What is a Neutropenic Diet?

What is a Neutropenic Diet?

March 9, 2022 | By River's Edge Pharmacy

A neutropenic (nu-tro-PEE-nik) diet is for people with weakened immune systems. This diet helps protect them from bacteria and other harmful organisms found in some food and drinks. If your immune system is not working well, your body may have a hard time protecting itself from these bacteria. Cooking foods (like beef, chicken, fish, and eggs) completely makes sure that all bacteria are destroyed.

What is a Neutropenic Diet? by River's Edge Pharmacy

Who Needs to Follow a Neutropenic Diet?

Doctors often recommend this diet before and after certain types of chemotherapy and other cancer treatments. A blood test called an absolute neutrophil count (ANC) can help determine the body’s ability to fight off infection. Many cancer patients have this blood test done routinely. When the ANC is less than 500 cells/mm3, the patient is often instructed to follow a neutropenic diet. This diet should be followed until the doctor tells the patient to resume his or her regular diet.

Patients undergoing autologous stem cell transplants typically follow this diet during the pre- transplant chemotherapy and for the first 3 or more months after transplant. Patients undergoing allogeneic stem cell transplants typically follow this diet during the pre-transplant chemotherapy and continue on it until they no longer take immunosuppressive drugs. The transplant team will tell the patient how long to follow this diet.

People who have had an organ transplant or who are being treated for HIV/AIDS also may need to follow this diet. If you are not sure if you should follow this diet, check with your doctor, nurse, or dietitian.

General Tips for a neutropenic diet

General Tips

Below is a list foods foods you should choose when you are on a neutropenic diet. Foods you should avoid are also listed.

PLEASE CHECK WITH YOUR DOCTOR, NURSE, OR DIETITIAN IF YOU HAVE QUESTIONS ABOUT THE DIET OR SAFE FOOD PREPARATION.


