By Jill Pease
For decades, patients undergoing blood cancer treatment have been told to avoid certain foods to reduce infection risk, guidance that some physicians hoped could safely be relaxed. Now, a University of Florida study offers clear evidence that a diet designed to limit exposure to foodborne microbes results in fewer serious infections, confirming it is still the safest choice.
The findings come at a time when some clinicians have questioned whether the diet, which prohibits raw fruits and vegetables, unpasteurized dairy and undercooked animal proteins during intensive cancer therapies, was overly restrictive and could contribute to poor nutrition, said co-lead author John Wingard, M.D., a professor emeritus of medicine at the UF College of Medicine.
“Recently, some doctors have questioned whether a more liberal diet could safely be encouraged, especially since it might make eating easier, more enjoyable and, hopefully, improve nutrition among patients,” Wingard said.
Published in the Journal of Clinical Oncology, findings from the large phase 3 randomized trial — considered the gold standard for clinical trials — demonstrated that patients hospitalized for blood cancer treatment who followed a diet restricting fresh fruits and vegetables had a lower risk of developing serious infection. The researchers stopped the trial early to safeguard patient safety.
“Given the evidence from this study, we cannot change the current standard of care,” said co-lead author Ji-Hyun Lee, Dr.P.H., a professor of biostatistics in the UF College of Public Health and Health Professions and associate director for Cancer Quantitative Sciences at the UF Health Cancer Institute. “This study provides truly critical information for patients who are vulnerable to infection.”
The “neutropenic” diet, gets its name from neutropenia, a condition in which patients have low levels of protective white blood cells called neutrophils. During chemotherapy, these cells are suppressed, increasing infection risk. The most serious infections arise from the intestinal tract and are linked to microbes in uncooked foods. Fresh fruits and vegetables are important components of a healthy diet once patients’ immune systems have recovered, but during treatment, clinicians prescribe the diet to protect against infection.
When the neutropenic diet was introduced more than a half-century ago, it was not tested in a randomized trial. While a few smaller studies have evaluated the diet, UF’s study is the largest and most rigorous.
Read the full story in the UF Health newsroom.