The Effectiveness of the Neutropenic Diet in Pediatric Oncology Patients
Condition: Acute Lymphoblastic Leukemia; Acute Myelogenous Leukemia; Non-Hodgkins Lymphoma; Sarcoma; Neuroblastoma
MeSH terms: Leukemia; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Leukemia, Myeloid; Neuroblastoma; Leukemia, Myeloid, Acute
Study type: Interventional

Summary: 
      The purpose of this study is to determine if FDA approved food safety guidelines are
      equivalent to a low bacterial diet (the neutropenic diet) with respect to the acquisition of
      infections during neutropenia in a sample of pediatric cancer patients.
    

Detailed description: 
      Historically, many interventions have been tried to reduce the incidence of infection by
      reducing patients' exposures to potential pathogens. The neutropenic diet is one such
      intervention that was intended to reduce the introduction of bacteria into the host's
      gastrointestinal tract. This diet excludes foods considered to be high risk for bacterial
      colonization, especially raw fruits and vegetables. The only studies evaluating this diet
      have used this intervention in combination with germ free environments, which have been
      phased out of practice, and the independent effect of this diet remains unknown. In addition,
      pediatric oncology patients suffer significant gastrointestinal side effects secondary to
      cancer therapy, which are likely to affect their satisfaction with this dietary regimen.
      Qualitative data in these children suggests that decreased pleasure from food is a major
      concern for them and preliminary data on the neutropenic diet showed that although patients
      were able to stick to it, they found it difficult. The Centers for Disease Control (CDC) and
      the Food and Drug Administration (FDA) offer more liberalized food safety guidelines for
      immunocompromised patients. We hypothesize that the neutropenic dietary restrictions offer no
      advantage over the FDA and CDC endorsed food safety guidelines and that the food safety
      guidelines will afford patients an improved quality of life through increased choice and
      control over their diet. The results of this study could potentially modify clinical practice
      to improve the quality of life of these patients without adverse effects on their rate of
      infection. Furthermore, the allowance of fresh fruits and vegetables back into the diets of
      these patients may have a positive impact on their health.
    

Intervention name(s): Food Safety Guidelines; Neutropenic Diet
Intervention type(s): Other; Other
Intervention description(s): Participants will be randomized to the food safety guidelines will receive information and recommendations regarding Food Shopping, Food Storage, Food Preparation, Safe Cooking, and Safe Serving of Food.; The Neutropenic Diet Guideline includes all information contained in the FDA Food Safety Guidelines with the addition of the following recommendations:
Avoid raw vegetables and fruit (Oranges and bananas are okay.)
Avoid take-out foods and fast foods and fountain drinks.
Avoid aged cheese (blue, Roquefort, Brie).
Cook all produce to well done. Eggs must be hard-boiled.
Avoid deli meats.
No raw nuts, nuts roasted in shell, or freshly ground nut butters from a health food store.
No well water
No yogurt
Other intervention name(s): Food Safety Diet; FDA Food Safety Guidelines; Low Bacteria Diet
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Supportive Care
Keywords: Neutropenic Diet; Food Safety Guidelines; child; cancer