by Scheinberg D
Neutropenic Diet

What Is a Low-Bacteria Diet?

A low-bacteria diet does not have foods that are apt to have:

  • Bacteria
  • Other types of germs that cause infection

Why Follow a Low Bacteria Diet?

This diet may be used by people with a weak immune system. It lowers their risk of getting sick from eating food. This diet may be needed before and after some cancer treatments.

Low-Bacteria Diet Basics

Raw or fresh foods are more apt to have harmful germs. These germs are destroyed when food is cooked well. For example, fresh veggies should be cooked until tender. Meats should be cooked until well-done. And eggs should be cooked until the yolk is firm.

Some foods like milk are pasteurized. This process briefly uses high heat to kill bacteria without cooking the food. Look for dairy products, juices, and ciders that have “pasteurized” on the label.

Eating Guide for a Low Bacteria Diet

Food Eat This... And Not This...

Grains

  • Breads, bagels, rolls, and muffins (except those with raw seeds or grains)
  • Pancakes, waffles, and French toast
  • Crackers and pretzels
  • Cooked and ready to eat cereals without raw nuts or oats
  • Cooked grains, rice, and pasta
  • Breads with raw grains or nuts
  • Cereals with raw grains or nuts
  • Raw oats
  • Uncooked fresh pasta
  • Pasta salad with raw veggies or eggs

Veggies

  • All cooked fresh, canned, and frozen veggies
  • Well-washed raw veggies and herbs
  • Canned veggie juices
  • Unwashed raw veggies or herbs
  • Raw sprouts like alfalfa
  • Commercial fresh refrigerated salsas
  • Buffet or deli salads
  • Potato salad with raw veggies or eggs
  • Unpasteurized veggie juices

Fruits

  • Canned and frozen fruits and juices
  • Pasteurized juices and ciders
  • Well-washed fresh fruits
  • Dried fruits
  • Unwashed fresh fruits
  • Unpasteurized fruit juices

Milk

  • Pasteurized milk and dairy products (like sour cream, yogurt, and whipping cream)
  • Commercial eggnog
  • Commercially packaged cheese made from pasteurized milk like American, Swiss, Parmesan, mozzarella, and mild and medium cheddar
  • Pasteurized cottage cheese
  • Processed cheese
  • Unpasteurized milk or yogurt
  • Soft-serve frozen yogurt or ice cream from a machine
  • Eggnog made with raw eggs
  • Unpasteurized and raw milk cheese
  • Moldy cheeses like bleu, Gorgonzola, Roquefort, and Stilton
  • Other cheeses: sharp cheddar, Brie, Camembert, and feta
  • Deli cheeses
  • Cheeses with uncooked herbs or veggies
  • Mexican-style cheeses like queso fresco and queso blanco

Meat and Beans

  • Well-cooked meat, fish, poultry, or meat substitutes like tofu
  • Single-serving cooked, canned, or frozen products
  • Canned chicken or fish
  • Cooked beans, lentils, and other legumes
  • Pasteurized or cooked tofu
  • Well-done eggs
  • Pasteurized egg substitutes
  • Canned and homemade soup (well heated)
  • Commercially packaged peanut butter
  • Canned or bottled roasted nuts
  • Rare or medium-rare cooked meat, fish, or poultry
  • Undercooked tofu (should be cut into a minimum of 1-inch cubes and boiled for at least five minutes in water or broth)
  • Deli cold-cuts
  • Pickled fish
  • Cold smoked fish, lox
  • Raw or undercooked eggs or egg substitutes
  • Cold soups and gazpacho
  • Tempeh products
  • Miso soup and other miso products
  • Roasted nuts in the shell
  • Unroasted (raw) nuts

Oils

  • Vegetable oil
  • Margarine
  • Mayo
  • Commercial, shelf-stable salad dressing
  • Salad dressings with raw eggs or aged cheese
  • Avocado dressing

Fats and Sweets

  • Butter, lard, shortening
  • Cream cheese
  • Snack chips like potato, tortilla
  • Cakes, pies, cookies, donuts
  • Baked custard, pudding, and gelatin
  • Commercial ice cream, sherbet, fruit ice, and popsicles
  • Candy
  • Chocolate
  • Jam
  • Pasteurized honey
  • Soft-serve frozen yogurt or ice cream from a machine
  • Homemade ice cream or sherbet
  • Cream-filled pastries and desserts (unless refrigerated)
  • Raw cookie dough
  • Raw honey

Drinks

  • Instant and brewed coffee and tea
  • Brewed herbal teas
  • Individual cans or bottles of carbonated beverages
  • Bottled water
  • Canned, bottled, and powdered drinks and sports drinks
  • Instant breakfast drinks
  • Well water
  • Cold-brewed tea
  • Unpasteurized fruit and veggie juices

Other

  • Non-dairy creamers
  • Chewing gum
  • Salt, pepper, sugar, and sugar substitutes
  • Ketchup, mustard, BBQ sauce, steak sauce, soy sauce, and other condiments
  • Well-washed dried herbs and spices
  • Gravy and cream sauce
  • Commercial pickles
  • Herbs and spices added to food after cooking
  • Hollandaise sauce
  • Home-canned pickles
  • Uncooked brewer’s yeast
  • Some nutritional supplements (Ask your doctor or registered dietitian.)

Suggestions

Here are some tips for eating a low-bacteria diet. A registered dietitian can help you learn more about this diet and how to make changes.

  • When you make food:
    • Wash your hands before and after.
    • Cook foods well and keep them hot until you eat them.
    • Do not make bread that has yeast as an ingredient.
  • When you go shopping:
    • Do not choose items from salad bars, bulk food bins, and food samples.
  • When you store and handle food:
    • Keep refrigerated foods cold (below 40 degrees Fahrenheit [4.4 degrees Celsius]).
    • Refrigerate or freeze leftovers right away.
    • Refrigerate foods after you open them (like salad dressing, apple sauce, and soy sauce).
  • When dining out:
    • Do not eat from salad bars, delis, and buffets.
    • Use single-serve condiments such as ketchup, mustard, mayo, soy sauce, steak sauce, salt, pepper, and sugar.

RESOURCES

American Cancer Society  http://www.cancer.org 

Eat Right—Academy of Nutrition and Dietetics  http://www.eatright.org 

CANADIAN RESOURCES

Canadian Cancer Society  http://www.cancer.ca 

Dietitians of Canada  http://www.dietitians.ca 

References

Leukemia and diet. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed April 7, 2022.

Neutropenic diet. Memorial Sloan Kettering Cancer Center website. Available at:https://www.mskcc.org/experience/patient-support/nutrition-cancer/diet-plans-cancer/neutropenic-diet. Accessed April 7, 2022

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