We are committed to making sure that Healing Meals is safe from contamination for the ill children and their families who enjoy these nutritious meals. Safe food handling is an extremely important part of our preparation, storage and pick-up practice. Every cooking shift has a ServSafe trained volunteer on-site and the culinary student volunteers from the Bergen County Academies have extensive training for safe food handling. Families receive portable freezer bags to pick-up their meals with a 60 day expiration date as they leave clinic for home with re-heating instructions.
We also follow Hackensack University’s Low Microbial Diet Guidelines for Immunosuppressed Patients:
- People with decreased immune function due to chemotherapy and radiation therapy are at an increased risk of developing a food-related infection. The purpose of a low microbial diet is to avoid specific foods that are likely to contain infection-causing organisms, while allowing a variety of healthy food choices.
- When following this diet, you may choose foods to eat from the “Can Eat” column. You should avoid foods from the “Do Not Eat” column. You may want to discuss the safety of any of these foods with your dietitian.
- The low microbial diet might be recommended by your physician before, during, and after all conditioning (chemotherapy and/or radiation) treatment.
- Patients who undergo an autologous stem cell transplant should expect to follow this diet for up to 3 months after transplant. Patients who receive an allogeneic transplant should follow this diet until all immunosuppressive drugs are discontinued. Please consult your physician and dietitian before discontinuing this diet.
Low Microbial Diet Guidelines
Food Group |
Can Eat |
Do Not Eat |
Dairy
|
● All pasteurized, grade ‘‘A’’ milk and milk products including commercially packaged eggnog, yogurt, ice cream, frozen yogurt, sherbet, ice cream bars, milkshakes, processed cheese slices and spreads, cream cheese, cottage cheese, and ricotta cheese● Dry, refrigerated, or frozen pasteurized whipped topping● Commercially packaged hard and semisoft cheeses such as cheddar, mozzarella, parmesan, swiss, monterey jack, etc.
● Cooked soft cheeses such as brie, camembert, feta, farmer’s cheese * ● Commercially sterile ready-to-feed and liquid-concentrate infant formulas (avoid powdered infant formulas if a ready-to-feed or liquid concentrate alternative is available) ● Note: although not completely risk free, the risk of contracting food borne illness from COOKED soft cheese is low. |
● Nonpasteurized or raw milk● Milk products made from nonpasteurized or raw milk● Cheeses from delicatessens
● Cheese containing chili peppers or other uncooked vegetables ● Cheeses with molds (such as blue, Stilton, Roquefort, gorgonzola) ● Mexican-style soft cheese such as queso fresco, queso blanco. ● No ice cream or frozen yogurt from ice cream parlors or fast food chains |
Meat and Meat Substitutes
|
● All meats cooked to well done (poultry >180°F; other meats >160°F● Canned meats (beef, pork, lamb, poultry, fish, shellfish, game, ham, bacon, sausage, hot dogs)● Eggs cooked until both white and yolk are firm
● Pasteurized eggs and egg substitutes (such as Egg Beaters®), and powdered egg white (all can be used uncooked) ● Commercially packaged salami, bologna, hot dogs, ham, and other luncheon meats, heated until steaming ● Canned and shelf-stable* smoked fish (refrigerate after opening) ● Pasteurized or cooked tofu ● Refrigerated smoked seafood such as salmon or trout if cooked to 160°F or contained in a cooked dish or casserole |
● Raw or undercooked meat, poultry, fish, game, tofu*● Raw or undercooked eggs and nonpasteurized egg substitutes; no eggs over easy, soft-boiled eggs, or poached eggs● Meats and cold cuts from delicatessens
● Hard cured salami in natural wrap ● Uncooked refrigerated smoked seafood such as salmon or trout labeled as ‘‘nova-style,’’ ‘‘lox,’’ ‘‘kippered,’’ ‘‘smoked,’’ or ‘‘jerky’’ ● Pickled fish ● Tempe (tempeh) products
|
Food Group |
Can Eat |
Do Not Eat |
|
Fruits and Nuts |
● Well-washed raw and frozen fruit except berries● Foods containing well-washed raw fruits● Cooked, canned, and frozen fruit
● Pasteurized juices and frozen juice concentrates ● Dried fruits ● Canned or bottled roasted nuts ● Shelled, roasted nuts, and nuts in baked products ● Commercially packaged nut butters (such as peanut butter, almond butter, soybean butter) |
● Unwashed raw fruits● Fresh or frozen berries● Unroasted raw nuts
● Roasted nuts in the shell ● Nonpasteurized fruit and vegetable juices ● Fresh fruit salsa found in the grocery refrigerator case ● Nonpasteurized items containing raw fruits found in the grocery refrigerator case |
|
Entrees Soups and Vegetables
|
● All cooked entrees and soups● Well washed raw and frozen vegetables including salads● All cooked fresh, frozen, or canned vegetables, including potatoes
