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Wednesday, March 6, 2013

The Neutropenic Diet – What Jason Can & Cannot Eat

This post is likely boring. However, we have received many inquiries about Jason’s diet. When he is released from the hospital we may ask others to assist us with meals and this will be a good list of foods and instructions that they can follow to the best of their abilities. We do not expect a lot of people to be willing to make meals for Jason – there is some work involved. But, if you are curious, or willing then feel free to enjoy this post. The Neutropenic Diet is interesting but not terribly harsh. It protects people with poor immune systems from acquiring illnesses or infections. Below the list of foods are food-handling instructions and tips for him while he is eating out, microwaving, and shopping. A Neutropenic individual has a low white blood cell count, which Jason has as a result of chemotherapy treatments. These cells prevent infection, without them it is necessary to avoid infection through people and food. If you are bored or think you would be up to the task of making us meals periodically, read on.

Let’s start with the foods that he cannot eat.

Dairy Food Group – Foods he CANNOT have:
-Non-pasteurized or raw milk
-Milk products made from non-pasteurized or raw milk
-Cheeses from delicatessens
-Cheeses containing chili peppers or other uncooked vegetables (no onion cheese, garlic cheese, etc).
- Cheeses with molds (such as blue cheese, Stilton, Roquefort, and Gorgonzola)
- Mexican-style soft cheese such as queso fresco or queso blanco (no cheese dips, nacho cheese, or cheese from a can.
-Milkshakes from machines.

Meat or Meat Substitute category – foods he CANNOT eat:
-Raw or undercooked meat, poultry, fish, game or tofu (eat only well-done meats)
-Raw or undercooked eggs and non-pasteurized egg substitutes; NO over-easy eggs, NO soft boiled eggs or poached eggs
-Meats and cold-cuts from delicatessens.
-Hard cured salami in natural wrap
-Uncooked refrigerated smoked seafood such as salmon or trout labeled as nova-style, lox, kippered, smoked or any jerky.
-Pickled fish of any kind
-Tempe (Tempeh) products

Fruits and Nuts Category – foods Jason CANNOT eat:
-Unwashed raw fruits
-Fresh or even frozen berries (no berries of any kind)
-Unroasted raw nuts
-Roasted nuts in the shell
-Non-pasteurized fruit and vegetable juices (no fresh fruit or vegi juice or homemade juices)
-Fresh fruit salsa
-Any non-pasteurized items containing raw fruits found in your grocery store refrigerator

Entrees and Soups category – Foods Jason CANNOT eat:
-Uncooked entrees or soups
-All miso products (such as miso soup, and miso paste)

Vegetable Category – Foods Jason CANNOT eat:
-Unwashed raw vegetables or herbs
-Fresh salsa
-Fresh, non-pasteurized salsa found in  grocery store
-Non-pasteurized items containing raw vegetables  found in grocery freezer
-All raw vegetable sprouts (alfalfa sprouts, clover sprouts, mung bean sprouts, all others)
-Salad bars or salads from delicatessens

Bread, Cereal, Rice and Pasta Category – Foods Jason CANNOT eat:
-Raw (not baked or cooked) grain products (such as raw oats) or granola

Beverages Category – Drinks Jason CANNOT drink:
-Un-boiled well water
-Cold-brewed tea
-Non-pasteurized fruit and vegi juices (No homemade fruit or vegetable juices)
-Mate tea
-Non-Pasteurized beer
-Any machine soft-drink, ice or milkshake such as in a restaurant.
*Avoiding caffeine is suggested by doctors

Desserts Category – foods Jason CANNOT drink:
-Unrefrigerated cream-filled pastry products, cream puffs, cakes or donuts
-Raw Cookie dough or cookie dough ice cream
-Any items containing raw or uncooked eggs.

Fats Category – foods Jason CANNOT eat:
-Fresh salad dressings (stored in the grocers refrigerator case) containing raw eggs or cheeses listed as ‘Do not eat’ under dairy.

Other Category – foods Jason CANNOT eat:
-Raw honey or honey in the comb
-Herbal and nutrient supplement preparations
-Brewers yeast, if uncooked

Food Safety Suggestions:
Illness caught by food is taking place more often. You need to follow safe food handling methods.

Safe Food Handling:
-Wash hands often – before, during, and after preparing your food. Use plenty of warm water and soap, and wash hands for at least 20 seconds.
-Use separate cutting boards for raw meats, poultry and seafood than you use for other foods. Clean work surfaces with plenty of hot water and soap.
-Keep cold foods cold (less than 40 degrees) and hot foods hot (greater than 140 degrees).
-Thaw meat, fish and poultry in the refrigerator – not on the counter.
-Wash fruits and vegis well, under running water, before peeling, cutting and cooking.
-Check “sell by” dates and “use by” dates – do not use if the food is out of date.
-Shop for perishables last and take them home right away.
-Do not buy or use goods from cans that are dented, swollen, or damaged.
-Do not leave cooked meats or other foods left out at room temperature for longer than 2 hours.

Special tips for eating out:
Check the condition of the restaurant. Are the plates, glasses and utensils clean? Are the restrooms clean and stocked with soap and paper towels?
-Eat early to avoid crowds
-Ask that all foods be prepared fresh
-Ask if juices are pasteurized
-Avoid raw fruits and vegis
-Ask for single-serving, packaged condiments
-Avoid salad bars, delis, buffets, potlucks, picnics, party trays, and sidewalk vendors.

Microwave Cooking:
-Rotate the cooking dish a quarter turn once or twice during cooking. Bacteria can survive in cold spots of food.
-Use a loose-fitting lid or vented plastic wrap to cover food when heating. Stir often.

Grocery Shopping:
-Select only the freshest food products
-Reject damaged, swollen, rusted or deeply dented cans. Check that packaged and boxed foods are sealed.
-Select flawless fruits and vegetables. They should look and smell fresh. Wilted salad greens may be a sign that the product is old.
-Avoid foods from delis, including prepared salads and sliced meats and cheeses.
- Avoid tasting free food samples.
-Shop at unpopular times to avoid people and germs

Bottled Water
Look for water labeled reverse osmosis treated, distillation, or filter capable of removing particles less than or equal to one micrometer in diameter.

And there you have it, the Neutropenic Diet, as given to us by this particular hospital.

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