Safe Eating

Eating safely

Your transplant center may give you special guidelines for preparing food. You and anyone who cooks for you should be careful to follow the recommended food safety practices. This includes cooking food thoroughly, storing leftovers carefully and eating them within a day (or not at all), and keeping hot food hot and cold food cold. You may need to stop eating some foods for a while, especially if you cannot control how they are prepared. For example, you may need to avoid:

• Some or all fresh fruits and vegetables - follow your transplant center's instructions. If your center allows fresh fruits and vegetables, wash and peel them first.
• Food in salad bars, buffets, pot lucks and at deli counters.
• Restaurant or fast-food sodas or ice machines.
• Food in bulk food bins.
• You also should not share cups, glasses or eating utensils with anyone.

Hospitals vary in their rules about what foods patients should avoid. If the instructions from your transplant team are different from what you read on this Web site, follow your transplant team's instructions. Talk to your transplant team if you have any questions.

Keeping your food and drink clean and safe

Good nutrition is important to regaining your strength and health, but until your immune system is fully functioning, all non-sterile foods and drinks pose a dangerous risk for infection.

Follow your care team's instructions for safe eating and food handling. Use the menus and recipes they provided. Talk to your care team about favorite foods and preparation techniques that might not be covered in their guidelines. Your dietitian might be able to help you modify your recipes to minimize any risks.

When grocery shopping

Use your knowledge about foods that are safe for an immune-suppressed person when shopping for items that are healthy, convenient and meet your personal requirements.

Safer choices

• Buy mostly prepared, packaged foods in boxes, cans or frozen.
• Buy pasteurized foods.
• Check freshness and expiration dates.
• Check that packaging is not damaged.
• Make sure frozen foods are frozen solid.

Note: Most municipal water is safe, but if you have concerns about your water quality or get your water from a well, use bottled water instead.

Fresh foods require extra precaution

These include:

• Meats and Poultry
• Eggs
• Fruits
• Vegetables
• Beans
• Grains
• Herbs

This restriction can be especially difficult for people with a strong personal or cultural preference for using fresh ingredients. If ready-made versions of your favorite foods are not available or just do not work for you, talk to your dietitian. He or she can help you figure out ways to safely prepare your favorite foods or come up with alternatives.

Items to AVOID

• Do not buy bulk foods or items from self-service bins.
• Do not buy deli meats, cheeses, pre-made salads, entrees, etc.
• Do not buy unpasteurized versions of honey, milk, cheese or yogurt.
• Do not buy unroasted nuts or nuts in the shell.
• Do not buy aged cheeses such as certain sharp cheeses or moldy cheeses such as brie and blue cheese.

Safer food storage

• Take your groceries home directly from the store and put them away immediately.
• Make sure refrigerated foods stay cold and frozen foods stay frozen.
• Pay attention to freshness dates and throw away expired foods.
• Make and store foods in small portions so they get used more quickly.
• Do not eat refrigerated foods that have been left out for more than two hours.
• Do not eat any foods that have been in the refrigerator for more than three days.

Safer food preparation

• Use hot, soapy water to clean surfaces where foods are prepared.
• Use disposable paper towels instead of sponges or rags.
• Use separate cutting boards, plates and utensils for raw foods and cooked foods. Especially avoid contact between cooked meats and raw meat juices.
• Clean cutting boards in a solution of one part bleach to ten parts water.
• Thaw frozen foods (including turkey) in the refrigerator, not on the counter or in the sink.
• Wash all fruits and vegetables before cutting them.
• Use a side-opening can opener so lids don't fall inside. (This also eliminates sharp edges.)
• Avoid handling raw meats, poultry and fish.
• Cook meats and poultry to a safe internal temperature.

Use a kitchen thermometer to prevent food-borne illness

According to the USDA, changes in color and texture are not reliable indicators of when foods are safe. A thermometer lets you know when the internal temperature is high enough to kill harmful bacteria.
Types of thermometers:

• Regular, oven-proof thermometers that go into food before cooking
• Digital thermometers used to test foods after cooking
• Microwave-safe thermometers that can only be used in microwave ovens
• Whatever kind of thermometer you use, keep it clean and make sure it is specifically designed for meat and poultry. Candy-making thermometers will not work.

Dining away from home

Food in restaurants - after the first 100 days after transplant, your center may allow you to eat in restaurants again. Talk to your doctor about when it is safe to visit restaurants. When you do, don't be shy about requesting special service. Ask that your food be brought to you as soon as it is ready so it is still hot. Your server should bring your food even if the meals for others at your table are not ready yet. Avoid crowds by calling ahead and dining during off times.

Foods and venues to AVOID when dining out:

• Foods that you don't know how they were prepared or stored.
• Ice from ice machines and soda fountains.
• Sodas from fountain machines.
• Potlucks.
• Buffets.
• Salad bars.
• Delicatessens.
• Soft-serve ice cream and frozen yogurt from machines.
• Free samples.
• Unrefrigerated cream.
• Food from sidewalk vendors.
• Foods containing raw eggs (Caesar salads, custards, cookie dough).
• Sushi, raw fish, smoked fish.