Nutrition Education Coordinator, Medical Nutrition Therapy Seattle Cancer Care Alliance Seattle, Washington
Participants will understand the current literature regarding evidence-based diet recommendations for immunocompromised oncology patients.
As neutropenia is associated with oncologic therapies, patients are at higher risk for developing infections, a major source of morbidity and mortality in the cancer population. Historically, oncology patients have been maintained on neutropenic diets to reduce infection rates. Hematopoietic cell transplant oncology patients also follow the diet precautions for the duration of immunosuppressive therapy to minimize infection risk. In recent years, however, the efficacy of the neutropenic diet has become controversial as the protective benefits have not been established. Several published studies have shown no improvement in outcome or higher incidence of infection in patients who follow a neutropenic diet. Furthermore, the neutropenic diet eliminates foods, such as fresh fruits and vegetables, which often results in patient dissatisfaction and compromised diet quality. Current evidence suggests that in place of a neutropenic diet, oncology patients be educated on avoiding high risk foods and practice safe food handling. A food safety education program for patients and caregivers, developed by registered dietitian nutritionists (board certified in oncology nutrition), has been a novel approach to share evidence-based diet guidelines. Key educational concepts covered in a weekly class setting include discussion of the four steps to food safety (clean, separate, cook, chill) and avoiding high risk foods. The class is well-attended and has been reported to be very useful by patients and caregivers. Less restrictive dietary modifications for the oncology population has resulted in improved patient satisfaction without compromised infection risk during cancer therapy.