Review of current practice in ‘clean’ diets in the UK

Abstract

A survey of current practice in the provision of ‘clean’ diets at UK bone‐marrow transplant (BMT) centres was carried out as a basis for updating the information given to patients at Sheffield Children's Hospital (SCH). ‘Clean’ diets are used to minimize the risk of infection from food in immuno‐suppressed patients. Information received varied greatly from sterile diets to modified ward diets. It was found difficult to collate the results for this reason. In addition, there has been little documented evidence on the use and effectiveness of these diets. In general, there appears to be a move away from a stringent sterile diet towards a more relaxed diet, giving patients a greater choice of foods. Following this survey, the information given to BMT patients at SCH was modified to allow greater freedom of choice, whilst maintaining sensible food hygiene guidelines.

Irradiated food for special diets

“…In another study, dietitians at 20 centres in the UK carrying out bone marrow transplant in children were asked for information on their current practice in "clean" diets [17]. The level of restrictions greatly varied among centres, in agreement with other reports [12**, 14,18 ].…”

Nutrition support

“…44,45 Sterile diets are now rarely used in the UK as there is limited evidence to suggest any benefi t from this level of restriction, and the preparation techniques used make the diet impractical, unpalatable, limiting and expensive to prepare. [47][48][49] These have shown disparity between the practices of different centers. In recent years, a number of audits have been conducted to determine current practice in UK transplant centers.…”

Barrier precautions, prophylaxis and neutropenic fever

“…45 Since good nutrition is of paramount importance for these patients in their recovery, the aim is to provide the patient with a diet which is as attractive and palatable as possible, 46 so as to avoid the signifi cant risks associated with total parenteral nutrition. Although it is possible to provide totally sterile food by irradiating it, this may render food unpalatable.…”