Neutropaenic diet

What is neutropaenia?

The term neutropaenia describes a situation where a certain group of immune cells – the neutrophils, fall to low levels within the blood. Neutrophils are important in defending the body against foreign organisms, particularly bacteria, and therefore, a patient with too few neutrophils is more susceptible to bacterial infections.

Many different kinds of chemotherapy, some radiation, and some cancers themselves can cause neutropaenia. Medical staff will monitor levels of the white blood cells, including the neutrophils, for people in these situations.

People who are neutropaenic need to be careful to avoid situations where they may come in to contact with high levels of potentially harmful bacteria. When people are diagnosed as neutropaenic they will be given advice on how they can do this by their hospital medical team. One area where some caution is needed is the diet as certain uncooked food items may carry large amounts of bacteria.

Please note that it is very important for those with neutropaenia to follow the specialist dietary advice given by the hospital medical team as the advice will vary depending on the severity and duration of the condition. The following is a list of our general dietary suggestions for those with neutropaenia.

Keeping food safe

• Wash hands thoroughly before and after handling food
• Check that the fridge temperature is 5 degrees C or lower
• Use foods within their use-by date
• Ensure all foods to be cooked are heated thoroughly
• Keep cooking utensils, pots and pans, chopping boards and work surfaces as clean as possible
• Wash all kitchen cloths regularly – it is best to leave washing-up to air-dry rather than using a tea towel
• Keep perishable food very hot or very cold – do not leave at room temperature for more than 15 minutes
• Thaw frozen foods in the fridge overnight – do not leave them out at room temperature
• Use leftovers only if they have been stored properly (airtight container in the fridge) for no longer than 24 hours
• Make sure all fruit and vegetables to be eaten raw are thoroughly washed

For more information on food hygiene please refer to the Food Standards Agency web site.

Neutropaenic diet

• If you are eating dairy foods avoid any that are unpasteurized
• Avoid raw or rare cooked meat, fish, eggs
• Avoid processed meats and pate
• Avoid tap water – use bottled and boil it before use, alternatively use reverse osmosis or distilled water (this does not need boiling)
• Avoid shellfish
• If you are preparing fresh juices drink them immediately after preparation
• Do use lots of garlic in the diet (raw is preferable) – garlic has powerful antibacterial and immune supportive properties
• Do use shitake mushrooms in cooking – these particular mushrooms have immune supportive actions
• Do include lots of fresh fruit and vegetables in the diet – a wide array of compounds in these foods help to regulate and support the immune system. Organic fruit and vegetables are fine as long as they are thoroughly washed. Some hospitals may recommend peeling all fruit and vegetables.
• Do include some Manuka honey in the diet which has powerful antibacterial properties

Supplements

• It is recommended that people avoid herbal supplements or probiotics if they are neutropaenic, unless these supplements have been particularly recommended by an experienced health professional who is aware of the situation.
• Do take a good quality multivitamin and mineral supplement, which will contain a balanced mix of nutrients, many with immune-supportive actions. Consider taking extra amounts of the immune boosting nutrient, vitamin C. We recommend taking up to 2g per day. For further details on recommended supplements please refer to the Penny Brohn Cancer Care Supplement Guidelines.

Date completed: December 2004.