Some oncologists recommend avoiding fresh fruits and vegetables for patients undergoing chemotherapy. This recommendation is controversial and lacks substantial evidence according to a 2000 Centers for Disease Control report. If you have questions about whether you can eat fresh fruit during chemotherapy, it's best to consult with your doctor about your specific situation.
Chemotherapy Special Precautions
In the 1960s immune-compromising chemotherapy came on the market. Patients treated with these agents were susceptible to infections due to their body's inability to produce enough neutrophils, a type of white blood cell. In certain patients, the next round of chemotherapy occurs only after the body's neutrophil count recovers. In other patients, such as those undergoing stem cell transplantation, eliminating neutrophils is a necessary part of treatment. When a patient's neutrophils drop below a certain level, oncologists recommend so-called "neutropenic precautions," which traditionally have included dietary restrictions.
The Neutropenic Diet: A Controversial Topic
Although oncologists developed dietary precautions for chemotherapy patients with low neutrophils, clinical evidence to support restricting fresh fruits and vegetables is lacking, according to the American Dietetic Association. Food safety and the proper hand-washing and washing of produce before eating are more important than restricting consumption. According to research published in 2007 in "Clinical Infectious Diseases," infection-related deaths in immunocompromised cancer patients are most often not due to dietary practices.
Supporting the Lack of Evidence
In May 2011, Dr. Steven Jubelirer published a review article in "The Oncologist," claiming that there is no evidence to restrict fresh fruits and vegetables in immunocompromised patients. According to Jubelirer, limiting these foods may lead to a reduction in quality of life, vitamin and mineral deficencies, food aversions and gastrointestinal side effects. The Centers for Disease Control likewise recommends not restricting fruits and vegetables as part of precautions for immunocompromised patients, but rather focusing on food safety and proper food handling to reduce risk of food-borne illness.
The Bottom Line
Although evidence is lacking, many health care facilities still practice restricting fresh produce as part of neutropenic precautions. Limiting fresh produce lessens the nutrient quality of the diet and should not be practiced unless otherwise directed to by the patients health care team. Ultimately, the decision to eat fresh fruits and vegetables throughout cancer treatment should be discussed between the patient and the health care team.
- "Clinical Infectious Diseases"; Outcomes of Bacteremia in Patients with Cancer and Neutropenia: Observations from Two Decades of Epidemiological and Clinical Trials; L. Elting, et al.; August 1997
- “Journal of the American Dietetic Association”; A Survey of the Use of Low Microbial Diets in Pediatric Bone Marrow Transplant Programs; M. French, et al.; October 2001
- Fred Hutchinson Cancer Research Center: Diet Guidelines for Immunosuppressed Patients
- "The Oncologist"; The Benefit of the Neutropenic Diet: Fact or Fiction; Steven Jubelirer; May 2011