The Benefit of the Neutropenic Diet: Fact or Fiction?

Abstract

There really should not be a debate about the use of neutropenic diet for cancer patients. Its usefulness has never been scientifically proven. However, neutropenic diets remain in place in many institutions even though their usefulness is controversial. Neutropenic diets were once thought to be important in protecting patients from having to succumb to infection from neutropenia while undergoing chemotherapy. Although food may contain harmful organisms and research has shown that bacterial translocation is possible, recent studies have been unable to obtain significant differences between placebo and intervention groups. The dietetic challenges neutropenic patients struggle with include decreased quality of life, malnutrition, gastrointestinal side effects, food aversion, and impaired cell-mediated immunity from vitamin deficiency. Unanswered questions in regard to the neutropenic diet include the following: (a) which food should be included; (b) which food preparation techniques improve patient compliance; (c) which patient populations benefit most; and (d) when should such a diet be initiated. Without scientific evidence, the best advice for neutropenic patients is to follow food safety guidelines as indicated by government entities. The Oncologist 2011;16:704 -707

Supportive care in severe and very severe aplastic anemia

“…19 Thus, the available data do not support the use of a special low-bacteria diet in neutropenic patients. 20 Despite the lack of evidence, surveys showed that 43-78% of the hospitals use a special neutropenic diet. We recommend considering basic principles such as: (1) washing hands before preparing food, (2) storing raw meat, fish, chicken in a way that avoids contamination of other food, (3) washing in hot water dishes and cutlery that contact raw meat before placing them in contact with other food, (4) using fresh food without any mold, (5) consumption of pasteurized juices and dairy products, (6) avoiding uncooked meats, seafood, eggs and unwashed fruits and vegetables; 20,21 and (7) avoiding raw nuts and dried fruits due to the risk of fungal spores.…”

Çocuk Sağlığı İzleminde Kanserden Sağ Kalanlar

“…Bu hastalarda şu an için öneriler temel gıda tüketimi-ne uygun olacak şekilde 1) çiğ et, deniz ürünü ve çiğ yumurta tüketmemeleri, 2) pastörize edilmiş süt ve süt ürünleri kullanmaları, 3) meyve ve sebzelerin iyice yıkanarak yenmesini içermektedir (10) . Hastaların …”

Reevaluating the Neutropenic Diet: Time to Change

“…The diet restricted all fresh fruits and vegetables from patients with neutropenia, with the intent to support germ-free or germ-reduced environments. In some cases, diet principles and restrictions were softened to allow family members to peel foods, such as oranges or bananas, to give to the patient (Jubelirer, 2011).…”

“…That environment was popularized with reference to the television character "The Bubble Boy" (Jubelirer, 2011).…”

“…The diet and its effects led patients to become dissatisfied with their food choices and restrictions. Therefore, diets for patients with neutropenia eventually were changed to a cooked diet (allowing fully cooked fruits and vegetables and not requiring sterilization), although evidence supporting the change in practice was limited (Jubelirer, 2011).…”