Eating During Chemo: The Neutropenic Diet

Keep Your Food and Drink Safe from Bacteria During Chemo

A bag of frozen vegetables.
A bag of frozen vegetables.. Sean Gallup/Getty Images

Neutropenia can catch you off guard during treatment for breast cancer. It's a blood condition in which your immune system - made of special white blood cells called neutrophils - is very low. Chemotherapy often causes neutropenia because it blasts fast-growing cells—not only cancer cells, but blood cells too. You and your doctor will work together to prevent infections and to rebuild your immune system.

Following a neutropenic diet can help protect your health.

Treatment for Neutropenia

During your chemotherapy treatments, if your immune system doesn't recover on its own, you may be given injections of Neupogen or Neulasta, which will stimulate your bone marrow to ramp up production of white blood cells. These drugs do have some side effects, but those are temporary and pose less of a risk than leaving neutropenia untreated.

Neutropenia Self-Care

When you are neutropenic you are more vulnerable to infections than you would be if your white blood cell count were normal. Take some everyday precautions to keep yourself healthy:

  • Practice good hand-washing techniques.
  • Wear gloves while gardening to avoid cuts and punctures.
  • Use antibacterial soaps and wipes to clean around your house.
  • Keep a good supply of hand sanitizer.
  • Limit exposure to people and pets.
  • Prepare all your foods carefully to avoid mold and bacteria.
  • Eat a neutropenic diet, to avoid bacteria and infection.

Neutropenic Diet Prevents Infections

Bacteria can hide in raw meat and seafood, while mold and dirt can stick in the nooks and crannies of fruits and veggies. Be picky or rather "piccy" about what you eat!

P - Prevent infection by using foods that can be cooked or have been pasteurized.

I - Inspect raw ingredients before you cook them.
C - Clean and scrub fruits, vegetables and cooking surfaces.
C - Cook your entrees and side dishes thoroughly.
Y - Yucky, moldy food - even cheese - should be thrown away uneaten.

Load Your Pantry Well

There will be days when you have a normal appetite; other days, your energy and your desire for food will be low. Prepare for days like these by stocking up on easy-to-prepare items, such as: frozen vegetables and entrees; packaged puddings and gelatins; smooth, soothing soups; jugs of juice; and ingredients for healthy smoothies. Remember to ask for help with cooking and cleaning up - you don't have to do all of that and recover from cancer treatments.

Skip the Salad, Pass Up Sushi

When your immune system is low, don't challenge it to work harder. That means avoiding raw, unwashed foods. Even if you love green salads and beautifully crafted sushi, the raw vegetables and seafood in these tempting treats could make you sick. If you like your morning eggs over-easy, try hard-boiled or scrambled eggs instead (thoroughly cooking egg yolks will kill bacteria).

Wash and peel fresh fruits and vegetables. Veggies like peppers and eggplant can be scrubbed, instead of peeled. Leave the bumpy stuff, such as broccoli, raspberries and cauliflower, alone until you recover - it's just about impossible to get those surfaces clean and completely free of grit, dirt and germs.

Drink Up, Carefully!

Chemo can also bring on mucositis, which can make eating unpleasant and sometimes painful. If that happens to you, don't give up on getting some nutrition. Try drinking your way through the difficulty - with nutritional drinks, sports drinks, milkshakes, smoothies and pasteurized juices. Be sure to check the expiration dates on any products, and don't consume anything that is past its sell-by date. Keep your risk for fevers and infections low by being vigilant about your food and drink.


Fever and infections. Home Care Guide for Cancer. American College of Physicians, Peter S. Houts, Editor. Softcover book. Last Modified: November 1, 2001.

Taking special care with food to avoid infections. What You Should Know About Cancer Treatment, Eating Well, and Eating Problems. National Cancer Institute. Last updated: 09/30/2009.

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