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Low-Bacteria Diet

Neutropenic Diet

by Cynthia M. Johnson, MA

En Español (Spanish Version)

What Is a Low-Bacteria Diet?

A low-bacteria diet does not have foods that are most likely to have bacteria or other infection-causing microorganisms.

Why Should I Follow This Diet?

If you have problems with your immune system, this diet will lower your risk of getting sick from eating food. You may need this diet before and after some cancer treatments.

Low-Bacteria Diet Basics

Bacteria and other harmful microorganisms are most likely to be in raw or fresh foods. These microorganisms are destroyed when you cook food well. For example, fresh veggies should be cooked until tender, meats should be cooked until well-done, and eggs should be cooked until the yolk is firm.

Some foods like milk are treated with a method known as pasteurization. It briefly exposes food to high heat to kill bacteria without cooking the food. Look for dairy products, juices, and ciders that have the word “pasteurized” on the label.

Eating Guide

Food	Eat This...	And Not This...
Grains	Breads, bagels, rolls, and muffins (except those with raw seeds or grains) Pancakes, waffles, and French toast Crackers and pretzels Cooked and ready to eat cereals without raw nuts or oats Cooked grains, rice, and pasta	Breads with raw grains or nuts Cereals with raw grains or nuts Raw oats Uncooked fresh pasta Pasta salad with raw veggies or eggs
Veggies	All cooked fresh, canned, and frozen veggies Well-washed raw veggies and herbs Canned veggie juices	Unwashed raw veggies or herbs Raw sprouts like alfalfa Commercial fresh refrigerated salsas Buffet or deli salads Potato salad with raw veggies or eggs Unpasteurized veggie juices
Fruits	Canned and frozen fruits and juices Pasteurized juices and ciders Well-washed fresh fruits Dried fruits	Unwashed fresh fruits Unpasteurized fruit juices
Milk	Pasteurized milk and dairy products (like sour cream, yogurt, and whipping cream) Commercial eggnog Commercially packaged cheese made from pasteurized milk like American, Swiss, Parmesan, mozzarella, and mild and medium cheddar Pasteurized cottage cheese Processed cheese	Unpasteurized milk or yogurt Soft-serve frozen yogurt or ice cream from a machine Eggnog made with raw eggs Unpasteurized and raw milk cheese Moldy cheeses like bleu, Gorgonzola, Roquefort, and Stilton Other cheeses: sharp cheddar, Brie, Camembert, and feta Deli cheeses Cheeses with uncooked herbs or veggies Mexican-style cheeses like queso fresco and queso blanco
Meat and Beans	Well-cooked meat, fish, poultry, or meat substitutes like tofu Single-serving cooked, canned, or frozen products Canned chicken or fish Cooked beans, lentils, and other legumes Pasteurized or cooked tofu Well-done eggs Pasteurized egg substitutes Canned and homemade soup (well heated) Commercially packaged peanut butter Canned or bottled roasted nuts	Rare or medium-rare cooked meat, fish, or poultry Undercooked tofu (should be cut into a minimum of 1-inch cubes and boiled for at least five minutes in water or broth) Deli cold-cuts Pickled fish Cold smoked fish, lox Raw or undercooked eggs or egg substitutes Cold soups and gazpacho Tempeh products Miso soup and other miso products Roasted nuts in the shell Unroasted (raw) nuts
Oils	Vegetable oil Margarine Mayo Commercial, shelf-stable salad dressing	Salad dressings with raw eggs or aged cheese Avocado dressing
Fats and Sweets	Butter, lard, shortening Cream cheese Snack chips like potato, tortilla Cakes, pies, cookies, donuts Baked custard, pudding, and gelatin Commercial ice cream, sherbet, fruit ice, and popsicles Candy Chocolate Jam Pasteurized honey	Soft-serve frozen yogurt or ice cream from a machine Homemade ice cream or sherbet Cream-filled pastries and desserts (unless refrigerated) Raw cookie dough Raw honey
Drinks	Instant and brewed coffee and tea Brewed herbal teas Individual cans or bottles of carbonated beverages Bottled water Canned, bottled, and powdered drinks and sports drinks Instant breakfast drinks	Well water Cold-brewed tea Unpasteurized fruit and veggie juices
Other	Non-dairy creamers Chewing gum Salt, pepper, sugar, and sugar substitutes Ketchup, mustard, BBQ sauce, steak sauce, soy sauce, and other condiments Well-washed dried herbs and spices Gravy and cream sauce Commercial pickles	Herbs and spices added to food after cooking Hollandaise sauce Home-canned pickles Uncooked brewer’s yeast Some nutritional supplements (Ask your doctor or registered dietitian.)

Tips

Here are some tips for eating a low-bacteria diet. Think about talking with a dietitian to learn more about this diet and how to make changes.

When you make food:
- Wash your hands before and after.
- Cook foods well and keep them hot until you eat them.
- Do not make bread that has yeast as an ingredient.
When you go shopping:
- Do not choose items from salad bars, bulk food bins, and food samples.
When you store and handle food:
- Keep refrigerated foods cold (below 40 degrees Fahrenheit [4.4 degrees Celsius]).
- Refrigerate or freeze leftovers right away.
- Refrigerate foods after you open them (like salad dressing, apple sauce, and soy sauce).
When dining out:
- Do not eat from salad bars, delis, and buffets.
- Use single-serve condiments such as ketchup, mustard, mayo, soy sauce, steak sauce, salt, pepper, and sugar.

RESOURCES:

American Cancer Society
http://www.cancer.org

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Dietitians of Canada
http://www.dietitians.ca

REFERENCES:

Leukemia and diet. EBSCO Nursing Reference Center website. Available at: https://www.ebscohost.com/nursing/products/nursing-reference-center. Accessed July 26, 2021.

Nutrition care manual. Academy of Nutrition and Dietetics website. Available at: https://www.nutritioncaremanual.org/index.cfm. Accessed July 26, 2021.

Last reviewed July 2021 by EBSCO Medical Review BoardDianne Scheinberg Rishikof MS, RD, LDN Last Updated: 7/26/2021

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