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Mauricio Rosas-Alvarez November 6, 2013

Neutropenic Diets
Are they effective?
According to the Academy of
Nutrition and Dietetics Evidence
Analysis Library:
If an adult oncology patient has
neutropenia, the registered dietitian
nutritionist (RDN) should provide
dietary counseling on safe food
handling and foods which may pose
infectious risks during the period of
neutropenia. A neutropenic diet is not
necessary, but safe food counseling
is recommended as a prudent
precaution. Research has not
demonstrated the effectiveness of
low-microbial diets.
the current American Society of Clinical Oncology (ASCO) guidelines, interventions
for Febrile Neutropenia such as footwear exchange, protected environments, respiratory or surgical masks,
nutritional supplements and a neutropenic diet are not recommended to be followed since research has
shown that there is lack of benefit to patients.
-Leukemia & Lymphoma Society:
Understanding Side Effects of Drug Therapy (revised 2013)
Cochrane Summaries
Independent high-quality evidence
for health care decision making
Low bacterial diet versus control
diet to prevent infection in cancer
patients treated with chemotherapy
causing episodes of neutropenia:
no statistically significant differences
between the treatment groups was
observed.
In May 2011, Steven J. Jubelirer published in The Oncologist
[scientific journal] a critical debate piece about the irrelevance of
Neutropenic Diets for cancer patients and controversial
usefulness due to the lack of needed scientific evidence.
He attests two studies as the primary reason for the genesis of
such diet order.
The gut as a portal of entry for bacteremia. Role of protein
malnutrition.
E A Deitch, J Winterton, M Li, and R Berg. Annals of Surgery.
1987 June; 205(6): 681692.
Bacterial translocation from the gastrointestinal tract.
Berg RD. Adv Exp Med Biol. 1999;473:1130.
These two studies, although dated, showed in controlled animal
studies that harmful bacteria, enterally placed in the gut and GI
tract, can travel through the intestinal mucosa to infect
mesenteric lymph nodes and body organs (bacterial
translocation).
Since no scientific evidence to date can prove the benefits of a
neutropenic diet over standard food safety practices, the best
advice for neutropenic patients is to follow food safety
guidelines as indicated by government entities.

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