Things We Do For No Reason: Neutropenic Diet

Abstract

For several decades, providers have routinely restricted the diets of neutropenic cancer patients by eliminating foods that might harbor pathogenic microbes to reduce infection rates. These diets, known as neutropenic or low-bacteria diets, are prescribed across the country with little uniformity in the extent or content of prescription. These diets are difficult to follow and force patients to omit fresh fruits and vegetables and limit dairy and meat products from their diet. These dietary omissions compromise nutritional intake in patients who are already at high risk of malnutrition. Randomized trials have shown that these restrictive diets are not superior in preventing infections than more liberalized diets. Evidence shows that adherence to the Safe Food-Handling guidelines issued by the Food and Drug Administration, a mandate for all hospital kitchens, provides adequate protection against food-borne infection, precluding the need for the neutropenic diet. Thus, routine use of the neutropenic diet should be abandoned.

Comparing a Neutropenic Diet to a Food Safety-Based Diet in Pediatric Patients Undergoing Hematopoietic Stem Cell Transplantation

“…The neutropenic diet eliminates food groups, putting patients at risk for nutritional deficiencies and decreased quality of life [4,11,12]. Pediatric bone marrow transplant patients are at significant risk for developing food aversions and vitamin deficiencies since fruit and vegetable consumption is significantly reduced with the neutropenic diet.…”

Assessment of Food Safety Knowledge and Behaviors of Cancer Patients Receiving Treatment

“…Furthermore, it has been a common practice that cancer patients follow a neutropenic diet during their treatment to decrease the risk of foodborne illness [31]. However, recent evidence suggests that following food safety recommendations is more beneficial to cancer outcomes than the consumption of neutropenic diets [32], due to its better nutrition outcomes and consumption of bioactive compounds found in such foods [33]. Therefore, to increase knowledge of proper food safety handling techniques and change food safety behaviors would be effective not only in preventing foodborne infections but also improving treatment outcomes in this population.…”

Telemonitoramento como tecnologia aliada ao cuidado de enfermagem ao paciente onco-hematológico

“…E os pacientes com doença onco-hematológica estão neutropênicos seja pela própria doença como pelo tratamento que é imunodepressor. E pacientes com neutropenia, ou seja, quantidade de neutrófilos inferior a 500/mm³, apresentam risco aumentado para infecção (Wolfe, Sadeghi, Agrawal, Johnson, Gupta, 2018).…”

“…Uma vez comprometida essa barreira em pacientes com câncer, causa maior suscetibilidade a organismos infecciosos. Sendo os locais mais comuns de infecção, além da pele, a corrente sanguínea, os pulmões, o trato urinário e gastrointestinal (Wolfe, Sadeghi, Agrawal, Johnson, Gupta, 2018).…”

“…Esta dieta é também conhecida como dieta com baixo nível de bactérias, a fim de limitar a introdução de microrganismos patogênicos no sistema gastrointestinal. É um tipo de dieta que normalmente limita-se a ingestão de frutas e vegetais frescos, carnes e peixes crus ou mal cozidos e queijos não pasteurizados (Wolfe, Sadeghi, Agrawal, Johnson, Gupta, 2018).…”