What Foods Should I Avoid on Chemo? Your Guide to Safe Eating

October 6, 2025 •

4 min read

Did you know that chemotherapy can weaken the immune system, making patients more susceptible to infections from food? This is why it is critical to understand what foods should I avoid on chemo to ensure food safety and support your overall health throughout treatment.

Quick Summary

Chemotherapy weakens the immune system, necessitating strict food safety to prevent infection. This article details specific raw and unpasteurized items, deli meats, and certain produce to avoid. It also offers strategies for managing common side effects through dietary changes.

Key Points

Avoid Raw Foods: To prevent bacterial infection, never eat raw or undercooked meat, poultry, seafood, or eggs during chemotherapy.
Steer Clear of Unpasteurized Items: Shun raw milk, honey, unpasteurized juices, and certain soft cheeses to minimize contamination risk.
Be Wary of Deli and Buffet Foods: Deli meats and buffet items are susceptible to bacterial growth and cross-contamination; avoid them or heat deli meats thoroughly.
Manage Produce Safely: Always wash fresh fruits and vegetables well; avoid raw sprouts and pre-cut produce from buffets and salad bars.
Watch for Medication Interactions: Certain foods, like grapefruit, can interfere with specific chemotherapy drugs, so consult your care team about all dietary choices.
Adapt to Side Effects: Adjust your diet to manage symptoms like nausea, mouth sores, or changes in taste by avoiding irritating foods.

Chemotherapy is a powerful treatment, but it can also suppress your immune system, a condition known as neutropenia. With fewer infection-fighting white blood cells, the risk of foodborne illness becomes a serious concern. Knowing which foods carry a higher risk of contamination and how to prepare meals safely is a critical part of your treatment plan. Beyond bacterial risks, certain foods can also interact with medications or aggravate common side effects like nausea, diarrhea, or mouth sores.

High-Risk Foods to Avoid During Chemotherapy

Raw and Undercooked Foods

Meat, Poultry, and Seafood: Avoid any raw or rare meat. This includes sushi, sashimi, ceviche, and raw shellfish like oysters, clams, and mussels. All meat, poultry, and fish should be cooked thoroughly to their safe minimum internal temperatures.
Eggs: Do not consume raw or undercooked eggs. This means no runny yolks from eggs cooked sunny-side up or poached. Foods containing raw eggs, such as homemade mayonnaise, Caesar salad dressing, hollandaise sauce, and raw cookie dough or cake batter, should also be avoided.

Unpasteurized Products

Dairy: Stay away from unpasteurized (raw) milk and dairy products. This includes certain soft cheeses like Brie, Camembert, blue-veined cheeses (e.g., Stilton, Roquefort), feta, and queso fresco, unless the label confirms they are made with pasteurized milk.
Juices and Honey: Unpasteurized fruit juices, apple cider, and honey should be avoided. Commercially processed, pasteurized versions are safe to consume.

Deli and Refrigerated Items

Deli Meats and Cold Cuts: These items, including cold hot dogs, salami, and ham, carry a risk of listeria contamination. Unless heated until steaming hot, choose pre-packaged, sealed versions instead of those sliced at a deli counter.
Refrigerated Pâtés and Spreads: Avoid all refrigerated meat spreads and pâtés.
Salad Bar and Buffet Items: Food from buffets, potlucks, and salad bars should be avoided as they are a high risk for bacterial contamination due to being at room temperature and handled by many people.

Certain Fruits, Vegetables, and Sprouts

Unwashed Produce: Always wash fresh fruits and vegetables thoroughly under running water, even if they have a peel. Some leafy greens and berries are difficult to clean completely and should be cooked or avoided if your immune system is severely compromised.
Raw Sprouts: Due to the warm, moist conditions they are grown in, raw sprouts like alfalfa, clover, and bean sprouts are very susceptible to bacterial contamination and should be avoided.

Managing Side Effects Through Food Choices

While some foods pose a general risk, others might aggravate specific chemotherapy side effects. A tailored diet can help manage these symptoms effectively.

For Nausea: Fatty, greasy, spicy, or strongly odored foods should be limited. Instead, opt for bland, low-fat items like crackers, toast, or rice.
For Mouth Sores: Spicy, acidic, and salty foods can irritate a sore mouth. Very hot or very cold foods can also be problematic. Choose soft, bland, room-temperature foods, like mashed potatoes, yogurt, or pureed soups.
For Diarrhea: High-fiber foods like raw vegetables and whole grains might need to be reduced. Focus on soluble fiber from items like bananas, white rice, and applesauce.
For Metallic Taste: If red meat tastes metallic, try alternative protein sources like chicken, turkey, or beans. Using plastic utensils can also help.

