The Neutropenic Diet: A Guide to Food Safety for a Weak Immune System

Neutrophil-Boosting Diet: What to Eat & What to Avoid

Neutrophils are white blood cells that play a key role in defending your body against infections. When your neutrophil count is low-neutropenia-your immune system becomes weaker, making it harder to fight off bacteria, viruses, and other harmful germs.

Neutrophil levels can drop for several reasons, including certain illnesses, medications, or treatments like chemotherapy. A neutropenic diet is a special eating plan designed for people with low neutrophil levels. The main goal of the neutropenic diet is to reduce the risk of foodborne infections by avoiding foods that are more likely to contain harmful bacteria.

Keep reading to discover how your daily meals can support your white blood cells and help your body stay better protected.

What is a Neutropenic Diet?

A neutropenic diet aims to lower the risk of getting sick from food bacteria. It’s often recommended for people with weak immune systems, especially those with neutropenia. Neutropenia happens when the body doesn’t make enough neutrophils, which help fight infections.

Who Might Need the Neutropenic Diet?

Doctors often suggest the neutropenic diet for cancer patients, especially those undergoing chemotherapy and stem cell or bone marrow transplants. These treatments can weaken the immune system, making it harder for the body to fight off infections. When immunity is low, even a small amount of bacteria from food can cause serious illness.

What are the food options for increasing neutrophils?

When following a neutropenic diet, the goal is to eat foods that are safe and low in bacteria. Here are some of the secure options:

Dairy

• Pasteurised milk
• Cheese
• Yoghurt
• Sour cream and ice cream

Starches

• Cooked pasta and rice
• All types of bread
• Cereal
• Pancakes and French toast
• Cooked beans, peas, corn, and sweet potatoes
• Whole grains
• Chips and French fries

Vegetables

• Cooked or frozen vegetables

Fruits

• Canned or frozen fruits
• Fruit juices
• Fresh fruits with thick skins (like bananas, oranges, or grapefruit) — only if they are washed well and peeled

Protein

• Meat that’s fully cooked (well-done)
• Canned meats
• Hard-boiled eggs or egg substitutes that are pasteurised

Drinks

• Tap water, bottled water, or distilled water
• Bottled or canned drinks
• Canned sodas
• Instant or brewed tea and coffee

What are the foods to avoid?

To help protect your immune system, avoid foods that might carry harmful bacteria. Here’s what to stay away from:

Dairy

• Unpasteurised milk or yoghurt
• Yoghurt with live or active cultures
• Soft cheeses (like Brie or feta)
• Cheeses with mould (such as blue cheese or Gorgonzola)
• Aged cheeses
• Cheeses that have raw vegetables in them
• Mexican-style cheeses like queso fresco

Raw Starches

• Bread made with raw nuts
• Uncooked pasta or oats
• Raw grains

Vegetables

• Raw vegetables or salads
• Fresh herbs or spices that haven’t been cooked
• Fresh sauerkraut

Fruits

• Raw fruits that haven’t been washed
• Dried fruits
• Unpasteurised fruit juice

Protein

• Raw or undercooked meat
• Deli meats (sliced at the counter)
• Cold or leftover meats
• Sushi
• Eggs with runny yolks

Drinks

• Sun tea or cold-brewed tea
• Eggnog made with raw eggs
• Fresh apple cider
• Homemade lemonade

What are the general tips for following a neutropenic diet?

If you're on a neutropenic diet, there are certain foods you should eat and others you should avoid to lower your risk of getting sick from bacteria in food. Always talk to your doctor, nurse, or dietitian if you’re unsure about what’s safe to eat.

Here are some basic tips to help you stay safe:

• Do not eat raw fruits or vegetables. Instead, eat cooked vegetables, canned fruits, and fruit juices.
• Stay away from raw or undercooked meat, fish, and eggs.
• Avoid all deli meats, including pre-packaged ones. If you choose to eat them, reheat them until they are steaming hot (165°F) before eating.
• Do not eat raw nuts. Baked goods with nuts are fine because they are cooked.
• Only eat dairy products that say "pasteurised" on the label.
• Avoid yoghurts and similar products that contain live or active cultures.
• Always wash your hands before preparing food.
• Clean all surfaces, knives, and cutting boards after use.
• Keep hot foods hot and cold foods cold.
• If you prefer bottled water, make sure the label says 'reverse osmosis', 'distilled' or 'filtered through a 1-micron or smaller filter'.
• If you use well water, boil it for at least one minute before drinking.

The goal of the neutropenic diet is not to increase neutrophils but to prevent foodborne infection when your white blood cell count is low.

However, it’s important to remember that diet alone may not be enough, especially if you have ongoing medical treatments or serious health concerns. Always consult your doctor or a registered dietitian to ensure your nutritional choices meet your specific needs.