The Effectiveness of the Neutropenic Diet

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The Effectiveness of the Neutropenic Diet in Pediatric Cancer Patients

http://clinicaltrials.gov/ct2/show/NCT00726934

Historically, many interventions have been tried to reduce the incidence of

infection by reducing patients' exposures to potential pathogens. The

neutropenic diet is one such intervention that was intended to reduce the

introduction of bacteria into the host's gastrointestinal tract. This diet

excludes foods considered to be high risk for bacterial colonization, especially

raw fruits and vegetables.

The only studies evaluating this diet have used this intervention in combination

with germ free environments, which have been phased out of practice, and the

independent effect of this diet remains unknown. In addition, pediatric oncology

patients suffer significant gastrointestinal side effects secondary to cancer

therapy, which are likely to affect their satisfaction with this dietary

regimen.

Qualitative data in these children suggests that decreased pleasure from food is

a major concern for them and preliminary data on the neutropenic diet showed

that although patients were able to stick to it, they found it difficult.

The Centers for Disease Control (CDC) and the Food and Drug Administration (FDA)

offer more liberalized food safety guidelines for immunocompromised patients.

We hypothesize that the neutropenic dietary restrictions offer no advantage over

the FDA and CDC endorsed food safety guidelines and that the food safety

guidelines will afford patients an improved quality of life through increased

choice and control over their diet.

The results of this study could potentially modify clinical practice to improve

the quality of life of these patients without adverse effects on their rate of

infection. Furthermore, the allowance of fresh fruits and vegetables back into

the diets of these patients may have a positive impact on their health.

Participants will be randomized to one of two dietary guidelines: the

neutropenic diet or the food safety guidelines endorsed by the FDA. Both diets

include the same guidelines regarding Food Shopping, Food Storage, Food

Preparation, Safe Cooking, and Safe Serving of Food.

The Neutropenic Diet Guideline includes the following additional

recommendations:

Avoid raw vegetables and fruit (Oranges and bananas are okay.)

Avoid take-out foods and fast foods and fountain drinks.

Avoid aged cheese (blue, Roquefort, Brie).

Cook all produce to well done. Eggs must be hard-boiled.

Avoid deli meats.

No raw nuts, nuts roasted in shell, or freshly ground nutbutters from a

healthfood store.

No well water

No yogurt