During cancer treatment, you may be advised to follow a neutropenic diet if you develop neutropenia. Neutropenia is when neutrophils, a type of white blood cell in your blood, are low. This can occur as a side effect of cancer treatment, and means that your body is more vulnerable to infection, as neutrophils defend the body from bacteria which cause infection.

Evidence for the benefits of the neutropenic diet is limited, and different cancer centers often have their own recommendations for their patients. The American Academy of Nutrition and Dietetics recommends that patients with neutropenia follow safe food handling techniques, and avoid foods which may pose a risk of infection. The avoidance of uncooked meats, seafood, eggs and unwashed fruits and vegetables is most commonly recommended.

This can cause a lot of anxiety for patients who are already dealing with the stress of cancer treatment, which may have other side effects affecting food intake such as taste changes or nausea. When dealing with any dietary restriction, it is important to communicate with your medical team or dietitian to ensure any questions you have are answered, which will help to take away some of the stress. Here are some more tips:

• Ask family members or friends to help you stock up on safe food such as canned fruits and vegetables. These have been heat treated to kill bacteria, and will provide a quick meal when tired. Frozen ready-meals can also be useful to have on standby, and are safe once prepared as per label instructions.
• If others will be cooking for you, let them know what foods you have been advised to avoid, and that all foods must be cooked thoroughly. Investing in a food thermometer is the safest way of ensuring this. Temperature should be tested at the thickest point. The American Institute for Cancer Research recommends that steaks, roasts & fish be cooked to 145º. Pork, ground beef and egg dishes should be cooked to 160º, while poultry should be cooked to 165º F before serving.
• Ensure that your fridge and freezer are both at the appropriate temperature to abide by the guidelines. Set the refrigerator between 34º F and 40º F. Keep the freezer set to 0–2º F or below and check regularly.
• When eating out, make sure that the restaurant has good hygiene standards. Each state varies with how it scores hygiene, however information about restaurants is usually freely available online, or via smartphone apps which can be downloaded, such as ‘What The Health’.
• Try to have a snack with you at all times which you know is safe to eat. Snacks available from street vendors and places such as salad bars are not safe to have, so having a backup will remove temptation and ensure you are receiving adequate nutrition.
• Write ‘Use By’ dates and dates that food was opened in large writing on the packaging. This makes it easier to identify when foods must be thrown out, keeping you safe.
• Minimize your risk of infection by using an anti-bacterial soap and warm water, and scrubbing your hands for 15-30 seconds several times per day, and every time before you prepare food.

Following a neutropenic diet is not easy, however it can be done. Check out our neutropenic recipes for delicious meals which are safe to eat and can be enjoyed by the whole family and our food safety blog for more detailed tips-it’s essential reading!