Table of ContentsView AllTable of ContentsFood SafetyFood Prep GuidelinesFood Storage GuidelinesFoods to AvoidEffectivenessPotential ChallengesOther TipsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Food Safety
Food Prep Guidelines
Food Storage Guidelines
Foods to Avoid
Effectiveness
Potential Challenges
Other Tips
Frequently Asked Questions
Theneutropenicdiet is a way of eating that may reduce the risk of developing bacterial infections from certain types of foods. Also known as a low-microbial diet, it is often recommended for people with severely weakened immune systems, such as cancer patients undergoingchemotherapy.
The neutropenic diet is named after a medical condition called neutropenia.Neutrophilsare an important type of white blood cell (WBC) that help fight infection. When the neutrophil count drops dangerously low, people are considered neutropenic. Neutropenic people can easily get bacterial infections from food and become ill.
This article will review the key features of the neutropenic diet and discuss its effectiveness.
Christopher Kimmel / Aurora Open / Getty Images
Food Safety in Neutropenia
Though the neutropenic diet is somewhat controversial, the FDA does endorse safe food handling practices for those experiencing neutropenia.Preventing bacterial transmission is the primary aim of the neutropenic diet. Although most healthy people will recover from foodborne illnesses quickly, those with a weakened immune system may not.
Your primary line of defense against infection is good handwashing. Properly preparing and storing food also reduces the risk of developing a bacterial infection from food.
Food Preparation Guidelines
Bacterial contamination often occurs during food preparation. Here are some guidelines to follow when preparing food for yourself or a loved one on a neutropenic diet:
Some oncologists use the mnemonic “PICKY” to help people remember safe food practices. The letters in “PICKY” stand for:Practice handwashing.Inspect foods before you cook them.Clean and scrub fruits and vegetables.Keep all cooking surfaces clean.Yucky, moldy food should be thrown away.
Some oncologists use the mnemonic “PICKY” to help people remember safe food practices. The letters in “PICKY” stand for:
Once prepared, here are ways to safely store foods consumed on a neutropenic diet:
Depending on the recommendations from your oncology team, you may be advised to avoid certain foods while undergoing cancer treatment. Foods typically avoided on the neutropenic diet include:
Although the neutropenic diet has been prescribed to cancer patients for years, there is no scientific evidence that shows it reduces infection rates during cancer treatment.In fact, these strict recommendations may be doing more harm than good.
Patients undergoing chemotherapy often experience a decrease in quality of life due to fatigue, loss of appetite, and stress. Not allowing cancer patients to eat and drink foods that satisfy the body and the mind can contribute to nutritional deficits and depression.
Conclusions from a 2018 study of children receiving immune-suppressive chemotherapy confirmed that neutropenic diets should be replaced with the FDA’s approved food safety guidelines.
In addition, the neutropenic diet is not standardized, meaning there are no published guidelines on the correct way to follow it. Instead, each cancer center adjusts the diet requirements according to their preference. This can lead to inconsistency and confusion for patients.
A 2019 study in theAmerican Journal of Clinical Oncology,which evaluated five randomized trials involving 388 people on chemotherapy, concluded that the use of a neutropenic diet was not associated with decreased risk of infection.
Other Ways to Reduce Infection Risk
In addition to safe food practices, here are other ways to reduce your risk of developing an infection during cancer treatment:
People at risk of neutropenia are often prescribed medications calledgranulocyte-colony stimulating factors (G-CSFs)such as Neulasta, Neupogen, or Ryzneuta. These medications stimulate the production of neutrophils resulting in decreased risk of acquiring an infection.
Summary
The neutropenic diet is a nutritional plan for those with a weakened immune system due to cancer treatment. Since contaminated food can cause bacterial infections, the neutropenic diet recommends safe food handling in addition to avoiding certain types of foods.
However, studies have not proved that the neutropenic diet reduces the risk of developing infections. Therefore, some oncology clinics emphasize safe food handling practices rather than following strict neutropenic diets. Talk to your oncology nurse about how to stay infection-free during cancer treatment.
Frequently Asked QuestionsAlthough there is no evidence that the neutropenic diet reduces infection rates during cancer treatment, your oncology team may continue to recommend it. Talk to your oncologist before starting any new diet while on chemotherapy.Although neutropenia alone does not usually cause fatigue, combined with other side effects of chemotherapy, it can result in feeling tired and run-down.
Although there is no evidence that the neutropenic diet reduces infection rates during cancer treatment, your oncology team may continue to recommend it. Talk to your oncologist before starting any new diet while on chemotherapy.