● Shelf-stable* bottled salsa (refrigerate after opening) ● Cooked vegetable sprouts (such as mung bean sprouts) ● Fresh, well-washed herbs and dried herbs and spices (added to raw or cooked foods) |
● All miso products such as miso soup and miso paste● Unwashed raw vegetables or herbs● Fresh, nonpasteurized vegetable salsa found in the grocery refrigerator case
● Nonpasteurized items containing raw vegetables found in the grocery refrigerator case ● All raw vegetable sprouts (alfalfa sprouts, clover sprouts, mung bean sprouts, all others) ● Salads from delicatessens |
|
Bread, Grain, and Cereal Products
|
● All breads, bagels, rolls, English muffins, muffins, pancakes, sweet rolls, waffles, French toast● Potato chips, corn chips, tortilla chips, pretzels, popcorn● Cooked grains and grain products, including pasta and rice
● All cereals, cooked and ready-to-eat |
● Raw (not baked or cooked) grain products (such as raw oats)● Patients should not mix or knead any bread products that contain fresh yeast. | |
Beverages |
● Boiled well water §● Tap water and ice made from tap water ¶● Commercially bottled distilled, spring, and natural water- see water handout
● All canned, bottled and powdered beverages ● Instant and brewed coffee and tea; cold brewed tea made with boiling water ● Herbal teas brewed from commercially packaged tea bags ● Commercial nutritional supplements, both liquid and powdered ● Commercially sterile ready-to-feed and liquid-concentrate infant formulas (avoid powdered infant formulas if a ready-to-feed or liquid concentrate alternative is available) |
● Unboiled well water● Cold-brewed tea made with warm or cold water● Nonpasteurized fruit and vegetable juices
● Mate´ tea ● Wine, nonpasteurized beer (Note: All alcoholic beverages should only be consumed following physician approval) |
Food Group |
Can Eat |
Do Not Eat |
Fat |
● Vegetable oils and shortening● Refrigerated lard, margarine, butter● Commercial, shelf-stable‡ mayonnaise and salad dressings including Blue Cheese and other cheese-based salad dressings (refrigerate after opening)
● Cooked gravy and sauces |
● Fresh salad dressings (stored in the grocer’s refrigerated case) containing raw eggs or cheeses listed as ‘‘Do Not Eat’’ under ‘‘Dairy.’’ |
Desserts
|
● Refrigerated commercial and homemade cakes, pies, pastries, and pudding● Refrigerated cream-filled pastries● Cookies, both homemade and commercially prepared
● Shelf-stable‡ cream-filled cupcakes (such as Twinkies®, Ding Dongs®) and fruit pies (such as Poptarts® and Hostess® fruit pies) ● Canned and refrigerated puddings ● Ices, popsicles, and similar products ● Candy, gum |
● Unrefrigerated cream-filled pastry products (not shelf-stable ‡)● Ice cream and frozen yogurt from an ice cream parlor or fast food restaurant. |
Other |
● Commercial pasteurized Grade A honey**● Salt, granulated sugar, brown sugar● Jam, jelly, syrups (refrigerate after opening)
● Catsup, mustard, BBQ sauce, soy sauce, other condiments (refrigerate after opening) ● Pickles, pickle relish, olives (refrigerate after opening) ● Vinegar |
● Raw honey; honey in the comb● Herbal and nutrient supplement preparations● Brewers yeast, if uncooked |
Concern arising from the detection of potential pathogens in food has not been supported by documented evidence of such organisms as the source of opportunistic infections in immunocompromised persons. The potential benefit of food safety recommendations directed specifically toward HCT recipients must be weighed against the uncertain value of such recommendations] and their potential to adversely affect patients‘ nutritional intake and/or quality of life.
*Shelf-stable refers to unopened canned, bottled, or packaged food products that can be stored before opening at room temperature; container may require refrigeration after opening.
* Aseptically packaged, shelf-stable tofu and pasteurized tofu do not need to be boiled. Nonpasteurized tofu must be cut into 1-inch cubes or smaller, and boiled a minimum of 5 minutes in water or broth before eating or using in recipes.
* Rinse under clean, running water before use, including produce that is to be cooked or peeled (such as bananas, oranges, and melon).
* Bring tap water to a rolling boil and boil for ≥1 minute minutes. Store boiled water in the refrigerator. Discard water not used within 48 hours (2 days).
* Recommend using boiled or bottled water if using a water service other than city water service. Please see Water Safety Guidelines in ‘‘Food Safety Guidelines.’’ See Water Safety Guidelines in ‘‘Food Safety Guidelines’’ for approved bottled water treatments.
* Honey products are not allowed for any child less than 1 year of age and not allowed for children with SCIDS until 9 months post transplant.
(Updated 04/01/2010; Original 2002 updated 1/09)