What is neutropenia and a healthy diet?

Treatment for all types of cancer acts to ‘kill off’ the harmful tumour cells in the body, and in doing so the treatment can also destroy healthy cells.

When this happens with blood cancers, the protective white cells in our body- neutrophils which naturally fight infection, are reduced by both the disease and by the treatments.

Neutropenia occurs when the level of neutrophils falls below a certain level as a result of your illness.  As your neutrophils are much lower than normal you are at greater risk of infection, including food borne infections and food poisoning, and so one of the measures to prevent this is to ensure scrupulous food hygiene.

As well as reducing the levels of neutrophils causing neutropenia, cancer treatments can affect your food intake,  common side effects include nausea and or vomiting, diarrhoea, weight changes, sore mouth, loss of appetite and swallowing difficulties.

What is a healthy diet?

To help ensure your treatment is as effective as possible a well-balanced nutritional intake is a good starting point.  This can be difficult if you are not feeling well and some ideas to cope with these particular difficulties will be covered in this chapter.

Diet and nutritional intake is an area where there is a huge amount of information available to the public, and unfortunately not all of it is based on scientific evidence.  It is advised that sensible healthy eating advice that is low fat, low added sugar, plenty of fruit and vegetables, high fibre and low salt, is followed for all patients and that no ‘special’ diets are used unless this is something recommended by your consultant or a qualified dietitian, and forms part of your clinical treatment.

However just knowing what makes up a well-balanced diet can lead to confusion. The Eatwell Guide shows that you should try to eat foods form all food groups every day and in the following proportions:

Try to have as many different food stuffs from all food groups shown below, as this will ensure you get all your necessary nutrients for good health.


These foods are often considered unhealthy. This is not true and you should try to have some starchy carbohydrate at each main meal like porridge, cereals, potato, pasta, rice or couscous. These foods should make up at least a third of what you eat. Wholemeal and wholegrain varieties will increase your fibre intake but white ones are also healthy foods.  Nutritionally all these foods are very similar and will provide you with a supply of energy throughout the day.

Fruit and vegetables

Make sure you have your five portions of fruit and vegetable a day.  This can be all kinds of fruit or vegetables- fresh, frozen, canned, dried or as juice or smoothies.   Smoothies made with frozen fruit and added milk can make a high energy drink and particularly helpful if your appetite is poor.  Fruit and vegetables also will provide dietary fibre which helps regulate your bowels and prevent constipation which can be a side effect with your treatment.

Dairy items

Milk, cheese and yogurt are good sources of protein and also calcium in the diet.  If you have lost weight or your appetite is poor these foods are very helpful as they tend to be relatively high in energy and can help to boost your overall calorie intake.

Other protein foods (meat, poultry, eggs, pulses, peas, beans and lentils, nuts and meat alternatives such as Quorn or tofu)

Protein is an important nutrient as it helps to maintain your muscle strength and enables you to go about your normal daily activities and reduces fatigue.  It is recommended that you have at least two portions of protein foods from this group every day, but you may need to increase this if you have lost weight to enable you to replace lost muscle tissue.

Oils and spreads

The last very small group is for fats and spreads which are used in cooking.  General healthy eating advice is to use less fat, and that the fat you do use comes from healthier unsaturated fats such as olive, sunflower, rapeseed or soya oils.  If you need to gain weight it is okay to use a little more of these fats to increase overall energy intake, but remember that the most important nutrient way to regain lost weight through illness is by increasing protein and overall energy intake.

Also sitting outside the Eatwell Guide are treat foods such as cake, biscuits, crisps or sweets and chocolate.  These foods are outside the main plate model as they are not essential to health.  However, they can make an important contribution to your total energy intake and also can help boost appetite.  A drink of ice cold milk and a small slice of sponge cake makes a good high energy snack between meals

In summary the nutrients each food group provides are:

Food group                                                Function in Body

Bread & Cereals                                              provide energy, B-vitamins, iron and folic acid and dietary fibre

Fruit and Vegetables                                     provide vitamins A, C and E, folic acid dietary fibre and potassium

Fish, eggs, Quorn, nuts, soya                       provide protein, iron, B vitamin- thiamine and B12, zinc

Milk and dairy products                                provide protein, Calcium, B vitamins- riboflavin and B12

Fats, oils and spreads                                    provide energy, essential fatty acids and fat soluble vitamins ADE and K