Food Safety after Bone Marrow Transplant
We all need to practice food safety. But it is more important after bone marrow transplant (BMT). Germs can get into foods during processing, storing, and preparation. You cannot always tell if food is bad by the way it looks, tastes, or smells.
The diet below helps reduce your risk of getting sick from the foods you eat. They can contain germs such as bacteria, viruses, or parasites.
Check with your main cancer doctor (oncologist) before you stop this diet. These guidelines were adapted from the U.S. Department of Agriculture and the Food and Drug Administration’s “Food Safety for Transplant Recipients.”
Follow the 4 basic steps of food safety.
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Clean
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Separate
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Cook
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Chill
1. Clean – Wash hands and surfaces often.
Germs can spread from one thing to the next in the kitchen. Cutting boards, kitchen counters, utensils, and food are all places where germs hide.
Follow all these tips to keep your hands and surfaces clean:
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Always wash your hands in warm, soapy water. Wash them for at least 20 seconds before and after you handle food, go to the bathroom, touch your pets, or change a diaper.
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Always clean cutting boards and counters.
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Make a cleaning solution. Mix 1 tablespoon of unscented liquid chlorine bleach with 1 gallon of water. Use this to wipe down cutting boards and counters.
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Put plastic cutting boards in the dishwasher set on the “wash” cycle.
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Use paper towels instead of cloth towels to clean kitchen counters. If you do use cloth towels, wash them on the “hot” cycle in the washing machine after each use.
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Wash all fruits and veggies. Wash all firm-skin fruits and veggies (such as apples, peppers, tomatoes, cucumbers) under running tap water. You must even wash the ones with tough rinds or skins – even if you only eat the insides. You must even wash packages of lettuce or spinach that say they are “pre-washed.”
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Wipe lids on canned foods and canned drinks with a clean paper towel before opening.
2. Separate – Don’t cross contaminate.
Cross contamination happens when germs spread between foods. Common foods that have germs that can spread are raw meat, turkey, chicken or any other poultry, eggs, and fish and seafood. Keep these foods separated from other foods.
Remember to do the following:
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Keep raw meat, poultry, seafood, and eggs separate from other foods. Do this while you shop in the grocery store, driving home, and after you put it in the refrigerator. Keep all raw meats, fish, and poultry below ready-to-eat foods in your refrigerator.
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Wash every plate that held raw meat, poultry, eggs or seafood with hot, soapy water before you use it again.
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If you reuse a marinade that was used on raw foods, make sure that you boil it first.
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Keep 2 cutting boards. Use one for raw meats, fish and poultry. Use the other one with vegetables, breads and fresh fruits.
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Keep a separate knife for each cutting board. Do not use the same knife on both cutting boards.
3. Cook – Cook to safe temperatures.
The USDA and FDA have guidelines for cooking foods safely. If you cook your foods to the minimal internal temperatures listed there, your foods should be safe.
For food safety, be sure to do the following:
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Use a food thermometer to measure temperature. Check several spots in meat, poultry, seafood, and egg products. You cannot tell if a food is well cooked just by looking at it. You can buy a food thermometer at stores like Kroger or Wal-Mart, or on Amazon.com for less than $10.
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Make sure meats are cooked to the right internal temperature. (See the chart on the next page.)
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Cook all raw poultry to 165°F.
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Cook beef and pork to 145°F with 3 minute rest time.
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Cook ground meats to 160°F.
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Cook seafood to 145°F.
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Cook egg dishes to 160°F.
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Cook eggs until yolks and whites are firm.
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Reheat sauces, soups, and gravies by bringing to a boil.
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Reheat all leftovers until steaming (165°F).
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Cook refrigerated meats within 1-2 days of purchase.
