The neutropenic diet... still ageless?

As practicing doctors and a practicing nutritionist in a large pediatric oncology program, we applaud Nicole Fox and Alison Freifeld for questioning the utility of the neutropenic diet. Not only is this diet poorly defined, with wide institutional variability, but it also places an added burden on an already at-risk population. We have seen the confusion among both families and practitioners trying to understand a seemingly arbitrary set of rules. The lack of evidence behind these diets makes it difficult for practitioners to be consistent within and across institutions. Even within our institution, patients not undergoing stem cell transplant receive no particular dietary prohibitions regardless of how long they are neutropenic, whereas those undergoing autologous transplant have significant limitations even though the duration of their neutropenia may be shorter.