Published: Mar. 28, 2007
Updated: Aug. 22, 2011
Guidelines for Immunocompromised Patients
These diet guidelines are for adult patients who are at risk for infection because of compromised immune systems.
Germs that cause infections can be found in food and water. The care you need to take depends on how well, or poorly, your immune system works.
A few simple precautions can reduce the risk of food borne diseases:
For cancer patients receiving standard dose treatments, the risk for infection needs to be balanced with the need to maintain adequate intake when you are not feeling well and some foods may taste unappealing to you.
Your cancer care team will advise you about when you need to avoid high risk foods. You may always choose to stick with the safer options.
For patients receiving stem cell transplant treatment, the risk for infection is higher. All stem cell transplant patients need to avoid high risk foods and beverages.
|High Risk Foods/Beverages||Safer Substitutes|
|Unpasteurized dairy products||Pasteurized dairy products (lactose free for allogeneic stem cell transplant patients), instant hot cocoa mix, individually packaged creamer
Even safer: ultra-heat-treated milk, commercial sterile canned shake products
|Cheeses with molds||Pasteurized processed American cheese
Lactose-free cheese (allogeneic stem cell transplant patients)
|Raw and undercooked eggs||Cooked pasteurized eggs until yolk and white firm or hard boiled.|
|Undercooked or raw poultry and meat||Well-cooked meat and poultry|
|Fish and seafood||Should be avoided|
|Deli meats and processed meats||Should be avoided. May have cooked hot dogs|
|Unpasteurized fresh squeezed fruit and vegetable juices||Pasteurized juices|
|Raw fruits with rough texture (i.e. raspberries, blackberries)||Should be avoided|
|Smooth raw fruits
|Should be washed under running water, then peeled or cooked. Canned fruits OK|
Avoid all sprouts
|Should be washed under running water, then peeled and cooked. Canned vegetables OK|
|Undercooked or raw tofu||Cooked well (boil in water or broth for 5 minutes).|
|Unroasted nuts or roasted nuts in the shell||Canned or bottled roasted nuts|
|Raw or unpasteurized honey||Pasteurized honey|
|Herbs and spices likely to be contaminated include allspice, black pepper, caraway, celery seed, chili peppers, cumin, onion powder, paprika, thyme, and turmeric||Herbs and spices less likely to be contaminated include cloves, fennel, garlic powder, and mint, which originate from plants that produce natural antimicrobial substances, as well as cinnamon, mustard, and nutmeg.|
|Tap water, bottled spring water, well water||Filtered water or water boiled for 1 minute and placed in clean bottle|
|Ice from ice machines||Fill clean ice cube trays with boiled water|
These guidelines are based on published recommendations from the Center for Disease Control, the Infectious Disease Society of America and the American Society of Blood and Marrow Transplantation, as well as published research literature.
They reflect recommendations for avoiding food borne illness and are not meant to serve as recommendations for a nutritious diet.
This article is intended as a resource for patients receiving their cancer care at Duke University Hospital or Duke Clinic. It is not intended to substitute for medical advice from your health care team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.