Food storage, preparation and cooking temperatures after transplant

Safe food storage and preparation are just as important as the foods you choose to eat after a blood or marrow transplant (also known as a blood stem cell transplant or bone marrow transplant). With your immune system still healing, these steps help lower your risk of foodborne illness.

Food can spoil quickly, and bacteria grow faster than you might think. Safe storage helps prevent foodborne illness and gives you peace of mind that what you’re eating is helping, not hurting, your recovery.

• Put away groceries right after you get home.
• Keep refrigerated foods cold and frozen foods frozen until you're ready to use them.
• Always check expiration dates and throw away food that's expired.
• Store food in small portions so it's eaten quickly.
• Eat leftovers within 2 days and label containers with the date.
• Refrigerate food within 2 hours of cooking. If in doubt, throw it out.

Preparation is where germs can spread most easily in the kitchen. Taking a few extra steps will help reduce your risk.

• Wash your hands with warm, soapy water before and after handling food.
• Clean counters, cutting boards and utensils with hot, soapy water or disinfecting wipes.
• Thaw frozen foods in the refrigerator, never on the counter or in the sink.
• Wash all fruits and vegetables under running water, even those you peel. Scrub firm produce with a clean brush.
• Don't use produce washes, soap, bleach or vinegar, and don't soak fruits or vegetables.
• Wash the tops of cans and your can opener before use.
• Use separate cutting boards, plates and utensils for raw and cooked foods.
• Wear disposable gloves or wash hands thoroughly after touching raw meat, poultry or fish.
• Clean cutting boards with 1 tablespoon of bleach in 1 gallon of water or in the dishwasher.

Even if food looks done, it may not be safe. Cooking food to the right internal temperature is the only reliable way to kill harmful bacteria. A food thermometer is an essential kitchen tool after transplant.

Planning to eat out? Get tips on safe restaurants and drinks.

After transplant, you may notice changes in your appetite, taste or digestion. These side effects are usually temporary, but they can make eating feel like a challenge. The right approach can make meals more enjoyable and give your body the fuel it needs.

It may help to:

• Rinse your mouth with a mix of 1 cup water + a half-teaspoon of baking soda before meals if your mouth feels dry.
• Try chilled or frozen foods (like cottage cheese or frozen yogurt) if your mouth is sore.
• Use plastic utensils or try mint or ginger if food tastes metallic.
• Avoid fried, fatty, spicy or acidic foods if your stomach is upset.
• Choose low-fiber foods (white bread, rice, eggs, potatoes, cooked chicken/fish without skin) to prevent diarrhea.
• Use lactose-free milk, soy milk or yogurt if dairy causes discomfort.
• Avoid sugar substitutes like sorbitol, mannitol or xylitol, which may cause gas or diarrhea.
• Eat smaller meals more often instead of three large meals.

Special thanks to the transplant dietitians who contributed to this article:

• Joy Heimgartner, MS, RDN, CSO, LD, and Joan Vruwink, RDN, LD
  Mayo Clinic Blood and Marrow Transplant
• Susan B. Little, MS, RDN, LD, CNSC
  University of Iowa Hospital and Clinics Transplant Center