For years, people have followed the neutropenic diet to help reduce their consumption of bacteria from foods. Although more research is needed to support the use of the neutropenic diet, your doctor may still recommend it based on your individual health needs and goals.

This diet has been suggested for people living with cancer, as they’re more prone to developing bacterial infections. It has also been recommended to people with weakened immune systems — specifically those with neutropenia, whose bodies produce an inadequate amount of white blood cells (neutrophils).

Neutrophils are blood cells that help protect your body from infection. When lower levels of these cells are present, your immune system weakens and your body is less able to defend itself against bacteria, viruses, and infections, including:

Prior to starting the neutropenic diet, discuss your dietary changes and health needs with your doctor to prevent interfering with any treatment plans. In addition, there are some general tips you can pair with the neutropenic diet to safely handle food and help prevent illness.

Some of these guidelines include:

  • washing your hands before and after handling food, as well as washing all surfaces and utensils
  • avoiding raw foods, specifically meat and undercooked eggs, along with cooking all meats thoroughly
  • avoiding salad bars
  • thoroughly washing fresh fruits and vegetables before eating or peeling (cooked fruits and vegetables are OK to eat)
  • avoiding unpasteurized dairy products
  • avoiding well water if it hasn’t been filtered or boiled for at least 1 minute (Bottled water is fine if it has been distilled or filtered or undergone reverse osmosis.)

Foods you’re allowed to eat on the neutropenic diet include:

  • Dairy: all pasteurized milk and dairy products, such as cheese, yogurt, ice cream, and sour cream
  • Starches: all breads, cooked pastas, chips, French toast, pancakes, cereal, cooked sweet potatoes, beans, corn, peas, whole grains, and fries
  • Vegetables: all cooked or frozen vegetables
  • Fruits: all canned and frozen fruit and fruit juices, along with thoroughly washed and peeled thick-skinned fruits like bananas, oranges, and grapefruit
  • Protein: thoroughly cooked (well-done) meats and canned meats, as well as hard-cooked or boiled eggs and pasteurized egg substitutes
  • Beverages: all tap, bottled, or distilled water, as well as canned or bottled drinks, individually canned sodas, and instant or brewed tea and coffee

Foods you should eliminate while following the neutropenic diet include:

  • Dairy: unpasteurized milk and yogurt, yogurt made with live or active cultures, soft cheeses (Brie, feta, sharp Cheddar), cheeses with mold (Gorgonzola, blue cheese), aged cheeses, cheeses with uncooked vegetables, and Mexican-style cheeses like queso
  • Raw starches: bread with raw nuts, uncooked pasta, raw oats, and raw grains
  • Vegetables: raw vegetables, salads, uncooked herbs and spices, and fresh sauerkraut
  • Fruits: unwashed raw fruits, unpasteurized fruit juices, and dried fruits
  • Protein: raw or undercooked meat, deli meats, sushi, cold meat, and undercooked eggs with runny yolk
  • Beverages: sun tea, cold brewed tea, eggnog made with raw eggs, fresh apple cider, and homemade lemonade

Based on the current findings, there’s not enough evidence to prove that the neutropenic diet prevents infection. Neither the National Comprehensive Cancer Network (NCCN) nor the Oncology Nursing Society Cancer Chemotherapy guidelines recommend the neutropenic diet.

One 2006 study examined the infection rate between two preventive diet plans. A group of 19 pediatric chemotherapy patients was either put on the neutropenic diet or a Food and Drug Administration (FDA)-approved food safety guidelines diet. Results from this study were inconclusive, showing no statistically significant differences between the two test groups.

A 2019 systematic review came to a similar conclusion. The authors of this meta-analysis did not find any evidence to support the use of a neutropenic diet for patients with cancer.

Also, there are no published guidelines on how to use this diet. Before recommending this diet as a treatment method, more research on its effectiveness is needed.

The neutropenic diet incorporates dietary changes to help prevent you from consuming harmful bacteria in foods and beverages. This diet is specifically meant for people with neutropenia, who are always advised to follow the FDA’s food safety guidelines. It’s also implemented among those with cancer and weakened immune systems.

Though some institutions incorporate this diet into medical treatment plans, more research is needed to demonstrate its effectiveness. Traditional treatment methods shouldn’t be ignored. Prior to participating in a new diet, discuss your options and risks with your doctor.