Nutrition therapy

Low microbial diet

Patients with a low white blood cell count can easily get sick from foods containing bacteria, viruses, yeasts and molds. These high-risk foods should be avoided while you are at higher risk of infection. This diet is generally referred to as the neutropenic or low-microbial diet.

The following are general guidelines for patients that have received a hematopoietic cell transplant:

  • Autologous transplant patients should follow this diet for first 3 months after transplant.

  • Allogenic transplant patients should follow this diet until off all immunosuppressive therapy like tacrolimus, prednisone and cyclosporine.

These foods should be avoided while your white blood count is low:

  • Raw and undercooked meat, fish, shellfish, poultry, eggs, hot dogs, sausage, bacon

  • Raw tofu, unless it is pasteurized or aseptically packaged

  • Deli meats unless heated until steaming

  • Pickled fish

  • Nonpasteurized milk and raw milk products

  • Soft and blue-veined cheeses

  • Mexican-style soft cheese

  • Cheese containing chili peppers or other uncooked vegetables

  • Fresh salad dressings containing raw eggs or the cheeses listed above

  • Unwashed raw vegetables and fruits

  • Commercial unpasteurized fruit and vegetable juices

  • Raw honey

  • All miso products and tempeh

  • Raw, uncooked brewer's yeast

  • Expired foods and beverages

  • Well water, unless boiled for 1 minute.

It's important to wash raw fruits and vegetables very well. The following are recipes for a spray and a wash that can be used 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.

These suggestions are not meant to replace talking to your doctor and registered dietitian. For more information regarding food and water safety, schedule an appointment with the Registered Dietitian at the UW Carbone Cancer Center by contacting Cancer Connect by calling (608) 265-1700.

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