In recent years, oncologists have been reevaluating the traditional neutropenic diet, which required all food to be cooked at high temperatures to reduce the risk of infections in cancer patients with suppressed immune systems. However, new evidence has emerged that challenges the effectiveness of moving away from this strict diet.
A study published in the Journal of Clinical Oncology revealed that certain blood cancer patients who followed a less restrictive diet had 11% more infections compared to those on the neutropenic diet. This finding has prompted physicians to reconsider the liberalization of diets for patients undergoing intensive cancer treatments.
The neutropenic diet was originally implemented to protect cancer patients, particularly those undergoing hematopoietic stem cell or bone marrow transplants, from potentially life-threatening infections while their immune systems were compromised. Hospitals went to great lengths to prevent outside food or fresh flowers from entering patients’ rooms to minimize the risk of introducing harmful bacteria or viruses.
Despite previous research suggesting that normal diets posed minimal infection risks, the shift towards more liberal diets for neutropenic patients was based on the belief that the neutropenic diet negatively impacted patients’ quality of life and nutrition. A study conducted at the University of Milan in 2023 provided the initial evidence that a non-restrictive diet was as effective as the neutropenic diet for certain stem cell transplant patients, leading to a widespread adoption of less restrictive dietary guidelines.
However, a recent study led by John Wingard at the University of Florida raised concerns about the liberalization of diets for neutropenic patients. The study found that patients on a liberalized diet had a higher rate of infections, and the diet did not improve patients’ nutrition or quality of life. This unexpected outcome has prompted oncologists to reconsider the balance between liberalizing diets and ensuring patient safety.
While the debate over the effectiveness of the neutropenic diet continues, physicians agree that it may still be reasonable to allow a non-restrictive diet for certain patients, such as those with solid tumors who are not as high risk or neutropenic for extended periods. Improving treatment options that are less toxic to the immune system could eliminate the need for a restrictive diet altogether.
In conclusion, the study highlights the complexities of managing the dietary needs of cancer patients with compromised immune systems. While the neutropenic diet has been a standard practice for decades, ongoing research is essential to optimize patient outcomes and ensure their safety during intensive cancer treatments.

