Eating With MBC and Neutropenia: Meal Ideas and Food Safety Tips

A nutritious diet is important for anyone living with MBC. "It improves quality of life and helps people feel their best, keep their energy up, and get good sleep," says Cara Anselmo, RDN, of Memorial Sloan Kettering Cancer Center in New York City.

These food preparation tips and meal ideas can help you stay nourished and infection-free during your treatment.

The U.S. Department of Agriculture has created special food safety guidelines for people who are at a higher risk of foodborne infections, including those with cancer. Follow these recommendations for preparing and storing food safely.

Clean Your Hands and Cooking Tools

Avoid Cross Contamination

Cook Thoroughly

Refrigerate or Freeze

Watch for improperly stored foods when eating out, too. "Avoid things like salad bars and buffets where the food is sitting out, because you don't know who's touched it, if it's been kept at the right temperature, and how long it's been sitting there," says Anselmo.

Some raw foods are safer than others if you have MBC and neutropenia. Produce is fine, as long as it's cleaned. "Make sure you wash fresh produce thoroughly under water before cutting into it and preparing it," Roberts says. Even wash fruits and vegetables that have a peel, such as bananas and avocados, because bacteria on the outside could get inside the fruit when you cut it open.

• Eggs
• Sushi, smoked salmon, and other fish and shellfish
• Meat
• Sprouts such as alfalfa, bean, and broccoli
• Unpasteurized milk, juice, and honey
• Cheese made from unpasteurized milk, which often includes soft cheeses like Brie, Camembert, and goat cheese

Today, the original neutropenic diet is rarely recommended. Sometimes people who've had a stem cell transplant must eat a more restrictive diet because their immune system has been wiped out and needs time to regenerate. But for people with neutropenia from cancer, it's more important to follow basic food safety practices, like avoiding raw or undercooked animal products and washing raw fruits and vegetables, Anselmo says.

Other dietary advice depends on the type of treatment side effects. For example, if you have diarrhea, avoid salads and other raw vegetables, beans, and whole grains. Instead, eat foods that are gentler on the digestive tract, like vegetable soup. If you have mouth sores or irritation, focus more on food temperature and texture. "Maybe it's avoiding things that are super hot or avoiding spicy foods or foods with hard edges like crackers," Anselmo says.

To ensure that you're getting enough nutrition, each meal should contain a mix of protein, healthy fats, and fiber-rich carbohydrates, says Anselmo. Calories and protein are especially important because neutropenia destroys white blood cells. "Your body needs fuel from calories and protein to be able to regenerate those blood cells," Roberts says.

Anselmo and Roberts recommend the following safe and healthy meal ideas for people with MBC and neutropenia.

Breakfast:

• Banana smoothie
• Hard-boiled egg on toast with avocado
• Bowl of oatmeal with a scoop of yogurt topped with fruit

Lunch:

• Brown rice with beans or lentils
• Peanut butter and banana on toast
• Grilled chicken, low-fat cheese, and black beans wrapped in a whole-grain tortilla

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Snack:

• Toast topped with peanut butter and apple slices
• Greek yogurt with nuts and seeds
• Cottage cheese with fruit

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Dinner:

• Vegetable soup
• Grilled chicken kabob

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A dietitian can help you plan meals that match your tastes and health needs. Ideally, choose someone who has experience working with people with cancer. "I definitely recommend connecting with a board-certified oncology dietitian — someone who has CSO after their credential. CSO means certified specialist in oncology," says Hillary Sachs, RD, a board-certified specialist in oncology nutrition.

To find a dietitian in your area, ask your oncology team or search the Academy of Nutrition and Dietetics website.

• Metastatic breast cancer treatments can cause a low white blood cell count (neutropenia), which increases the risk for foodborne illness.
• To ensure that your food is safe, clean your hands and cooking tools, and cook foods to the recommended temperature before eating them.
• Avoid undercooked meats, poultry, and fish, and unpasteurized dairy and juice.
• Consult a dietitian to help you plan safe and healthy meals.