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Good nutrition is important for gaining strength and health after transplant. But, because your immune system is still working to get stronger, some foods and drinks could put you at a higher risk for infection. That’s why it’s important to follow your transplant team’s advice on how to safely choose, prepare and handle food. Use the menus and recipes they give you. Your dietitian (a nutrition expert) on your transplant team can help you create recipes that are best for you.
For more information about food safety after a blood or marrow transplant, download the U.S. Department of Agriculture and the Food and Drug Administration's food safety information booklet.
When you're choosing something to eat
Foods that 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 semi-soft 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 and poultry cooked to a safe internal (inside) temperature
- Seafood, when handled properly and cooked to a safe internal (inside) temperature
- 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 soy butter
- Commercially packaged breads and cereals
- Prepackaged snack foods like pretzels, popcorn and tortilla chips
Foods that are high risk and generally are 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 undercooks fish or shellfish, including sashimi
- Refrigerated smoked fish
- Partially cooked seafood
- Hot gods, deli meats and luncheon meats that have not been reheated
- Frozen foods that are not frozen solid
- Foods in damaged packaging (packages with dents or cracks)
- Expired foods (check the expiration date on packaging)
- Bulk food items or items from self-service bins
- Unroasted nuts or nuts in the shell
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, 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
- Salad bars, buffets and potlucks
- Street or sidewalk vendors (e.g., food trucks, food stands)
- Crowded restaurants to avoid coming in contact with people who might be ill
- 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. Talk to your dietician if you have questions.
Tips for safe food storage
- Bring your groceries home and put them away right after leaving the store
- 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 two 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 two 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 change in your taste buds. These side effects are usually temporary. Work with your dietician 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 1/2 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 food tastes metallic
- Avoid fried, fatty, spicy and acidic foods, like tomato juice, if your stomach is upset
- Eat low-fiber foods to help prevent diarrhea (like white bread, rice, eggs, potatoes, cooked fish and chicken without skin)
- Avoid 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 or diarrhea
- Eat small meals throughout the day instead of larger meals
Thank you to the transplant dietitians who made significant contributions to this article:
- Joy Heimgartner, MS, RDN, CSO, LD, and Joan Vruwink, RDN, LD at Mayo Clinic Blood and Marrow Transplant
- Susan B. Little, MS, RDN, LD, CNSC at University of Iowa Hospital and Clinics Transplant Center