Investigating the use of the neutropenic diet: a survey of U.K. dietitians

Abstract

Background: Patients with chemotherapy-induced neutropenia are at increased risk of infection. Historically, dietary restrictions commonly referred to as 'clean', 'low bacteria', 'low-microbial' or 'neutropenic' diets have been prescribed to reduce the risk of foodborne infection. Although research does not support their effectiveness, they continue to be used in clinical practice. The present study aimed to investigate the use of dietary restrictions in patients with cancer in the UK by surveying registered dietitians (RDs).

Methods: An online questionnaire was distributed to 573 RDs via local and specialist interest groups of the British Dietetic Association.

Results: One hundred and ten questionnaires were returned. Of these, 67.8% of RDs prescribed dietary restrictions to patients, with 'neutropenic diet' being the most commonly used term. Specialist oncology or haematology RDs were more likely to use the diet than nonspecialist RDs (P < 0.005). The variety of foods restricted varied greatly and was often contradicting. Unpasteurised dairy products and raw or lightly cooked meat or fish were most commonly restricted. Less than half (43.6%) of RDs had a policy in place for the use of neutropenic diets, with specialist oncology and haematology RDs more likely to report this (P < 0.005).

Conclusions: Neutropenic dietary advice provided by dietitians in the UK varies greatly. Further high-quality research is required to create an evidence base from which national clinical guidelines can be formed.

Keywords: cancer; diet; dietitian; infection; neutropenic.