Safer eating during your cancer treatment

Good food safety and food hygiene is very important during and after cancer treatment because you are at greater risk of infection. You can get an infection from harmful bacteria or fungus present in food. This is because some cancer treatments can temporarily:

• weaken your immune system and lower the white blood cells which usually fight infection
• damage the gut lining which separates the foods we eat from our bloodstream. This change can make it easier for normal gut bacteria to move out of the gut and cause an infection.

What about the neutropenic diet?

People with cancer may have been advised in the past to follow a very restrictive ‘neutropenic diet’. We now know there is no scientific evidence that this diet reduces infection rates.

A neutropenic diet can also be confusing to follow, causing anxiety about what to eat. It can increase the risk of malnutrition because it restricts foods that you may want to eat.

Having reviewed the evidence, we don’t recommend following a neutropenic diet.

We recommend practicing good food hygiene, with minimal food exclusions. Please read this page for more tips.

You can use the advice on this page together with any dietary requirements even if you:

• have been advised to follow a specific diet (for example high-calorie)
• follow a diet for ethical, religious or health reasons (for example gluten-free or vegetarian).

All food provided by University College London Hospitals (UCLH) meets safety regulations and is safe to eat.

If food is brought in from outside the hospital, please make sure that you eat it while it’s hot. If that’s not possible, store it in an airtight container in your fridge.

Use the same cup, water bottle or jug for six hours at most. Wash them thoroughly after that time and throw away any disposable water bottles.

So that you can prepare and enjoy some of your own foods at UCLH or the Cotton Rooms, you will have access to:

• a fridge
• hot drinking water
• a microwave (please note that staff can’t use the microwave on your behalf).

Almost all foods will be safe to eat if they are prepared, cooked and stored correctly. But you should avoid the foods listed below while you’re having treatment. This is because they may contain harmful bacteria.

• Raw and runny eggs (fresh, well-cooked, Lion-marked eggs are safe to eat).
• Sushi made with raw fish.
• Unpasteurised dairy products. These include mould-ripened and blue veined cheeses, such as brie, camembert or stilton.
• Pâté.
• Reheated rice (rice should always be prepared and eaten straight away).
• Raw or undercooked meat, fish and shellfish.
• Food labelled as ‘probiotic’.

You can start eating these foods again when you finish your treatment.

Snack ideas:

• individual yoghurt, custard, jelly or rice pudding pots
• individual portion size of carrots and hummus, olives or nuts
• individual smoothie, milkshake or juice bottles
• sausage rolls or pork pies
• individually wrapped cheddar cheese and crackers
• crackers, biscuits, breadsticks or crisps
• apple or banana with nut butter.

Please follow these food safety tips both during and after your cancer treatment.

Shopping

• Avoid buffet food or open salad/deli bars in restaurants and supermarkets.
• Check ‘use by’ and ‘sell by’ dates before buying and eating food.
• Avoid bruised fruit and vegetables or damaged packages and tins.
• When shopping and packing, keep raw and ready-to-eat foods separate.

Storage

• Make sure that you store food following the storage instructions on packaging. Don’t eat food past its use by date.
• Always cover your food with cling film or foil, store in an airtight container, or wrap it well in freezer bags or freezer wrap. This can help to prevent contamination.
• Cool cooked food at room temperature and then place in the fridge or freezer as soon as possible.
• Use refrigerated leftovers within 48 hours and defrosted leftovers within 24 hours.
• Keep raw and cooked meats separate when storing. Store raw meats at the bottom of the fridge to prevent contamination.
• Don’t overfill your fridge. Leaving space allows air to circulate and maintains the set temperature.

Preparation

• Wash and dry your hands with warm soapy water before cooking and eating, and after touching raw food. Protect cuts and wounds before handling food.
• Clean all surfaces before and after cooking. Use a detergent, disinfectant or sanitizer suitable for food surfaces. Please check the manufacturer’s instructions.
• Use different chopping boards, plates and utensils for raw and cooked food.
• Keep chilled foods out of the fridge for the shortest time possible during preparation.
• Defrost food fully in the fridge and eat within 24 hours. Re-heat frozen food once only.
• Make sure all reheated food is piping hot before eating.
• Wash fresh fruit and vegetables before eating but don’t wash meat.

Eating out

Check the food hygiene ratings of restaurants and takeaway places before eating out or ordering food. Visit the Food Standards Agency website.

When you finish your cancer treatment, you will no longer need to avoid eating any of the foods listed above. You can also start eating again from buffets, deli/salad bars and restaurants/takeaways of your choice.

You should still continue to follow the safety advice about food shopping, preparation and storage.

If you have any questions about your diet or are struggling with eating or drinking, contact your clinical nurse specialist (CNS). You can also ask for a referral to a dietitian.

Haematology dietitians

Tel: 020 3447 9289

Email: uclh.dietitiansdept@nhs.net

Address: Grafton Way Building, 1 Grafton Way, London, WC1E 6AS

For more detailed food safety tips please visit:

• NHS website
• Food Standards Agency

University College London Hospitals NHS Foundation Trust cannot accept responsibility for information provided by external organisations.