Neutropenic Diet
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Neutropenic Diet

A Neutropenic diet is a low bacteria diet that safeguards individuals with weakened immune systems due to reasons like transplant procedures, cancer treatment, viral infections, and aplastic anemia. A clean diet is essential as a weak immune system makes it challenging for the body to protect itself from foodborne bacteria, reducing the risk of infections from contaminated food or drinks.

Neutropenic diet is a diet with very low bacterial count to help protect people with weakened immune systems. This can be caused by several reasons:

  • Immune suppression following transplant procedures (e.g., bone marrow, heart or kidney)
  • Cancer patients undergoing chemotherapy or radiotherapy Viral infections for example in the case of HIV or AIDS Aplastic anemia

When the immune system is weak, the body will find it difficult to protect itself from certain food bacteria and will require a 'clean' diet to prevent infections. This diet helps to reduce risk of infection that may be caused by contaminated food or drinks.


Neutropenic Diet: Do's & Don'ts

The rule-of-thumb is to have cooked foods and avoid all raw food items. This is because heat during cooking makes sure that all microorganisms in the food are destroyed. It is advisable to practice safe food handling to ensure food is hygienic to minimize exposure to bacterial and food contamination. Here are some tips on safe food handling:

  • Always clean hands, food utensils and equipment with warm soapy water before eating
  • Wash raw materials thoroughly before cooking Choose vegetables that are fresh and not damaged
  • Use separate chopping boards for meat and vegetables to prevent cross contamination and use plastic chopping boards as they can be more easily cleaned
  • Clean mouth of canned or bottled foods before opening
  • Ensure that canned foods are properly packaged and within expiry date before purchasing
  • Keep hot foods hot (above 63°C) and cold foods cold (below 5°C) Cook food thoroughly until well done, especially meat and eggs
  • Thaw frozen foods in the microwave or in the chiller. Never thaw at room temperature
  • Discard all leftover food if not consumed within 4 hours after cooking
  • For easily perishable foods (e.g. custard, pudding, egg, and food items made with cream, discard within 1 hour after cooking if not consumed)
  • Order a la carte food items and avoid pre-prepared foods which may be left cold for a period of time such as buffet, fast food, salad or sandwiches on the shelf


RecommendedTo Avoid
Bread, cereals, rice and pasta
· Commercially-packed bread, rolls, pancakes, waffles
· Fully-cooked rice, pasta, noodles, oats, ready-to-eat breakfast cereals
· Cooked potato, sweet potato, or yam
· Biscuits, crackers, cookies, french toast
· Bread, buns, cakes, doughnuts & muffins in bakeries left exposed
· Raw oats or muesli 
· Potato salad, pasta salad or those added with raw eggs
· Uncooked cookie dough
Meat, fish, poultry, nuts, beans, eggs & nuts
· Well-cooked fresh meat or fish
· Fully-cooked egg
· Canned tuna or meat with no raw vegetables
· Tofu (cook in < 1-inch cubes) Canned food (e.g., baked beans, legumes, meat, soup) to be well heated/ fully-cooked
· Commercially-packed nuts roasted without shells
· Raw or partially cooked meat, fish or poultry
· Cold ham, sausages, salami from the deli section
· Partially cooked egg
· Raw Seafood (eg oyster, sashimi)
· Miso paste & miso soup
· Pate (liver, usually served cold)
· Tempe products (fermented-soy)
· Roasted nuts in the shell
· Canned fruits or frozen fruits
· Fruit juices in tetra pack (pasteurized) 
· Uncut fresh fruits with skin (e.g. whole pear, apple)
· Cut fruits and freshly squeezed juice to     be consumed immediately)
· Dried fruit & nuts mix (e.g. raisin, prunes)
· Pre-prepared cut fruits
· Pre-Prepared or unpasteurized fruit juice
· Well-cooked fresh, canned or frozen  vegetables
· Vegetable juices in tetra pack (pasteurized)
· Cooked herbs and spices
· Raw vegetables (e.g. salad, ulam)
· Uncooked vegetable juice
· Uncooked herbs & spices or pepper
· Fresh sauerkraut & raw garnishes
Milk, yogurt & cheese
· All pasteurized milk, cheese & yogurt Commercially-packed ice cream & sherbet
· Milk supplements & infant formula 
· Commercially-packed whipped cream, thickened cream, or sour cream (consume once opened, do not keep for later)
· All unpasteurized dairy products
· Homemade or soft-serve ice cream
· Cheese seasoned with herbs & vegetables
· Moldy cheese (e.g blue cheese, Stilton)
· Soft cheese (e.g Brie, Camembert, Feta, Farmer’s cheese) or those from the deli section
· Yogurt from a machine or those made from live cultures
· Pre-made smoothies or milk shakes
Fats & Spreads
· Butter, margarine, oil, shortening Commercially-packed salad dressing
· Peanut butter
· Avocado dressing 
· Fresh salad dressing
· Raw or unpasteurized honey
· Boiled water, distilled water, reverse osmosis (R.O.) water
· All bottled beverages
· Unboiled water
· Ice-blended drink
· Freshly baked cakes & pastry
· Individually packed jam, jelly & syrups
· Fast food
· Unrefrigerated bakery items containing cream or custard
· Traditional herbal supplement or Chinese herbs
· Brewer’s yeast, if eaten uncooked


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