Oncology: Low Microbial (Neutropenic) Diet Guidelines
When your immune system is weak, you are at greater risk of getting sick from foods containing bacteria, viruses, and mold. Your doctor will provide guidelines as to when you should start following the low microbial diet and when it is no longer needed. This handout includes suggestions for food and water safety to help you avoid foodborne illnesses.
Some foods and beverages are more commonly associated with foodborne illnesses. The following high risk foods and beverages should be avoided:
- Avoid foods from delis including: prepared salads, sliced meats, and cheeses.
- Avoid tasting free food samples.
- Check “sell by” and “use by” dates – do not use expired foods.
- Do not buy or use goods from cans that are rusted, bulging or dented.
- Select fruits and vegetables that look and smell fresh.
- Check that packaged and boxed foods are sealed.
- Shop for perishables last and take them home right away.
Safe Food Handling and Preparation
- Wash hands often – before, during, and after you prepare food and before eating. Use plenty of warm water and soap and wash hands for at least 20 seconds.
- Clean work surfaces and utensils with plenty of hot water and soap. Use paper towels or clean clothes. If using cloth towels, wash them often in the hot cycle of the washing machine.
- Choose plastic, glass or marble cutting boards instead of those made of wood. After a cutting board touches raw meat, poultry or fish never use it for other foods unless cleaned first.
- Thaw meat, fish, and poultry in the refrigerator – not on the counter. Cook foods immediately after thawing.
- When microwave cooking, use a loose-fitting lid or vented plastic wrap to cover food. Rotate the cooking dish and stir often. Bacteria can survive in cold spots of food.
- Keep your refrigerator less than 40°F and your freezer temperature at 0°F.
- Safely cook your foods to the recommended safe internal temperatures. Use a food thermometer. Do not leave cooked meats or other foods out at room temperature for longer than 2 hours.
Cleaning Fresh Produce
Wash raw fruits and vegetables before peeling or cutting. Use clean running water and scrub lightly with a clean sponge or brush. Do not use soaps or detergents on produce. These products can linger on foods and are not safe for consumption. You may choose to make a homemade spray or wash to clean your produce.
Spray: In a spray bottle, mix together 1 tablespoon of lemon juice, 2 tablespoons of baking soda, and 1 cup of water. Spray the mixture on the produce and allow it to sit for 2-5 minutes. Lightly scrub the produce with a clean sponge or brush. Rinse produce under cool water and pat dry with a clean towel.
Wash: Mix together ½ cup of white vinegar and 3 tablespoons of salt. Stir the mixture until the salt has dissolved. Add vinegar and salt mixture to a sink full of cool water. Mix all ingredients well. Soak produce for 15-20 minutes. Rinse produce in cool water and pat dry with clean towel.
Tips for Eating Out
- Avoid crowded restaurants.
- Check the condition of the restaurant. Are the plates, glasses and utensils clean? Are the restrooms clean and stocked with soap and paper towels? The cleanliness of the restaurant may give you a clue as to the amount of care taken while preparing your food.
- Avoid salad bars, delis, buffets, potlucks and sidewalk vendors. Avoid the high-risk foods and beverages listed on page 1 of this handout.
- Ask that the food be prepared fresh.
- Ask for single serving, condiment packets.
- If you plan to save leftovers to eat at a later time, refrigerate within 2 hours after purchase or delivery. If air temperature is above 90°F, refrigerate within 1 hour.
Check with your local health department and water utility about the safety of tap water. Not all communities disinfect their public water supplies and should not be assumed to be safe. If they do not disinfect, then the water should be brought to a rolling boil for one minute before drinking. Large amounts of water can be boiled and then stored in your refrigerator up to 72 hours. For a list of approved water filters, call the National Sanitation Foundation International at 1-800-673-6275 or visit their website at www.NSF.org.
Well water must be tested at least once a year to make sure it is free of germs and chemicals. The water should be tested right before the start of your cancer treatment. The test results must be negative for germs and chemicals, before you can drink it. If you have further questions about your water check the Centers for Disease Control website at http://www.cdc.gov/healthywater/drinking/.
Look for water labeled as undergoing one of the following processes: reverse osmosis treated, distillation, or filter capable of removing particles less than or equal to 1µm (micrometer) in diameter. To confirm that specific bottled water has undergone one of these processes, contact the International Bottled Water Association (IBWA) at 1-800-928-3711 or visit their website at www.bottledwater.org. If the IBWA does not have information on a specific brand, call the bottling company directly.
Source: Food Safety.gov: www.foodsafety.gov
What is the most important thing you learned from this handout?
What changes will you make in your diet/lifestyle, based on what you learned today?
If you would like to schedule an appointment with the Registered Dietitian at the Carbone Cancer Center, please call 608-265-1700
The Spanish version of this HFFY is # 483
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/17/2013
Copyright © 09/17/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#476
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