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Frozen meats must be cooked within 3-4 months of purchase.
| Food Type |
Examples |
Temperature |
| Ground meat or meat mixtures |
Beef, pork, veal, lamb |
160°F |
| Turkey, chicken |
165°F |
| Whole cuts of beef, veal, lamb |
Steaks, roasts, chops |
145°F |
| Whole cuts of poultry (chicken, turkey, duck) |
Breasts, wings, thighs, legs |
165°F |
| Pork |
All cuts of pork |
160°F |
| Eggs and egg dishes |
Eggs or any foods that have eggs in them |
165°F -- cook until yolks and whites are firm and fully cooked |
| Casseroles |
Casseroles |
165°F |
| Leftovers |
Reheat all leftovers |
165°F |
| Fish |
|
145°F, or cook until flesh is opaque and separates easily with a fork |
4. Chill – Refrigerate right away.
Harmful bacteria grow slowly in cold temperatures. Chill foods the right way by doing the following:
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Keep refrigerator temperature at or below 40°F. Keep freezer temperature at or below 0°F. Use an appliance thermometer to make sure that the temperature is accurate and constant.
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After buying groceries, make sure that you refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours.
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Never thaw food on the counter or sink at room temperature. Always thaw food in the refrigerator, under running cold water, or in the microwave. After thawing food in cold water or in the microwave, cook it right away.
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You can divide large amounts of food into shallow containers. This will chill them faster in the refrigerator.
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Mold is harmful. Be careful with fresh berries. Eat fresh berries within 1-3 days of purchase. Do not use them if you see mold on them.
Follow these grocery shopping tips.
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Carefully read food labels. Make sure food is not past its “sell by” or expiration date.
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Put raw packaged meat, poultry, or seafood into a plastic bag before placing it in the shopping cart. This will keep juices from dripping on – and spreading germs to – other foods.
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Buy only pasteurized milk, cheeses, eggs, honey and juices.
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When buying canned goods, make sure that they are free of dents, cracks, or bulging lids.
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Do not buy fruits or veggies that are bruised or damaged.
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Put cold and frozen foods in your shopping cart last.
Follow these tips for eating out.
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Avoid all food from salad bars, deli counters, buffets, and food trucks.
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Avoid community condiment dispensers – single serving packets are best.
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Avoid raw lemons added to water.
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Make sure all meat, fish, and poultry is cooked to well done. Request this when you order.
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Do not eat raw sushi. Sushi with cooked ingredients and vegetarian sushi is fine.
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If you plan to save leftovers to eat later, refrigerate them as soon as you can. Always refrigerate foods within 2 hours after buying or delivery.
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Don’t hesitate to send a meal back if you don’t think it’s been cooked properly.
So, what foods should you eat?
Whether you are in the hospital or at home, you need to know which foods are safest. While all meals prepared at University of Kentucky Hospital have been prepared strict food safety guidelines, some foods are still lower risk than others. Please review the list below of foods so that you can know which foods are best for you to eat and which you should limit. If you have any questions, please ask to speak with your Registered Dietitian.
| Lower Risk |
Higher Risk
|
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Well-cooked meat & poultry, cooked to a safe minimum internal temperature
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Seafood (fish & shellfish) cooked to 145 °F
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All leftovers reheated to 165 °F
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Canned fish & seafood
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Pasteurized milk & milk products (including yogurt)
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Well-cooked eggs (firm yolks & whites)
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Washed, raw fresh fruits and veggies, including salads (except sprouts)
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Cooked veggies & fruits
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Any cheeses labeled “made from pasteurized milk” (hard, soft, processed, cream, etc.)
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Raw or undercooked meat or poultry not cooked to a safe internal temperature
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Raw fish or undercooked or partially cooked fish, shellfish
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Unpasteurized raw milk & raw milk products
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Raw/undercooked eggs
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Homemade Caesar dressings, cookie dough, & eggnog containing raw or undercooked eggs
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Raw sprouts
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Any unwashed fresh fruits or veggies
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Soft cheeses made from unpasteurized milk like feta, brie, queso fresco, camembert, & molded cheeses (like blue cheese or gorgonzola)
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For more information, please check out these trusted resources:
For any other questions or concerns about your diet, please ask to speak with your Registered Dietitian.