Jody, transplant recipient
Good nutrition is a key part of gaining strength after transplant. But, because your immune system is still getting stronger, some foods and drinks could put you at a higher risk for infection.
That’s why it’s so important to follow your transplant team’s instructions on how to safely choose, prepare and handle food. Use the menus and recipes they give you. Your dietitian (a nutrition expert) might also be able to help you create more recipes.
The following tips are meant as a guide to help you as you make food choices. However, always listen to your transplant team’s instructions.
These foods are low risk and generally safe to eat:
Dairy and eggs
- Pasteurized foods like milk, eggs, yogurt, cottage cheese, tofu and refrigerated juice. Look for the word “pasteurized” on the label
- Commercially packaged hard and semisoft cheeses, including cheddar, mozzarella, parmesan, Swiss and Monterey Jack
Fruits and vegetables
- Washed fresh fruits and vegetables
- Cooked vegetables including sprouts
Meat and seafood
- Meat or poultry cooked to a safe internal (inside) temperature (find the safe temperatures listed later on this page)
- Seafood, when handled properly and cooked to a safe internal temperature
Packaged foods
- Prepared, packaged foods in boxes, cans or frozen, like fruits and vegetables
- Roasted and shelled nuts (look for the word “roasted” on the label)
- Commercially packaged peanut, almond and soybean butter
- Commercially packaged breads and cereals
- Prepackaged snack foods like pretzels, popcorn and tortilla chips
- Honey
These foods are high risk and generally not safe to eat:
Dairy and eggs
- Unpasteurized (raw) milk
- Soft cheeses made from unpasteurized (raw) milk, such as feta, Brie or queso fresco
- Foods that contain raw or undercooked eggs, such as homemade raw cookie dough, homemade eggnog or homemade Caesar salad dressing
Fruits and vegetables
- Unwashed fresh fruits and vegetables
- Fruits and vegetables with bruises or bad spots
- Raw sprouts, such as alfalfa or bean sprouts
Meat and seafood
- Raw or undercooked fish or shellfish, including sashimi
- Refrigerated smoked fish
- Partially cooked seafood
- Hot dogs, deli meats and luncheon meats that have not been reheated
Packaged foods
- Frozen foods that are not frozen solid
- Foods in damaged packaging (packages with dents or cracks)
- Expired foods (check the expiration date on the packaging)
- Bulk foods or items from self-service bins
- Unroasted nuts or nuts in the shell
Safe temperature recommendations
Use a meat and poultry thermometer to make sure the internal temperature of your food is high enough to kill bacteria. Simply looking at color and texture is not reliable enough. If you don’t have a thermometer, make sure to buy one designed for meat and poultry.
165°F Chicken, turkey and duck (whole, pieces and ground)
160°F Ground beef, pork, veal, egg dishes
145°F Beef, pork, veal, lamb (steaks, roasts and chops), fish
When you’re choosing something to drink
- Water: Most tap water is safe to drink. If you get your water from an uncertified well or are worried about your water quality, boil your water before drinking it or using it in food preparation. Or, use bottled water instead.
- Alcohol: Alcohol could interact with the medicines you are taking. Talk to your doctor before having a beer, glass of wine or other drinks with alcohol.
When you’re eating away from home
If you go out for a meal, there are extra precautions you may need to take. But first, talk with your doctor about when it’s safe for you to eat away from home.
Places to avoid:
- Delis
- Salad bars, buffets and potlucks
- Street or sidewalk vendors (food trucks, food stands, etc.)
Restaurant tips:
- Avoid crowds by calling ahead and visiting during less busy times.
- Ask how your food will be prepared and if it contains raw eggs, meat or fish.
- If you order meat, ask that it be cooked until well done.
When you’re storing and preparing food
Storing and preparing food in the right way is just as important as the foods you eat. If you have any questions about storing or preparing your food safely, talk to your dietitian.
Tips for safe food storage:
- Bring your groceries home right after leaving the store and put them away immediately.
- Make sure refrigerated foods stay cold, and frozen foods stay frozen until use.
- Throw away expired food and pay close attention to freshness.
- Make and store foods in small portions so they are used up quickly.
- Do not eat any leftover foods that have been in the refrigerator for more than 2 days. Put a date on containers so you know how long they’ve been there.
- Do not eat foods that have been left out of the refrigerator for 2 or more hours.
Tips for safe food preparation:
- Wash your hands with warm, soapy water before and after handling food.
- Use hot, soapy water with disposable sponges and paper towels, or disinfecting kitchen wipes to clean areas where food is prepared, and for washing dishes.
- Thaw frozen foods (including meat) in the refrigerator, not on the counter or in the sink.
- Wash all fruits and vegetables well before cutting them, even those that you peel before eating. The best way to wash fruits and vegetables is with running water. You can also scrub them with a produce brush. Don’t use produce washes, soap, bleach, peroxide or vinegar. Don’t soak fruits or vegetables.
- Wash the top of cans and can opener with hot, soapy water before use.
- Use a side-opening can opener so lids don’t fall inside.
- Avoid touching raw meat, poultry and fish. Or, wear disposable gloves and wash your hands well before and after touching raw meat, poultry and fish.
- Use separate cutting boards, plates and utensils for raw foods and cooked foods. Be especially careful to avoid contact between cooked meat and raw meat juices.
- Clean cutting boards with a solution of 1 tablespoon of bleach to 1 gallon of water or wash in the dishwasher.
- Cook meat and poultry to a safe internal (inside) temperature.
- Cook hot dogs and lunch meat until they are steaming.
Ideas to make eating easier and more enjoyable
You may find that you have less of an appetite or a change in your taste buds. These side effects are usually temporary. Work with your dietitian to plan meals that are satisfying, healthy and meet your nutritional needs.
It may help to:
- Rinse your mouth with a mixture of 1 cup water and ½ teaspoon baking soda before eating if your mouth is very dry.
- Try eating chilled or frozen foods, like cottage cheese or frozen yogurt, if your mouth is sore.
- Use plastic utensils and try mint or ginger if foods taste metallic.
- Avoid fried, fatty, spicy and acidic foods, like tomato juice, if your stomach is upset.
- To help prevent diarrhea, eat low-fiber foods like white bread, white rice, eggs, potatoes, cooked fish and chicken without skin.
- Avoid the milk sugar lactose if you have diarrhea by using lactose-free milk, soy milk or yogurt instead.
- Ingredients like sorbitol, mannitol and xylitol, which are found in many sugar-free products, can often cause nausea, gas and diarrhea.
- Eat small meals throughout the day instead of larger meals.
Resources for you
Find more tips for managing eating problems after transplant at BeTheMatch.org/FoodSafety.
The National Cancer Institute’s Eating Hints booklet is for people who are having or are about to have cancer treatment. Learn more at cancer.gov by typing “eating hints” in the search bar.
Thank you to the transplant dietitians who made significant contributions to this article:
- Joy Heimgartner, MS, RDN, CSO, LD; and Joan Vruwink, RDN, LD Mayo Clinic Blood and Marrow Transplant
- Susan B. Little, MS, RDN, LD, CNSC University of Iowa Hospital and Clinics Transplant Center