Who doesn’t love this time of year? The gifts, the lights, the food...especially the food! It’s a time of happiness and giving, but things can be a bit more complicated when you’re undergoing chemotherapy. As much fun as the holidays are, you have extra things to consider as a patient during this season. With a low bacteria diet and a variety of medications, it can be tricky to navigate all the delicious pitfalls as wafting scents of prime rib tempt you. To help you navigate safely, I’ve highlighted some important considerations of a low bacteria diet as well as some tips to help you make the most of your feasting through the festivities. This guide will be especially helpful for recovering cancer patients who are undergoing chemotherapy or similar treatments.
What is a low bacteria (neutropenic) diet and why is it important?
Before we dive into how you can stay safe from infection, let’s quickly go over what a low bacteria diet is and why it’s important.
Chemotherapy can really cause havoc for your body. But that’s what it’s designed to do. The chemicals that are pumped into your bloodstream are designed to kill any fast growing cells. Rapidly multiplying cancer cells fall firmly into this category but the drugs aren’t specific for them. The drugs also target any other cells that replicate quickly. This can include any cells from your hair follicles to your stomach to your mouth and to your blood. This broad effect leads to the wide range of side effects that are observed with chemotherapy like balding or nausea.
With the chemotherapy killing blood cells, it makes your body much more susceptible to infection. With a lower number of white blood cells, you have compromised defenses against any bacteria that comes your way. What would normally be quickly eradicated by your immune system becomes much more difficult for your body to fight against. A cold becomes a trip to the hospital and any infection can be deadly while undergoing treatment.
Because of this, cancer patients have a special low bacteria diet to help prevent any kind of infection that could come from food. Bacteria live everywhere, including on our food. Most cooking techniques will kill any microbes before they get into the final dish. However, a low bacteria diet will specifically omit certain types of food and preparation techniques that could lead to higher amounts of bacteria in the dish. Less chance of a live bacteria in the final dish means less chance of it being ingested which means less chance of an infection. While these preventative measures limit the choices, it’s important to know what you can and cannot eat to be safe.
Here are some of the more critical recommendations to follow during a low bacteria diet. As always, talk to your doctor for specific recommendations!
- Cook everything and I mean everything
First and foremost, don’t eat any uncooked food! Nothing in your diet should be raw. This means no salad, coleslaw, sushi, and even the lettuce and tomatoes on your burgers. The cooking process kills any harmful bacteria through heat. So make sure to thoroughly cook everything.
- No more bloody steaks
When we say cook everything, this also means the inside of those steaks. For you carnivores, this means replacing that bloody steak with a something well done. For most meat, you’ll want to look for a minimum internal temperature of ~ 170° F. While your meat may be tougher, this is the best way to ensure that there are no bacteria left alive on your piece of meat.
- Always wash your vegetables/fruits
You should thoroughly wash all fruits and vegetables. Since we don’t know what has come into contact with our produce, it is best to rinse them off before preparing. But this is already something you should be doing, even without a low bacteria diet.
- Dairy products must be pasteurized
Pasteurization is a process of sterilizing food through heat or irradiation. Many dairy products undergo this process to decontaminate dairy and improve its shelf life. You should be extra vigilant for this marking when buying this food.
- Try to only eat food that you know has been prepared and handled properly
Since bacteria is all over our food, it is critical to know how yours is being handled and prepared. Because of this, it is recommended to stay away from eating out, especially at fast food restaurants. We would always check the health rating of any restaurants before dining there. Anything other than an “A” rating would be passed over.
- Only eat food that is fresh or just opened
Fresh food has much lower risk of having bacteria on the food than does something that has been sitting out. If you do need to keep leftovers, be sure to put it in the fridge immediately after you’ve finished eating. Once again, when reheating, be sure to thoroughly heat up your food. Check the internal temperature of your food items for a minimum of ~ 170° F.
The Feasting Hacks
With all those considerations, it can be difficult to feel included in the festivities and really enjoy your holiday meals with the family. But it’s important for you to be a part of the fun, as long as your health is the priority. Having experienced the holidays as a newly diagnosed patient, I know how terrifying the idea of hospital trip can be. So, I’ve listed out some of my personal tips to enjoy your holiday meals all while staying infection free.
- Find out what’s in everything before it goes into our mouth
Always know what you are eating. There is a long list of foods that you should try to avoid while on a low bacteria diet. It can be difficult, but try to stick by these recommendations. They are meant to keep you safe and away from the hospital.
- When in doubt, ask, ask, ask
There’s always a variety of food at parties, but it’s your responsibility to know what it is, how it’s been prepared, and (most importantly) if it’s safe to consume. If you don’t know, ask around, never be afraid or feel embarrassed to inquire about what you’re eating. Asking more questions is always better than a trip to the hospital.
- Grab your food first
Before everyone huddles around the table, it’s important to grab your food first. While this usually isn’t an issue for most people, when your immune system is compromised, it becomes more important. Shared food has greater chances of becoming contaminated with bacteria and the more people that handle the same plate of food, the greater the chances of contamination. Just think of how many times someone reached for a piece of bread with their hands! It’s totally possible that they brushed up on a few other pieces in the process (hopefully by accident). And do you really know how clean your five year old cousin’s hands are? So take a bit of initiative and get in line first! Or better yet, make your own plate of food in the kitchen before the dishes even get onto the dining table.
- Beware of new allergies
During treatment, you’ll be under a wide variety of medication, each possessing its own rolodex of side effects. Sometimes these can cause changes in your body. I experienced this first hand, developing a sudden new food allergy in the middle of my treatment.
I grew up eating shellfish, all kinds of shrimp, mussels, and oysters. But I didn’t have any for a couple weeks after I started treatment. Then I had some seafood jambalaya and as I started eating, my lips and cheeks started to feel tingly. Then they became numb. About 2 minutes later I hear a gasp from my mom across the table as my face was becoming puffy, red and swollen. From then on, we started carrying an Epipen, just in case. Luckily, once my treatment ended, so did my newfound food allergy.
While it is uncommon to develop new allergies, it can definitely happen, so be careful when eating. The most common food allergies are: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans.
- Be vigilant about how you feel after eating
As you can see, there can be unpredictable side effects when undergoing treatment. All our bodies will respond to drugs differently so it’s always smart to stay mindful about how you feel after eating. When in doubt regarding new symptoms, always ask your doctor.
- Give others the opportunity to care for you
This one might just be the hardest thing to do. Whether you feel shy, embarrassed, or a burden, just remember you are loved and appreciated. To others, you are an inspiration and a hero for facing such tremendous obstacles and people understand that sometimes heroes need help too.
In my experience, they will be more than happy to accommodate your needs. I never liked asking for help because I saw myself as weak or a burden. But I realized that my loved ones were not aware of my insecurities because they were so awestruck by the challenges I was facing. Because I felt embarrassed, my parents decided to ask our friends and family to prepare a duplicate dish just for me so I could feel included during holiday potlucks and parties.
Those little acts of kindness were so impactful for me and I was so grateful to be a part of the festivities. So give others the chance to show you love!
The holidays are such a special time of the year. With so many loved ones by your side, it’s a chance to really appreciate the support network that you have and enjoy your time with them. With these recommendations, hopefully you will be able to feast with a little less worry.
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