RESTRICTED DIET: MICROBIAL-FREE DIET

Question 1

INDICATION FOR A MICROBIAL FREE DIET

Answer 1

• After chemotherapy
• Other cancer therapy
• Leukaemia (bone marrow transplant)
• Heart transplant
• HIV/AIDS

Question 2

CONTRA-INDICATION OF A MICROBIAL FREE DIET

Answer 2

Purpose: A neutropenic diet for patients with weakened immune systems. This diet helps protect patients from bacteria and other harmful organisms found in some food and drinks. If ones immune system is not working well, the body may have a difficult time protecting itself from bacteria.

Question 3

NOTES TO CONSIDER WHEN IMPLEMENTING A MICROBIAL FREE DIET

Answer 3

Raw foods must not be eaten. No raw vegetable garnishes on plates and no cold meals are permitted including salads. Hot foods must be served piping hot and must not be kept for more than 15 minutes before serving. Food and drink should be consumed within 30 minutes of service and any left-overs must be discarded immediately. Food handles must practice safe food handling. Wash hands before handling foods, wash all surfaces, cutting boards and cutting utensils thoroughly. Keep hot foods hot and cold foods cold. Food should not be heated in a microwave.

Question 4

MILK AND MILK PRODUCTS ALLOWED AND TO AVOIDIN A MICROBIAL FREE DIET

Answer 4

ALLOWED:
Ice-cream in tubs. Dairy food in packets.
Homogenised, full cream or low fat milk. Condensed or evaporated milk. Milkshakes made in a sterile blender. Flavoured UHT milk.
Processed cheese, packaged slices, cooked cheese, in sauces and other dishes. Cooked mozzarella and parmesan cheeses.

TO AVOID:
Soft-serve ice-cream, Ice-cream with dried fruit or nuts. Cream or sour cream. Unpasteurized dairy products. Yoghurt.
Commercially prepared milkshakes. Unpasteurized milk.
Cottage cheese, uncooked hard cheese (cheddar, brie, feta), cream cheese, cheese based salad dressing.

Question 5

MEAT AND MEAT ALTERNATIVES ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 5

ALLOWED:
Well cooked eggs (hard boiled or scrambled).
Hot cooked legumes, kidney beans, soy beans and chickpeas. Chilli beans, baked beans and canned beans.
Hot cooked meat, poultry (dish straight from the oven), canned and frozen products heated according to packet directions.

TO AVOID:
Raw or soft eggs (poached), products containing raw eggs or eggs with cracked shells.
Cold legumes (bean salad).
Raw or cold meats (ham, salami, luncheon meats). Raw or cold poultry or fish. Cold meat pies.

Question 6

VEGETABLES ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 6

ALLOWED:
Cooked vegetables (fresh, frozen or canned).  Raw tomatoes and cucumber (soaked in Chorine solution for 60 minutes).	

TO AVOID:
Raw vegetables or herbs. Stir fry vegetables and raw garnish.

Question 7

FRUITS ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 7

ALLOWED:
All stewed, canned and cooked fruit. Fresh oranges, mandarins and bananas.
Soak fresh fruit in Chlorine solution (Biocide) for 60 minutes, then wrap in plastic before serving.

TO AVOID:
Dried fruit. Fresh fruit except those allowed.

Question 8

BREAD, CEREAL, RICE PRODUCTS ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 8

ALLOWED:
Hot, cooked pasta and rice. Instant noodles. Bread, rolls, dry biscuits, muffin sand biscuits from newly opened packets. Breakfast cereals from fresh, single serve packets. Cooked cereals. Baking made in a clean environment.

TO AVOID:
Cold pasta and rice dishes.
Unprocessed bran. Unwrapped bakery bread and rolls. Bread and cereals with whole grains, nuts and dried fruit. Cereals and biscuits from bulk bins. Baked products filled with cream or custard.

Question 9

FATS ALLOWED IN A MICROBIAL FREE DIET

Answer 9

Oils, butter and margarine.

Question 10

BEVERAGES ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 10

All boiled hot soups.
Coffee, tea, milo, fruit juices from cans or cartons. Carbonated drinks, cordials, Ensure and other commercial supplements. Cold soups.
Freshly squeezed fruit or vegetable juices or with broken seals. Non-carbonated drinks.

Question 11

COOKINGS METHODS ALLOWED AND TO AVOID IN A MICROBIAL FREE DIET

Answer 11

ALLOWED:
•	Boiling 
•	Steaming
•	Blending
•	Braising
•	Sautéing 
•	Grilling
•	Roasting	
TO AVOID:
•	Deep-fat frying
•	Frying

Question 12

DISCUSS PLATING AND GARNISHING IN A MICROBIAL FREE DIET

Answer 12

Plate neatly like the normal meal.

Best to not garnish at all.