temperature of 40 ‚ °F/4 ‚ °C or less.
- Throw away food that has been at room temperature longer than 2 hours.
- Throw away leftovers older than 2 days.
Where can I learn more?
Centers for Disease Control and Prevention ‚
http://www.cdc.gov/cancer/preventinfections/ ‚
Leukemia and Lymphoma Society ‚
http://www.lls.org/diseaseinformation/managingyourcancer/treatmentnextsteps/foodnutrition/neutropenicdiet/ ‚
United States Department of Agriculture ‚
http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/basics-for-handling-food-safely/ct_index ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