Lack of Efficacy of the Neutropenic Diet in Decreasing Infections among Cancer Patients: A Systematic Review

Nutr Cancer. 2020;72(7):1125-1134. doi: 10.1080/01635581.2019.1675723. Epub 2019 Oct 12.


The objective of this systematic review is to evaluate the existing evidence supporting the effectiveness of the neutropenic diet in decreasing infection and mortality among cancer patients. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Scopus for relevant articles published from database inception until March 2019. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed for this review. Individual studies were evaluated using the Oxford Center for Evidence-Based Medicine guidelines. A total of 473 articles were identified and 11 articles were selected after assessing eligibility. Our review showed that the neutropenic diet does not decrease infection rates or mortality among cancer patients. Currently, there is no uniform definition for the neutropenic diet across different institutions. For example, some institutions follow general food safety practices while others avoid foods that increase exposure to microbes and bacteria, and some follow both. Given these differences in practice regarding what constitutes a neutropenic diet, it is advisable that safe food handling and preparation practices recommended by the Food and Drug Administration be uniformly followed for neutropenic patients.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Bacterial Infections / prevention & control
  • Cohort Studies
  • Diet / methods*
  • Humans
  • Infection Control / methods*
  • Infections / epidemiology*
  • Meta-Analysis as Topic
  • Mycoses / prevention & control
  • Neoplasms / drug therapy*
  • Neoplasms / mortality
  • Neutropenia / chemically induced
  • Neutropenia / diet therapy*
  • Pneumonia / prevention & control
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Treatment Outcome


  • Antineoplastic Agents