{"id":364245,"date":"2025-12-22T09:43:09","date_gmt":"2025-12-22T09:43:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/364245\/"},"modified":"2025-12-22T09:43:09","modified_gmt":"2025-12-22T09:43:09","slug":"unpopular-diet-for-cancer-patients-gets-another-look","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/364245\/","title":{"rendered":"Unpopular diet for cancer patients gets another look"},"content":{"rendered":"

Oncologists have been moving away from the notoriously unpopular neutropenic diet. It requires nearly all food to be cooked to high temperatures \u2014 or, as some have described it, \u201cboiled to death\u201d \u2014\u00a0to reduce the risk of food-borne illnesses. But since evidence in recent years suggested the diet didn\u2019t actually help ward off infections, doctors started leaning away from a strict neutropenic diet.<\/p>\n

Now, a new study published last week in the Journal of Clinical Oncology<\/a> is giving some physicians pause about fresh fruits and vegetables for patients whose treatment involves heavy suppression of the immune system, particularly neutrophils, white blood cells that are key to preventing infection. Contrary to research in the past, the trial found that certain blood cancer patients who were allowed a less restrictive or liberalized diet had 11% more infections than patients who were prescribed the neutropenic diet.<\/p>\n

\u201cThere has been a move in the last 10 years in liberalizing diets for patients, for sure,\u201d said Talal Hilal, a hematologist oncologist and bone marrow transplant physician at the Mayo Clinic who did not work on the study. But reading the paper, Hilal said, \u201cit does pose the question of maybe we need to revisit how liberal we want to be with our patients.\u201d<\/p>\n

Oncologists first began using the neutropenic diet decades ago, particularly for intensively treated cancer patients like those undergoing hematopoietic stem cell or bone marrow transplants. These procedures can give certain blood cancer patients an opportunity for a cure, but sometimes use heavy doses of chemotherapy that\u2019s extremely harsh on the immune system.<\/p>\n

While the weakened immune system is recovering after the procedure, infections have a higher potential of turning deadly, until the patient\u2019s cell counts recover. Hospitals have been known to go to great lengths to protect these patients including preventing outside food or fresh flowers<\/a> from entering their rooms. As cruel as it may have felt, clinicians assured themselves it was better than potentially introducing dangerous bacteria, viruses, or fungal spores to the defenseless.<\/p>\n

\t\t\t\"\"\t\t<\/p>\n

\t\t\t\t\"\"\/
\n\t\t\t\tSTAT Plus: Bone marrow transplant patients could be spared from \u2018bland\u2019 diet, study finds<\/a><\/p>\n

Over the years, though, evidence suggested that normal diets don\u2019t pose much of an infection risk. Rather, neutropenic diets were blamed<\/a> for decreasing patient quality of life and increasing malnutrition. So hospitals have gradually shifted toward being more liberal when it comes to neutropenic patients.<\/p>\n

In particular, a group at the University of Milan published the first randomized evidence<\/a> that a non-restrictive diet was not inferior to the neutropenic diet for certain stem cell transplant patients in 2023, leading many oncologists to rejoice that the benefits of the neutropenic diet were finally debunked. They also showed a non-restrictive diet improved quality of life.<\/p>\n

But John Wingard, a hematologist-oncologist and emeritus faculty at the University of Florida, wanted to take another look. In particular, he wanted to know if un-restricting the diet for neutropenic patients would actually improve patients\u2019 nutrition, an ongoing challenge for many cancer patients undergoing intensive therapy. Like the Milan group, Wingard enrolled over 200 blood cancer patients and randomized them to get either a liberalized diet allowing fresh fruits, vegetables, and pasteurized yogurt, or the neutropenic diet. In this study, patients were allowed to eat home-cooked or restaurant food as long as it adhered to diet guidelines.<\/p>\n

Wingard planned to look at how many clinically confirmed infections were in each group at different time periods. \u201cWe had to prematurely stop the trial from data safety monitoring committee because the liberalized diet had 11% more infections,\u201d Wingard said. Only about half of the patients who were allowed the liberalized diet actually consumed fresh fruits or vegetables, Wingard added. \u201cWhen we did an analysis of just the people who complied with the liberalized diet, the rate of infection was 1.5 times higher.\u201d<\/p>\n

The study also suggested that allowing the liberalized diet didn\u2019t seem to improve patients\u2019 nutrition or quality of life.<\/p>\n

Taken together, Mayo Clinic\u2019s Hilal said he\u2019s starting to rethink his practice of being more permissive with transplant patients\u2019 diets. \u201cI feel like if you are liberalizing diet and you\u2019re not even seeing improvements in quality of life or nutritional status, then there is no trade-off here. Why would I be very easy with liberalizing my diet, if I don\u2019t benefit in any other domain?\u201d he said.<\/p>\n

There are some caveats, Hilal said. For one, the patient population in both the 2023 Milan group study and this study are different. The 2023 paper was a multi-center study, which can help remove hospital-specific biases. It was also done in Europe, where certain practices may be different than what\u2019s typical in the U.S., which could plausibly make comparison harder as well. \u201cThey are also a higher-risk population that seems to be enrolled in this JCO paper,\u201d he said.<\/p>\n

Ultimately, Hilal said he felt the study may reignite a debate on the neutropenic diet, and cancer researchers might argue over the strengths and weaknesses of both trials. \u201cIt\u2019ll probably get discussed. People will take sides,\u201d he said.<\/p>\n

Notably, Hilal and other physicians, including Wingard, said that it\u2019s likely still reasonable to allow a non-restrictive diet with other patients like solid tumor patients who may still be neutropenic, but not as high risk or neutropenic for as long as bone marrow transplant patients. This study also showed that being neutropenic longer was the main variable associated with infection. No patients died during the study intervention either, and oncologists can manage many infections well.<\/p>\n

As for why neither diet improved nutrition or quality of life for patients, Wingard thinks that might be because intensive cancer treatment can leave patients nauseous, without an appetite, and generally uncomfortable. No matter what food they get, some patients will just struggle to eat.<\/p>\n

\u201cI don\u2019t think the neutropenic diet is that bad,\u201d Wingard said. \u201cIt\u2019s just that patients who have been treated this way have a symptom called dysgeusia, which means everything tastes bad. And then you have nausea and stuff.\u201d<\/p>\n

Probably the best way to settle the neutropenic diet debate and help patients\u2019 quality of life and nutrition, Wingard said, is to focus on improving treatment. New effective therapies that are less toxic to the immune system would mean there\u2019s no need for something like the neutropenic diet.\u00a0\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Oncologists have been moving away from the notoriously unpopular neutropenic diet. It requires nearly all food to be…\n","protected":false},"author":2,"featured_media":364246,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[64,63,1617,137,19900,532,10557],"class_list":{"0":"post-364245","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-au","9":"tag-australia","10":"tag-cancer","11":"tag-health","12":"tag-hospitals","13":"tag-nutrition","14":"tag-patients"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/364245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=364245"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/364245\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/364246"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=364245"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=364245"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=364245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}