Dietary Restrictions for Patients With Neutropenia

Patients with neutropenia need to follow a special diet to reduce the risk of infection. Do you know what they should avoid in their diet? Read the following article to find out.
Dietary Restrictions for Patients With Neutropenia
Eliana Delgado Villanueva

Written and verified by the nutritionist Eliana Delgado Villanueva.

Last update: 27 May, 2022

Patients with neutropenia need to follow a special diet in order to reduce the risk of infection. A neutropenic person has a low level of white blood cells, especially white blood cells known as neutrophils.

There are several causes, but this condition is especially prevalent in patients who have cancer and must undergo chemotherapy treatment. Below, we’ll talk about the restrictions and advice that you should take into account to get adequate nutrition in these cases.

What is neutropenia?

Low blood neutrophils.
Neutropenia is a reduction in the blood neutrophil count. As a result, the immune system weakens and the risk of various infections increases.

Neutropenia is a reduction in the blood neutrophil count, according to a study published in Clinical Cornerstone. If severe, it increases the risk and severity of bacterial and fungal infections. Focal symptoms of infection may go unnoticed, but fever is present during the most severe infections.

Doctors diagnose neutropenia by means of a white blood cell count with a differential formula, but evaluation requires identifying the cause. If fever is present, infection is presumed, therefore requiring immediate empirical treatment with a broad-spectrum antibiotic. This is especially essential when neutropenia is severe.

What’s the right diet for patients with neutropenia?

The truth is that the answer can be a challenge as there are no uniform standards for the administration of a neutropenic diet. What’s more, there are many variants. Even within the same hospital, there may be different professionals who defend different dietary schemes for the same purpose. It’s possible to find some protocols, such as the one published in the Journal of Human Nutrition and Dietetics, but worldwide systematization is lacking.

What is suggested to restrict neutropenic patients?

Fish and seafood.
In order to ensure adequate nutrition, it may be advisable to restrict some foods that are currently part of the diet.

Depending on what your oncologist tells you and the center where you’re undergoing chemotherapy, you may be advised to avoid certain foods. Foods to avoid include the following:

  • Raw meats and seafood
  • Raw nuts
  • Butter
  • Any food that may contain raw eggs
  • Soft or aged cheeses
  • Unpasteurized cheese
  • Unpasteurized milk
  • Fruit and vegetable juices
  • Bulk grains
  • Cream-filled cakes and pastries that aren’t frozen
  • Raw honey or honeycomb
  • Water from water sources or wells
  • Water supplemented with vitamins
  • Sauces or dressings from supermarkets

What risks could the neutropenic diet bring?

Oncologists are now placing more emphasis on safe food handling techniques, rather than restricting foods. Chemotherapy already has a big impact on a person’s body and appetite. Further restricting food may worsen any underlying nutritional deficiencies.

While you may hear that a neutropenic diet can be good, safe food handling and limiting the intake of certain foods is as important as ever in reducing disease, and potentially mortality, while receiving chemotherapy.

Even in recent years, the effects of the ketogenic diet on these patients have been investigated, with promising results on reducing mortality.

You may be interested in reading: Researchers Have Discovered a New Cancer Treatment that Might be Better than Chemotherapy

Important aspects to take into account

A cancer patient in a hospital bed talking to her doctor.

Neutropenic patients face other disadvantages when it comes to feeding. The presence of sores and a lack of appetite are just a few examples.
People receiving chemotherapy also have to struggle daily with other challenges:

  • Mouth sores, it’s necessary to choose foods that are less likely to cause harm by eating them. It’s best to avoid citrus or spicy foods.
  • Loss of appetite. Even if you don’t feel like eating, there are some tips that can help you get the nutrients you need.
  • Changes in taste. Some chemotherapy drugs can make everything you eat taste metallic. Choosing foods, such as those with strong flavors and eating with plastic utensils and other changes can be helpful.
  • Fatigue is one of the most uncomfortable symptoms of cancer treatment. As a result, it’s not uncommon for people to not eat as healthily as they should. (Be aware that loved ones of people with cancer often feel helpless, and asking for help is something you can do for them.)

If you’re concerned about food handling or what you may or may not eat while receiving chemotherapy, talk to your oncologist and ask if it would be a good idea to see a nutritionist that specializes in oncology.


In addition to safe food practices, there are many ways you can reduce your risk of developing an infection during chemotherapy, especially when your white blood cell count is low. Staying away from friends and family who have coughs or colds often come to mind. However, pets can also be a source of infection.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Schwartzberg LS., Neutropenia: etiology and pathogenesis. Clin Cornerstone, 2006.
  • Carr SE., Halliday V., Investigationg the use of the neutropenic diet: a survey of UK dietitians. J Hum Nutr Diet, 2015. 28 (5): 510-5.
  • Lv M., Zhu X., Wang H., Wang F., et al., Roles of caloric restriction, ketogenic diet and intermittent fasting during initiation, progression and metastasis of cancer in animal models: a systematic review and meta analysis. PLoS One, 2014.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.