Discharge Instructions: Eating a Low-Bacteria Diet
Your healthcare provider has prescribed a low-bacteria diet for you. The purpose of this diet is to help you eat healthy foods with low amounts of bacteria (germs). This can decrease your risk of getting an infection. A low-bacteria diet is prescribed when your immune system is not working well because of illness or medical treatment. All food on a low-bacteria diet is cooked or prepared to reduce the amount of bacteria in the food. Here are some guidelines to follow.
Keep raw meat away from other food. Wash your hands after handling raw meat.
Cook all fish, poultry, and meat items until they are well done.
Throw away leftovers that have been refrigerated for more than 3 days.
Never eat food that doesn't smell good or that has mold on it.
Check for dented or bulging food cans, torn boxes, or leaky plastic wrappers. Don’t eat food from these containers.
Throw away food if the expiration date has passed.
Don’t eat at buffets or salad bars. Don’t eat food from deli counters, steam tables, or other places where food sits for long periods. Don’t eat food that has been kept under warming lights.
Don’t sample food at grocery stores. Don’t buy or eat food from containers that other people have shared.
Don’t take food from a container with a spoon, put it in your mouth, and put it back into the container. This will introduce bacteria into the container.
Don't eat meals prepared and given to you by friends or neighbors because you don't know if was prepared safely or not.
Don’t drink well water that has not been tested.
Don’t drink alcohol unless your doctor says it’s OK.
Cleaning to reduce bacteria
Keep your hands clean. Wash them with soap and water. Be sure to rinse off the soap before handling food or liquids.
Wipe up spills promptly. You can use a bleach solution (1 tbsp bleach in a quart of warm water) to clean your kitchen. Keep all surfaces that may touch food as clean as possible.
Every day, replace dish towels with clean ones or use disposable paper towels.
Before opening cans and bottles, wash the outside with soap and warm water.
Wash your hands and fruits such as oranges and bananas before preparing them. With melons, peel the melon first, then rinse it off before you eat it.
Eating hot foods
Heat hot food at 165°F (74°C) or higher.
Keep your hot food hot until you eat it. A minimum temperature of 140°F (60°C) is recommended. This will keep bacteria from growing in your food.
Eating cold foods
Keep cold food and liquids cold, at 40°F (4°C) or lower, until you eat or drink them.
Eat foods you've taken out of the refrigerator within 2 hours.
Don’t leave dairy products or mayonnaise out of the refrigerator for more than 30 to 60 minutes (less on warm days).
Thaw frozen foods in the refrigerator. Don’t thaw them at room temperature.
Here are some guidelines for selecting different types of foods.
Select from the following foods: well-cooked chicken, fish, beef, or pork; cooked dried beans, peas, or lentils; boiled, poached, or scrambled eggs; cottage cheese; American cheese or other cheese made from pasteurized milk; peanut butter from a tightly sealed container.
Avoid the following foods: aged or ripened cheeses such as blue, feta, or brie; eggs with cracked shells or eggs that are not cooked all the way; nuts or trail mix; pickled fish; raw eggs or homemade eggnog; raw fish, lox, or sushi; raw, rare, or undercooked meats and poultry; raw or fresh-ground peanut butter; tofu, tempeh, or other aged soy foods, such as miso.
Select pasteurized milk, pasteurized yogurt, ice cream or frozen yogurt, pudding, or custard.
Avoid raw or farm-fresh milk, raw yogurt, raw milk cheese, and raw milk ice cream. Avoid aged or ripened cheeses.
Breads, grains, and starches
Select the following foods, prepared and packaged: bread, rolls, muffins, hot dog or hamburger buns; cooked rice or pasta; dry cereal; cooked cereal; mashed potatoes; baked potatoes; saltine crackers; graham crackers; popcorn; potato or corn chips.
Avoid granola cereals with nuts or dried fruit. Avoid breads or muffins with nuts or dried fruit.
Select cooked vegetables, canned vegetables, canned vegetable juice, and canned tomato sauce or paste.
Fresh vegetables should be washed under running water before you cut or peel them, even vegetables grown at home or bought from a store or farmers’ market. Washing vegetables with soap, detergent, or commercial produce wash is not recommended. Scrub the skins of firm produce, such as squash, with a clean produce brush. After washing, dry the vegetables with a clean cloth towel or paper towel to reduce any bacteria that might remain on the surface.
Avoid pickled vegetables such as olives, onions, pickles, or pickled cabbage; raw sprouts, freshly squeezed vegetable juices, commercially prepared salads, and salsas.
Select canned fruit or applesauce; canned fruit juice or nectar.
Fresh fruits should be washed under running water before you cut or peel them, even fruit grown at home or bought from a store or farmers’ market. Washing fruits with soap, detergent, or commercial produce wash is not recommended. Scrub the skins of firm fruits, such as melons, with a clean produce brush. After washing, dry the fruit with a clean cloth towel or paper towel to reduce any bacteria that might remain on the surface.
Avoid raw juices made from fresh fruits.
Select packaged margarine or butter, packaged salad dressing, and packaged cream cheese.
Avoid dressings made from raw or farm-fresh raw dairy products.
Select gelatin desserts and packaged cookies.
Avoid desserts with coconut, raw unwashed fruits, raw nuts, and raw honey. Also, avoid constructed desserts. These are handled a lot when they’re made.
Make a follow-up appointment as directed by our staff.
When to call your healthcare provider
Call your healthcare provider right away if you have any of the following:
Fever above 100.4°F (38°C) or shaking chills
Shortness of breath
Dizziness or lightheadedness
Loss of consciousness
Diarrhea that does not go away after 2 loose stools
Pain or cramping in the stomach
Any chest pain
October 10, 2017
Jubelirer, SJ., The Benefit of the NEurtropenic Diet: Fact or Fiction? Oncologist (2011); 16(5); 704-707
Horowitz, Diane, MD,Wilkins, Joanna, RD, CD