Nutrition

Whether you think you already eat healthy or not, now is the time to get serious about proper nutrition. Patients have the ability to contribute to their overall health - as well as optimize the production of new blood cells by their bone marrow - when they eliminate unhealthy or overly-rich food and drink and follow a diet recommended by their doctor. Food handling and preparation are just as important, so those tips are also included in this section.  

Proper nutrition is important to optimize blood production and maintain general overall health. People with bone marrow failure disease should always consult with their treating physician before changing their diet.

Health Goals are related to nutrition 

You diet really does matter.  A balanced diet is important to maintain, but it is especially important for bone marrow failure patients to maintain a healthy diet before, during and after treatment. This is to minimize the impact of treatment side-effects and to fight treatment-related fatigue.

Maintain a healthy weight

  • Your body mass index (BMI) should be between 19-25. If you are uncertain of your BMI, you can find more information from the National Institutes of Health.
  • Know your waist circumference. Men's waistline should be under 40 inches (102 cm); women's should be under 35 inches (89 cm).

Base your diet on sensible portions of minimally processed foods

  • Eat a variety of vegetables, fruits, whole grains and legumes. Focus on foods high in vitamins and minerals, as well as fiber, protein and energy.
  • Eat mostly foods of a plant origin, and eat a variety of colors to ensure you are meeting nutrient needs.
  • Eat at least 5 portions (14-21 oz) of non-starchy vegetables and fruits daily.
  • Eat relatively unprocessed grains and legumes with every meal.

Know what foods to avoid

  • Limit consumption of energy-dense processed foods.
  • Limit intake of refined, starchy foods and salt-preserved, salted or salty foods. Your sodium intake should be less than 2,400mg daily. Preserve foods without using salt.
  • Consume "fast food" sparingly – complete avoidance is best of all.  

Beverages

  • Water is the beverage of choice. Drink 8 glasses of water daily.
  • Caffeinated drinks subtract from daily fluid intake as caffeine has diuretic qualities.
  • Avoid sugary drinks such as sodas and fruit juices.

Tips on a neutropenic diet for patients with a low neutrophil count

If you or your loved one have been diagnosed with a bone marrow failure disease, or have recently undergone a bone marrow transplant, this can lead to a weakened immune system, which can create special dietary concerns.

If you have a very low neutrophil count (low white blood cell count), ask your doctor about a special diet called a neutropenic diet. This diet helps you limit exposure to bacteria and fungus, which are normally present in food. This will reduce your risk of getting a food-borne illness (food poisoning). If your physician feels a neutropenic diet is best for you, consider consulting with a dietician. Your physician’s office or local hospital can refer you to a dietician in your area.

Tips to observe while neutropenic

  • Do not eat blue cheese or any cheeses that say "aged" on the label. 

  • Only drink beverages that have been pasteurized to kill germs. Milk you buy from the supermarket is fine to drink. Avoid home-made fermented drinks, such as homemade wine, cider, root beer, ale, vinegar and non-pasteurized milk.

  • Avoid open buffets, salad bars, and crowded restaurants, where germs or bacteria can more easily contaminate your food.  Do not try free food samples.

  • Do not eat raw or lightly cooked, soft-boiled eggs or raw vegetable sprouts.

  • Wash and peel fresh fruit and vegetables very well before eating them. Avoid raw nuts.

  • Be sure to refrigerate hot leftovers before they cool down to avoid bacterial contamination.

  • Avoid well water.

Resources on Cancer and Nutrition

Nutrition Resources

Digestive Complications

Diarrhea

  • Drink plenty of water.
  • If you have frequent loose BM’s (>4 daily), drink 8 ounces of an isotonic drink for every BM (Gatorade, Powerade, coconut water, etc).
  • Include foods with soluble fiber at every meal, including potatoes, applesauce or rice.
  • If you aren’t eating these foods, then take Benefiber or similar product:  2-3 teaspoons daily.

Constipation

  • Eat a breakfast with a hot drink and high-fiber foods.
  • Increase your activity level as tolerated and as approved by your doctor.
  • Drink 8-10 cups of liquid daily: try water, prune juice, teas and hot lemonade.
  • Discuss a fiber supplement with your doctor.
  • Laxatives should be a last resort.

Bloating/Gas

  • Avoid chewing gum.
  • Drink directly from a glass and refrain from using straws.
  • Limit carbonated beverages.
  • Avoid cabbages, broccoli, Brussels sprouts and cauliflower.

Lack of Appetite

  • Snack throughout the day.
  • Make every bite count by choosing high-calorie, high-protein foods more often.
  • When preparing food at home, fortify it with protein or calorie supplements such as dry milk powder, whey protein or Benecalorie.

FOOD SAFETY

Food Preparation Tips

  • Maintain a clean kitchen. Always wash utensils and countertops before cooking. 
  • Always wash your hands before handling food.
  • Have two separate cutting boards, one for meats and the other for fruits and vegetables.
  • Bleach the meat cutting board after each use to reduce bacterial contamination. 
  • Wash fruits and vegetables under running water prior to peeling or cutting, including "prewashed" salads. (Don’t use detergents or bleach). 
  • Thaw meat, seafood and poultry in the refrigerator or microwave and cook them immediately to a safe temperature. 
  • Always check “sell-by” and “use-by” dates
  • Don’t leave foods out for more than 2 hours.
  • Keep hot foods hot (>140°F), and cold foods cold (<40 ° F) 

Food Storage Tips

  • If you have leftovers, place them in containers and freeze or refrigerate them immediately.
  • Throw away refrigerated leftovers within 48 hours. 
  • Throw out stored foods that look or smell strange. Never taste them!
  • Throw away eggs with cracked shells.

Clean-up Tips

  • When washing dishes, use disposable cloths or launder your sponges/dish towels after each use. Change hand towels daily.
  • Let dishes air-dry or place them in dishwasher.