Foods for a Successful Neutropenic Diet

Beverages
Foods to choose when on a neutropenic-diet
  • Instant and brewed decaf or regular coffee and tea
  • Individual cans or bottles of carbonated beverages
  • Tap, bottled and distilled water. Ice cubes made with tap water
  • Brewed herbal teas
  • All canned, bottled and powdered beverages and sports drinks
Foods to avoid when on a neutropenic-diet
  • Any others, such as cold brewed tea or sun tea
Starches (including breads, crackers, cereal, and potatoes)
Foods to choose when on a neutropenic-diet
  • All types of bread, rolls, English muffins, fruit muffins, bagels, sweet rolls, donuts
  • Waffles
  • French toast, pancakes
  • Potato chips, corn chips, tortilla chips, pretzels, popcorn, crackers, melba toast
  • All types of cooked and ready-to-eat cereals
  • Cooked grains, rice, and pasta, such as noodles, macaroni, and spaghetti
  • Cooked white or sweet potatoes and yams, French fries, tater tots, hash browns, etc.
Foods to avoid when on a neutropenic-diet
  • Breads and rolls with raw nuts
  • Cereals containing raw nuts
  • Raw oats
  • Uncooked pasta, pasta salad, or potato salad with raw vegetables or eggs
Dairy Products
Foods to choose when on a neutropenic-diet
  • Pasteurized milk; fat-free milk, 2% milk, whole milk, buttermilk, or chocolate milk
  • Sour cream
  • Milkshakes using individual cartons of ice cream and milk, or homemade milkshakes
  • Commercial eggnog
  • Commercial supplements such as instant breakfast drinks. Liquid and powdered drinks
  • Commercial frozen milkshakes
  • Refrigerated and frozen pasteurized whipped topping
Foods to avoid when on a neutropenic-diet
  • Unpasteurized milk or yogurt
  • Milkshakes made with non-commercial ice cream or made in a blender
  • Yogurt or soft ice cream from a machine
  • Eggnog made with raw eggs
  • Yogurt and yogurt products made with live and active cultures
Cheese
Foods to choose when on a neutropenic-diet
  • Commercially packaged cheese (for example, American, Swiss, Parmesan, mozzarella, cheddar)
  • Pasteurized cottage cheese, ricotta cheese
  • Processed cheese (for example, Velveeta)
Foods to avoid when on a neutropenic-diet
  • Unpasteurized and raw milk cheese
  • Cheeses with molds (for example, blue, Gorgonzola, Roquefort, and Stilton cheeses)
  • Soft cheeses (for example, Brie, Camembert, feta, farmer cheese)
  • Cheeses containing uncooked vegetables
  • Mexican-style cheeses, such as queso fresco and queso blanco
Desserts (and other sweets)
Foods to choose when on a neutropenic-diet
  • Cakes, pies, and cookies
  • Baked custard, pudding, and gelatin
  • Commercial ice cream, sherbet, fruit ice, and Popsicles
  • Refrigerated cream-filled pastries and desserts
  • Candy, including chocolate
  • Pasteurized honey and syrup
  • Chewing gum
Foods to avoid when on a neutropenic-diet
  • Cakes with raw nuts. Raw, un-baked cookie dough
  • Soft ice cream or yogurt from a machine
  • Non-commercial or homemade ice cream or sherbet
  • Cream-filled pastries that are not refrigerated
  • Candy with raw nuts
Fats
Foods to choose when on a neutropenic-diet
  • Butter or margarine
  • Cream cheese, sour cream, salad dressings, or mayonnaise
  • Oil (all types)
  • Shortening used in cooking
  • Non-dairy creamers
Foods to avoid when on a neutropenic-diet
  • Avocado dressing
  • Fresh salad dressing containing aged cheese, raw eggs, or fresh herbs
Meat (Includes fish, poultry, dried beans, eggs, meat substitutes, and soups)
Foods to choose when on a neutropenic-diet
  • Well-cooked meats, beef, lamb, pork and pork products, poultry, game, fish, shellfish, hot dogs, sausage, bacon
  • Canned tuna or chicken (with no raw vegetables)
  • Cooked baked beans and all other cooked legumes, dried beans, casseroles, stews, and entrées
  • Frozen entrées
  • Pasteurized or cooked tofu
  • Eggs, well-done
  • Pasteurized egg substitutes (for example, Egg Beaters) and powdered eggs
  • Canned and homemade soup (heated well)
Foods to avoid when on a neutropenic-diet
  • Rare or medium-rare cooked meat, fish, or poultry
  • Stir-fried foods
  • Cold cuts from delicatessens
  • Cold meat or poultry
  • Fast food
  • Raw eggs
  • Eggs not well-cooked, such as sunny-side-up (runny yolk)
  • Old soups and gazpacho, all miso products such as paste and soup
  • Sushi
  • Sashimi
Vegetables
Foods to choose when on a neutropenic-diet
  • All well-cooked canned, frozen or fresh vegetables
  • Canned vegetable juices
Foods to avoid when on a neutropenic-diet
  • All raw vegetables
  • Stir-fried vegetables
  • Fresh salads
  • Fresh sauerkraut
Miscellaneous
Foods to choose when on a neutropenic-diet
  • Individual packages of salt, sugar, and pepper used after cooking
  • All other herbs or seasonings added during cooking
  • Low-sodium seasoning added during cooking
  • Gravy and cream sauce
  • Commercial peanut butter. Jam and jelly
  • Commercial pickles processed in jars or cans
  • Lactaid drops
  • Canned or bottled roasted nuts
  • Nuts in baked goods
  • Shelled, roasted nuts
Foods to avoid when on a neutropenic-diet
  • Spices, herbs, or seasonings added to foods after cooking (except for allowed items)
  • Uncanned or home-canned pickles and kosher pickles
  • Freshly made peanut butter
  • Hollandaise sauce
  • Raw nuts
  • Roasted nuts in shell
Dietary Supplements
Foods to choose when on a neutropenic-diet
  • Commercial high-calorie/high-protein drinks, puddings, and snack bars if approved by a doctor or nurse
Foods to avoid when on a neutropenic-diet
  • Supplements and vitamins (unless approved by a doctor or nurse)

Sample Diet for a Successful Neutropenic Diet

Sample Diet for a Successful Neutropenic Diet

Breakfast

  • 1- large egg scrambled
  • Medium biscuit with 1tsp butter and 1 tsp Jelly
  • 1/2 cup apple juice
  • 1/2 cup 2% milk
  • Coffee or tea
Sample Diet for a Successful Neutropenic Diet

Morning Snack

  • 1 cup dry cereal
  • 1 cup 2% milk
  • 2 Tbsp dried fruit
Sample Diet for a Successful Neutropenic Diet

Lunch

  • Baked Meat loaf/ gravy
  • 1/2 cooked corn
  • 1/2 cup canned peaches

Sample Diet for a Successful Neutropenic Diet

Afternoon Snack

  • 1 cup of milkshake or high-protein drink
Sample Diet for a Successful Neutropenic Diet

Dinner

  • 3 ounces Baked or Roasted Chicken
  • 1/2 cup oven fried potatoes
  • 1/2 cup glazed carrots
  • Dinner roll with butter or margarine
  • 1/2 cup fruit cocktail
  • Coffee or tea
Sample Diet for a Successful Neutropenic Diet

Evening Snack

  • Slice pound cake with whip topping

ACCREDITATIONS

River's Edge Pharmacy proudly displays the URAC, ACHC, and NABP Accreditations as they demonstrate their commitment to quality healthcare services.

River's Edge Pharmacy is accredited by URAC

Utilization Review Accreditation Commission

View Accreditation
River's Edge Pharmacy is accredited by ACHC

Accreditation Commission for Health Care

View Accreditation
River's Edge Pharmacy is accredited by ACHC

National Association of Boards of Pharmacy

View Accreditation