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 So many people have heard the term “neutropenic diet” but did you know that there are no evidenced-based studies supporting the use of the neutropenic diet? Did you know the CDC, FDA, American Cancer Society, and the Academy of Nutrition and Dietetics do not recommend the neutropenic diet?

The benefit of the neutropenic diet has never been scientifically proven. Since there is an absence of evidenced-based studies supporting the use of the neutropenic diet, there are no official published guidelines on what foods are allowed vs. not allowed. However, there are studies that have shown that following a traditional neutropenic diet may actually be harmful as it can lead to patients with a decreased quality of life, malnutrition, gastrointestinal side effects, food aversion, and impaired cell-mediated immunity from vitamin deficiency.

For decades, the idea of a neutropenic diet has restricted foods in a patient’s diet with the assumption it would reduce the risk of infection in cancer patients. The idea behind this was that in restricting certain foods, it would also reduce introduction of potentially harmful bacteria into the gastrointestinal tract. However, this theory has not been proven and there is no universal definition of what the neutropenic diet is. Hospitals across the country all have their own definition of the neutropenic diet including what foods are or are not allowed to be eaten. The CDC, FDA and the American Cancer Society DO NOT support the neutropenic diet, instead, these institutions recommend standard safe food handling methods which actually allow washed fresh fruits and vegetables.

The National Comprehensive Cancer Network (NCCN) 2009 guidelines on prevention and treatment of infectious complications do not mention the use of the neutropenic diet. The Oncology Nursing Society (ONS) Cancer Chemotherapy guidelines and Recommendations for Practice state that “no recent studies have linked dietary restrictions with a lower risk of infection for neutropenic patients with cancer; however, basic principles, such as avoiding uncooked meats, seafood, eggs, and unwashed fruits and vegetables, may be prudent.” The United States Department of Agriculture (USDA) recommendations for food safety for people with cancer include the following: (a) consumption only of pasteurized juices and dairy products; (b) washing hands in warm soapy water before handling, preparing, and eating food; (b) consuming food that has not passed the expiration date; and (d) storing raw meat, fish, and chicken carefully in wrapped containers to avoid spillage of juice onto other foods. Notably there is no recommendation for the restriction of fresh fruits and vegetables.

For a complete look at standard food safety guidelines for immune-suppressed patients visit this link. But first, watch this short, 5 minute video, which perfectly sums up the misuse of the neutropenic diet.

Reference:

Oncologist. 2011 May; 16(5): 704–707. Published online 2011 Apr 6. doi: 10.1634/theoncologist.2011-0001