Although neutropenia alone does not usually cause fatigue, combined with other side effects of chemotherapy, it can result in feeling tired and run-down.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Food facts.Jubelirer SJ.The benefit of the neutropenic diet: fact or fiction?The Oncologist. 2011;16(5):704-707. doi:10.1634/theoncologist.2011-0001Moody KM, Baker RA, Santizo RO, et al.A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients.Pediatr Blood Cancer. 2018;65(1):e26711. doi:10.1002/pbc.26711Ball S, Brown TJ, Das A, Khera R, Khanna S, Gupta A.Effect of neutropenic diet on infection rates in cancer patients with neutropenia: a meta-analysis of randomized controlled trials.Am J Clin Oncol. 2019;42(3):270-274. doi:10.1097/COC.0000000000000514Khanal PR, Satyal D, Bhetwal A, et al.Renaissance of conventional first-line antibiotics in clinical isolates: assessment of MICs for therapeutic antimicrobials in enteric fever cases from Nepal.Biomed Res Int.2017;2017:2868143. doi:10.1155/2017/2868143Severance EG, Xiao J, Jones-Brando L, et al.Toxoplasma gondii-a gastrointestinal pathogen associated with human brain diseases.Int Rev Neurobiol. 2016;131:143-163. doi:10.1016/bs.irn.2016.08.008Glaspy J, Bondarenko I, Burdaeva O, Chen J, Rutty D, Li R, Wang S, Hou Q, Li S.Efbemalenograstim alfa, an Fc fusion protein, long-acting granulocyte-colony stimulating factor for reducing the risk of febrile neutropenia following chemotherapy: results of a phase III trial. Support Care Cancer. 2023 Dec 16;32(1):34. doi: 10.1007/s00520-023-08176-6
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Food and Drug Administration.Food facts.Jubelirer SJ.The benefit of the neutropenic diet: fact or fiction?The Oncologist. 2011;16(5):704-707. doi:10.1634/theoncologist.2011-0001Moody KM, Baker RA, Santizo RO, et al.A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients.Pediatr Blood Cancer. 2018;65(1):e26711. doi:10.1002/pbc.26711Ball S, Brown TJ, Das A, Khera R, Khanna S, Gupta A.Effect of neutropenic diet on infection rates in cancer patients with neutropenia: a meta-analysis of randomized controlled trials.Am J Clin Oncol. 2019;42(3):270-274. doi:10.1097/COC.0000000000000514Khanal PR, Satyal D, Bhetwal A, et al.Renaissance of conventional first-line antibiotics in clinical isolates: assessment of MICs for therapeutic antimicrobials in enteric fever cases from Nepal.Biomed Res Int.2017;2017:2868143. doi:10.1155/2017/2868143Severance EG, Xiao J, Jones-Brando L, et al.Toxoplasma gondii-a gastrointestinal pathogen associated with human brain diseases.Int Rev Neurobiol. 2016;131:143-163. doi:10.1016/bs.irn.2016.08.008Glaspy J, Bondarenko I, Burdaeva O, Chen J, Rutty D, Li R, Wang S, Hou Q, Li S.Efbemalenograstim alfa, an Fc fusion protein, long-acting granulocyte-colony stimulating factor for reducing the risk of febrile neutropenia following chemotherapy: results of a phase III trial. Support Care Cancer. 2023 Dec 16;32(1):34. doi: 10.1007/s00520-023-08176-6
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Food and Drug Administration.Food facts.Jubelirer SJ.The benefit of the neutropenic diet: fact or fiction?The Oncologist. 2011;16(5):704-707. doi:10.1634/theoncologist.2011-0001Moody KM, Baker RA, Santizo RO, et al.A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients.Pediatr Blood Cancer. 2018;65(1):e26711. doi:10.1002/pbc.26711Ball S, Brown TJ, Das A, Khera R, Khanna S, Gupta A.Effect of neutropenic diet on infection rates in cancer patients with neutropenia: a meta-analysis of randomized controlled trials.Am J Clin Oncol. 2019;42(3):270-274. doi:10.1097/COC.0000000000000514Khanal PR, Satyal D, Bhetwal A, et al.Renaissance of conventional first-line antibiotics in clinical isolates: assessment of MICs for therapeutic antimicrobials in enteric fever cases from Nepal.Biomed Res Int.2017;2017:2868143. doi:10.1155/2017/2868143Severance EG, Xiao J, Jones-Brando L, et al.Toxoplasma gondii-a gastrointestinal pathogen associated with human brain diseases.Int Rev Neurobiol. 2016;131:143-163. doi:10.1016/bs.irn.2016.08.008Glaspy J, Bondarenko I, Burdaeva O, Chen J, Rutty D, Li R, Wang S, Hou Q, Li S.Efbemalenograstim alfa, an Fc fusion protein, long-acting granulocyte-colony stimulating factor for reducing the risk of febrile neutropenia following chemotherapy: results of a phase III trial. Support Care Cancer. 2023 Dec 16;32(1):34. doi: 10.1007/s00520-023-08176-6
Food and Drug Administration.Food facts.
Jubelirer SJ.The benefit of the neutropenic diet: fact or fiction?The Oncologist. 2011;16(5):704-707. doi:10.1634/theoncologist.2011-0001
Moody KM, Baker RA, Santizo RO, et al.A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients.Pediatr Blood Cancer. 2018;65(1):e26711. doi:10.1002/pbc.26711
Ball S, Brown TJ, Das A, Khera R, Khanna S, Gupta A.Effect of neutropenic diet on infection rates in cancer patients with neutropenia: a meta-analysis of randomized controlled trials.Am J Clin Oncol. 2019;42(3):270-274. doi:10.1097/COC.0000000000000514
Khanal PR, Satyal D, Bhetwal A, et al.Renaissance of conventional first-line antibiotics in clinical isolates: assessment of MICs for therapeutic antimicrobials in enteric fever cases from Nepal.Biomed Res Int.2017;2017:2868143. doi:10.1155/2017/2868143
Severance EG, Xiao J, Jones-Brando L, et al.Toxoplasma gondii-a gastrointestinal pathogen associated with human brain diseases.Int Rev Neurobiol. 2016;131:143-163. doi:10.1016/bs.irn.2016.08.008
Glaspy J, Bondarenko I, Burdaeva O, Chen J, Rutty D, Li R, Wang S, Hou Q, Li S.Efbemalenograstim alfa, an Fc fusion protein, long-acting granulocyte-colony stimulating factor for reducing the risk of febrile neutropenia following chemotherapy: results of a phase III trial. Support Care Cancer. 2023 Dec 16;32(1):34. doi: 10.1007/s00520-023-08176-6
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