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Karavelioglu B, Dayi T, Hacet F. The neutropenic diet: Are well-cooked vegetables still good sources of nutrients? A mini-narrative review. Nutr Res 2024; 121:61-66. [PMID: 38042024 DOI: 10.1016/j.nutres.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/05/2023] [Accepted: 11/05/2023] [Indexed: 12/04/2023]
Abstract
A low immune response is fatal for humans because increased infection risk is related to both morbidity and mortality. The neutropenic diet is applied if a person's neutrophil count is <2000 cells/μL. When compared with standard nutrition treatment, the neutropenic diet is found to be related to deficiencies in dietary fiber, vitamins C, A, and D, magnesium, and calcium. This is also related to malnutrition in patients diagnosed with cancer. Although raw vegetables are good sources of these nutrients, they can also be sources of pathogen microorganisms. Thus, the consumption of well-cooked vegetables is an essential principle in the neutropenic diet. Although many cooking methods are available, pressure cooking is the most commonly used in neutropenic diet kitchens to reduce pathogen transmission risk. According to many studies, the cooking process is associated with significant nutrient loss. In particular, boiling is found to be related to losses in vitamins C, A, and K, phenolic compounds, flavonoids, calcium, zinc, manganese, magnesium, copper, and iron in different types of vegetables. Even though some studies have shown that standard nutrition treatment with the adoption of food safety guidelines does not increase infection risk and the neutropenic diet is related to malnutrition, no guidelines have thus far suggested the application of standard nutrition treatment in neutropenic patients. Consequently, additional studies are required to compare the beneficial and harmful effects of the neutropenic diet to a standard nutrition treatment and support the application of standard nutrition treatment with the adoption of food safety guidelines at least in mildly neutropenic patients.
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Affiliation(s)
- Burçin Karavelioglu
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Near East University, Nicosia, Cyprus
| | - Taygun Dayi
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Near East University, Nicosia, Cyprus; Unit of Nutrition and Dietetics, Near East University Hospital, Nicosia, Cyprus.
| | - Fatma Hacet
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Near East University, Nicosia, Cyprus
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Jahan D, Peile E, Sheikh MA, Islam S, Parasnath S, Sharma P, Iskandar K, Dhingra S, Charan J, Hardcastle TC, Samad N, Chowdhury TS, Dutta S, Haque M. Is it time to reconsider prophylactic antimicrobial use for hematopoietic stem cell transplantation? a narrative review of antimicrobials in stem cell transplantation. Expert Rev Anti Infect Ther 2021; 19:1259-1280. [PMID: 33711240 DOI: 10.1080/14787210.2021.1902304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hematopoietic Stem Cell Transplantation (HSCT) is a life-saving procedure for multiple types of hematological cancer, autoimmune diseases, and genetic-linked metabolic diseases in humans. Recipients of HSCT transplant are at high risk of microbial infections that significantly correlate with the presence of graft-versus-host disease (GVHD) and the degree of immunosuppression. Infection in HSCT patients is a leading cause of life-threatening complications and mortality. AREAS COVERED This review covers issues pertinent to infection in the HSCT patient, including bacterial and viral infection; strategies to reduce GVHD; infection patterns; resistance and treatment options; adverse drug reactions to antimicrobials, problems of antimicrobial resistance; perturbation of the microbiome; the role of prebiotics, probiotics, and antimicrobial peptides. We highlight potential strategies to minimize the use of antimicrobials. EXPERT OPINION Measures to control infection and its transmission remain significant HSCT management policy and planning issues. Transplant centers need to consider carefully prophylactic use of antimicrobials for neutropenic patients. The judicious use of appropriate antimicrobials remains a crucial part of the treatment protocol. However, antimicrobials' adverse effects cause microbiome diversity and dysbiosis and have been shown to increase morbidity and mortality.
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Affiliation(s)
- Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, 111/1/A Distillery Road, Gandaria Beside Dhupkhola, Dhaka 1204, Bangladesh
| | - Ed Peile
- Department of Medical Education, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Salequl Islam
- Department of Microbiology, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh
| | - Sharlene Parasnath
- Department of Clinical Hematology, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Cato Manor, Durban, South Africa
| | - Paras Sharma
- Department of Pharmacognosy, BVM College of Pharmacy, Gwalior, India
| | - Katia Iskandar
- Lebanese University, School of Pharmacy, Beirut, Lebanon.,INSPECT-LB: Institute National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Universite Paul Sabatier UT3, INSERM, UMR1027, Toulouse, France
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar, India
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Timothy Craig Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital, Mayville, South Africa.,Department of Surgery, Nelson R Mandela School of Clinical Medicine, UKZN, South Africa
| | - Nandeeta Samad
- Department of Public Health, North South University, Bangladesh
| | | | - Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
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Heng MS, Barbon Gauro J, Yaxley A, Thomas J. Does a neutropenic diet reduce adverse outcomes in patients undergoing chemotherapy? Eur J Cancer Care (Engl) 2019; 29:e13155. [DOI: 10.1111/ecc.13155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/30/2019] [Accepted: 08/01/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Mei Shan Heng
- Nutrition and Dietetics College of Nursing and Health Science, Flinders University Adelaide SA Australia
| | - Jessica Barbon Gauro
- Department of Nutrition and Dietetics Flinders Medical Centre Bedford Park SA Australia
| | - Alison Yaxley
- Nutrition and Dietetics College of Nursing and Health Science, Flinders University Adelaide SA Australia
| | - Jolene Thomas
- Nutrition and Dietetics College of Nursing and Health Science, Flinders University Adelaide SA Australia
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Maia JE, da Cruz LB, Gregianin LJ. Microbiological profile and nutritional quality of a regular diet compared to a neutropenic diet in a pediatric oncology unit. Pediatr Blood Cancer 2018; 65. [PMID: 28960796 DOI: 10.1002/pbc.26828] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/07/2022]
Abstract
It has been hypothesized that a neutropenic diet has lower microbe content. Here, the microbiological and nutritional contents of regular and neutropenic diets offered to pediatric patients were analyzed. Microbiological contamination was detected in five of 36 of the food samples analyzed, yet there was no statistical differences between the diets (P = 1.00) or in their odds ratio (0.62) (95% CI = 0.05-6.35; P = 0.63). The strict neutropenic diet did have less fiber (P = 0.05) and vitamin C (P = 0.01). Thus, the regular diet appears safe, and possibly provides greater benefits, for pediatric patients with neutropenia.
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Affiliation(s)
- Juliana Elert Maia
- Health of the Children and Adolescent Post Graduation Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciane Beitler da Cruz
- Nutrition and Dietetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Pediatric Oncology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lauro José Gregianin
- Health of the Children and Adolescent Post Graduation Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Pediatric Oncology Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Jeon OK, Lee YH, Kim MH. Knowledge of and Compliance with Neutropenic Diet in Patients with Hematologic Malignancy undergoing Chemotherapy. ASIAN ONCOLOGY NURSING 2018. [DOI: 10.5388/aon.2018.18.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ok Kyung Jeon
- Department of Nursing, Pusan National University Hospital, Busan, Korea
| | - Yeon Hee Lee
- Department of Nursing, Dong-Eui University, Busan, Korea
| | - Myung Hee Kim
- College of Nursing, Pusan National University, Yangsan, Korea
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