The Grapefruit Warning

Grapefruit and grapefruit juice are a special case and should be avoided entirely during certain chemotherapy treatments. This is because compounds in grapefruit can interfere with enzymes in your digestive system that metabolize some chemotherapy drugs. This can lead to higher, potentially toxic, drug levels in your bloodstream, or reduce the drug's effectiveness. Always consult your oncology team to confirm if this applies to your specific medication.

Comparison of High-Risk and Safer Food Choices


Food Category	High-Risk Foods (Avoid)	Safer Food Choices (Consult a Doctor)
Protein	Raw or undercooked meat, poultry, seafood (sushi, sashimi)	Well-cooked meat, poultry, and fish
Eggs	Raw or undercooked eggs (runny yolks), homemade mayonnaise	Thoroughly cooked eggs (firm yolks and whites), pasteurized egg products
Dairy	Unpasteurized milk, soft cheeses (Brie, Feta, Blue Cheese), unpasteurized yogurt	Pasteurized milk and dairy products, hard cheeses
Deli Items	Cold cuts, deli-sliced meats, refrigerated pâtés	Pre-packaged deli meat heated until steaming hot
Produce	Unwashed produce, raw sprouts (alfalfa, bean), buffets/salad bars	Thoroughly washed whole fruits and vegetables, cooked vegetables
Juices	Unpasteurized cider and juices	Pasteurized juices

Conclusion

While a cancer diagnosis can feel overwhelming, focusing on proper nutrition and food safety is a proactive step you can take to support your body. The guidelines for what foods should I avoid on chemo are designed to protect your compromised immune system from foodborne illness and to help manage treatment side effects. Remember that your dietary needs are unique, and what affects one person may not affect another. Always discuss your diet with your healthcare team, including an oncologist or registered dietitian, to create a personalized nutrition plan that supports your recovery and overall well-being. By following these precautions, you can reduce risks and focus on healing.

For more information on food safety during cancer treatment, consult resources like the Memorial Sloan Kettering Cancer Center guide at https://www.mskcc.org/cancer-care/patient-education/food-safety-during-cancer-treatment.

Frequently Asked Questions

The concept of a strict 'neutropenic diet' has been debated, with some studies showing no proven benefit in reducing bacterial exposure compared to general food safety guidelines. The current emphasis is on strict safe food handling and avoiding specific high-risk foods, not restricting entire food groups unnecessarily. Always consult your doctor or dietitian for guidance based on your specific treatment and immune status.

It is generally safer to eat freshly prepared home-cooked meals. If you do eat out, choose reputable restaurants with good health inspection ratings. Avoid buffets, salad bars, and street vendors. Ask for all meats, eggs, and seafood to be cooked well-done, and avoid foods with raw ingredients like homemade mayonnaise.

Grapefruit contains compounds that can interfere with the enzyme CYP3A4, which is responsible for breaking down certain chemotherapy drugs. This can cause a toxic buildup of medication in your bloodstream. It is crucial to discuss this with your oncology team, as this interaction does not apply to all chemotherapy regimens.

To combat nausea, eat small, frequent meals rather than three large ones. Stick to bland, low-fat, and low-odor foods like crackers, toast, or yogurt. Avoiding greasy, fried, and spicy foods can help. Sipping cool, clear beverages can also be soothing.

If food tastes metallic, try using plastic or bamboo utensils instead of metal silverware. Avoid canned foods and opt for fresh or frozen alternatives. Experiment with different seasonings like lemon juice or herbs to enhance flavors. Alternative proteins like chicken, turkey, or beans may also taste better than red meat.

If you have mouth sores, avoid acidic, spicy, and salty foods that can cause irritation. Choose soft, bland, and moist foods, such as mashed potatoes, scrambled eggs, yogurt, and creamy soups. Serving foods at room temperature or cooler can also provide comfort.

Alcohol can stress the kidneys and worsen side effects like dehydration and nausea. It may also interact with your chemotherapy drugs. It is generally best to avoid alcohol, at least during the initial cycles of treatment, and always discuss alcohol consumption with your doctor.