Diet for Immunosuppressed
Adapted from: Fred Hutchinson Nutritional Guidelines for the profoundly
immunosuppressed patients undergoing stem cell transplant.
These guidelines should NOT be considered a substitute for your doctor's advice.
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Allowed in BEVERAGE GROUP
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All canned, bottled, powdered beverages
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Instant and brewed coffee
See caution on brewed teas =>
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Commercial bottled distilled, spring and natural waters
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Tap water - but only if from a validated city water service
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Avoid in BEVERAGE GROUP
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Well water - unless tested yearly and found safe (boil for 5 minutes if unsure)
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Un-pasteurized fruit ciders
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Brewed herb teas (NEW)
Bacillus cereus is an emerging pathogen that causes invasive disease in immunocompromised hosts. A case-control study, prompted by a clinical case, demonstrated an association between dietary tea ingestion and B. cereus bacteremia. Policies designed to interrupt transmission of this pathogen to susceptible patients should be considered. Source
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Allowed in DAIRY GROUP
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All pasteurized milk and milk products, including cheese
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Non-dairy pasteurized cream products
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Dry, refrigerated and frozen pasteurized whipped topping; Ice cream;, frozen yogurt
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Sherbet, ice cream bars, milkshakes
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Commercial nutritional supplements and baby formulas - liquid and powdered
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Avoid in DAIRY GROUP
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Un-pasteurized or raw milk products, including yogurts
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Cheeses containing chili peppers or uncooked vegetables
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Sharp cheddar, brie, camembert, feta cheese, farmers cheese
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Yogurt ("pasteurized" stated on label)
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Cheeses with molds, including: blue, Stilton, Roquefort, Gorgonzola
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Allowed in DESSERT GROUP (see Caveat 1)
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Refrigerated commercial or homemade cakes, pies, pastries and pudding
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Homemade and commercial cookies
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Shelf-stable cookies, cream-filled cupcakes, fruit pies, pastries, pop tarts and puddings, Ices, popsicle-like products
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Avoid in DESSERT GROUP
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Un-refrigerated cream-filled pastries, cakes, cookies, and pies
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Allowed in FRUITS & NUTS GROUP
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Canned and frozen fruits and fruit juices
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Thick-skinned fresh fruits
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Well washed raw fruit
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Dried fruits
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Canned or bottled roasted nuts
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Nuts in baked products
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Avoid in FRUITS & NUTS GROUP
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Unwashed raw fruits
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Thin-skinned fruits
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Un-roasted, raw nuts, nuts in a shell
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Salads from delicatessens
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Commercial salsas stored in refrigerated case of store
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Allowed in BREADS & GRAIN GROUP
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Cooked and dry ready-to-eat cereals
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Cooked and canned legumes: lentils, split peas
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All breads, bagels, rolls, chips, crackers, muffins, pancakes, popcorn, sweet rolls, waffles
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Refrigerated cream-filled pastries (see Caveat 1)
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Cooked pasta, rice, and other grains
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Avoid in BREADS & GRAIN GROUP
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Unrefrigerated, cream-filled pastry products
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Raw grain products
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Allowed in FATS GROUP (See Caveat 2)
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Oil, shortening, lard, margarine and butter - refrigerated after opening
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Commercial shelf-stable mayonnaise and salad dressings (including Roquefort, Blue cheese dressings) - when refrigerated after opening
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Avoid in FATS GROUP
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Fresh salad dressings containing aged cheese
(e.g., blue, Roquefort) kept in refrigerated case in store
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Allowed in OTHER GROUP (see Caveat 1)
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Soups
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Salt and granulated sugars, brown sugar
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Jams, jelly, syrups - refrigerated after opening
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Pasteurized honey
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Condiments refrigerated after opening, including
catsup, mustard, BBQ sauce,
olives, pickles, relish; soy sauce,
vinegar candy, gum
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Avoid in OTHER GROUP
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Raw or un-pasteurized honey
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Herbal and non-traditional (health food store) nutrient supplements (check with doctor before taking any supplements)
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Brewers yeast, if eaten uncooked
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All miso products (e.g., miso soup)
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Allowed in MEAT GROUP
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All well cooked meats: poultry, fish, shellfish, ham, bacon, sausage and hot dogs
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Well cooked eggs (white cooked firm with thickened yolk is acceptable)
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Pasteurized egg substitutes (e.g., Egg Beaters)
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Commercial packaged salami, bologna, other luncheon meats. Hard smoked fish, refrigerated after opening
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Avoid in MEAT GROUP
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Raw or undercooked meats
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Pickled fish
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Cold smoked salmon, lox (or other fish)
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Allowed in VEGETABLE GROUP
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All canned and frozen vegetables and potatoes
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Cooked fresh vegetables
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Well washed raw vegetables and fresh herbs (check with your doctor first)
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Dried herbs and spices (may be added during or after cooking and to raw foods)
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Bottled and canned salsa, refrigerated after opening
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Avoid in VEGETABLE GROUP
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Unwashed raw vegetables
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Salads from delicatessens
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Commercial salsas stored in refrigerated case of store
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Food Tips for Managing Nausea and Maintaining Oral Health
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Getting adequate nutrition and liquids can be a challenge when you are experiencing nausea as a result of treatment.
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Notify your doctor when the medications you are taking are not adequate to control the nausea.
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Obtain prescriptions prior to treatment so that you can have medications on hand and begin to take them on time.
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General Food Safety Tips:
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Drink lots of liquids through a straw to bypass mouth sours.
Hydration is important for all of these reasons: Fight constipation,
reduces risks associated with medications that might affect the bladder and kidneys,
Supports healing and general health.
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Boil well water or any liquids you suspect might not be free of bacteria.
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Have smaller portions, more frequently, instead of fewer larger meals.
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Cook foods until tender and soft.
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Avoid hot foods because they can burn the mouth and have stronger odors.
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Prepare cool dishes that will have less odor.
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Use a cleaned blender to prepare purées and soups - to aid in digestion
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Wash your hands before preparing and eating foods.
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Rinse your mouth with a saline, baking soda, and water often, and after all meals.
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Safe foods shopping list - for managing nausea
Informing your health care provider is also extremely important so that your symptoms
can be monitored and prescribed medications can be modified if necessary.
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Limit
Foods that are rich, sugary, and high in fat
Caffeine
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BEVERAGES - sip liquids slowly thru a straw:
Seltzers
Ginger ale or tea
Tea with low-fat milk
Bottled water
Pasteurized fruit juices
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PROTEIN:
Whey protein drink (for nutrition), blend with low fat milk
Egg - well-cooked, scrambled with toast
Chicken cutlet - broiled with light seasoning
Fish - non-oily - broiled neutral-tasting, such as flounder and scrod
Beans and rice - cooked, but do not season with strong spices
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GRAINS
(Be sure to rinse mouth after eating - see General Tips, above)
Crackers
Pretzels
Toast
Pastina, Noodles - add to mild soup stocks
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FRUITS & VEGETABLES
Cooked, jarred and canned vegetables and fruit are safest
Baby food
Canned fruit - pears, apple sauce
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COOL SNACKS for liquid
Popsicles
Sherbet
Gelatins - flavored
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Resources
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Managing Nausea and Vomiting
ccn.aacnjournals.org | cancerbackup.org.uk | thedietchannel.com
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Caveat 1:
Avoid excessive sugar. See Oral Health
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Caveat 2:
Avoid fatty foods; they can contribute to nausea.
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