Dietary guidelines for children with cancer should change

Dietary guidelines for cancer-stricken children who are undergoing chemotherapy should be changed, according to researchers.

The gruelling treatment places stress on their immune system and they are often advised to undertake a neutropenic diet – one where they avoid uncooked food to minimise exposure to germs.

Strawberries are considered to be especially risky because of their pitted surface which provide the perfect spot for bacteria to lurk.  

However, the latest research from York University has found that attempting to sterilise food does not help prevent infection – and harms children’s quality of life.

The scientists are now calling for a switch in emphasis to focus on making food safe rather than sterile.

The guidelines for children with cancer are often to follow the neutropenic diet, where they avoid uncooked foods to minimise exposure to germs

The guidelines for children with cancer are often to follow the neutropenic diet, where they avoid uncooked foods to minimise exposure to germs

Dr Bob Phillips was the lead author in the research printed in the journal Paediatric Blood and Cancer.

He said: ‘We suggest that dietary guidelines for child cancer patients should contain advice on avoiding foods that are high risk for food poisoning – much like existing guidelines for pregnant women.

‘Our review shows that supporting nutrition for children with cancer is important, but that the neutropenic diet offers children less nutrients, reduces their quality of life by making food tasteless and does not reduce infections.’


The diet, often recommended for children undergoing chemotherapy, tries to eliminate the consumption of raw food.

This is because their immune system is weakened by the treatment, and in a bid to reduce germs, food is cooked or sterilised.

The diet became popular in the 1970s when doctors began recommending boiling, cooking or zapping food for ill children.

It advises that cancer-stricken children should avoid fresh fruit and vegetables, alongside partially cooked foods such as poached or soft boiled eggs.

Similarly, all dairy products should be pasteurised and children should avoid nuts.

 Source: UPMC

He added that the changes would be key to cancer-stricken children.

Dr Phillips said: ‘Our recommendations would make a small, but important difference to the lives of children with cancer by allowing them to eat a more normal diet.’

The neutropenic diet became popular in the 1970s when health professionals began to recommend boiling, zapping and cooking food for children with cancer to kill any bacteria on it.

Under the diet, children are advised not to eat raw or partially raw foods, such as poached of soft-boiled eggs. 

It is still widely recommended across Europe and by some health services in the UK.

Children generally have much stronger doses of chemotherapy than adults could withstand, and often do not have surgery as part of their treatment like older people would.

Side effects of the treatment is different for every child, but perhaps the most frequent is fatigue due to the toll chemotherapy takes on their bodies.

Chemo can also cause temporary nerve damage in children, which can manifest as shooting pains or tingling, alongside hair loss which can be particularly upsetting to youngsters.

Another unpleasant side effect is mouth sores, which can become painful during treatment as they can sometimes bleed.

There are about 25 major types of cancer that affect children, with the most common being the blood cancer leukaemia.

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