Overview of nutritional approach in hematopoietic stem cell transplantation: COVID-19 update

Table 4 Nutritional approach in immunosuppressed patients

Food restrictions
1	Raw and undercooked meat, fish, shellfish, poultry, eggs, sauce
2	Unpasteurized or raw milk, cheese, yoghurt and other dairy products, soft cheeses, delicatessen cheeses, cheeses containing hot peppers or other uncooked vegetables, cheeses with molds
3	Foods containing raw or uncooked meat, tofu, pre-cooked cold meats, pickled fish, tempeh, raw eggs
4	Raw cereal products, unpackaged bread, cakes, pastries, cream cakes, dried fruits, nuts or coconut
5	Unwashed and unpeeled raw fruit, damaged fruit, berry fruits (strawberry, raspberry, blackberry), grapes (unless peeled), unroasted raw nuts, unpasteurized juice, dried fruit
6	Unwashed raw vegetables or herbs, delicatessen salad Herbs and spices should not be sprinkled on food after cooking
7	Well water (unless tested annually and found safe), cold brewed tea made with lukewarm or cold water, prepared and brewed unpasteurized fruit or vegetable juices
8	Uncooled, cream filled pastry products
9	Unwrapped or communally used butter, margarine, spreads or ghee, fresh salad dressings containing aged cheese or raw eggs, stored in refrigerated case
10	Raw or unpasteurized honey, herbal and non-traditional nutritional supplements, brewer's yeast if eaten without cooking
Food safety recommendations
General	Particular care should be taken when handling, preparing and consuming food to avoid contracting a foodborne illness. 4 steps to follow in terms of food safety: (1) Cleaning: Washing hands, surfaces and products; (2) Separation: Avoiding cross-contamination; (3) Cooking: Cooking at proper temperature; and (4) Chilling: Refrigerate immediately
Shopping	Always check expiration dates. Avoid purchasing food close to its expiration date and never consume after the specified date. Do not buy damaged packaged food such as crushed boxes or ripped packages. Do not taste foods in supermarkets. Buy perishable foods first, then frozen perishables and finally refrigerated perishable products. Check for water on the floor by meat stands, freezers or refrigerators. Avoid hot places when carrying food
Storage	Store raw and cooked food separately. Check if your fridge and freezer are at the right temperature. Adjust refrigerator temperature to below 5C, freezer below 18C. Discard wastes after 3 d of refrigeration. Never leave perishable products out of the refrigerator for more than 2 h
Preparation	Wash hands thoroughly with hot water and soap before and after touching food. Use separate cutting boards to prepare beef, fish, chicken or vegetables. Prefer boards made of glass to wooden ones. Use only treated water to prepare food and clean the surface before you start preparation. Make sure canned food is clean. Wash cans before opening
Cooking	Avoid using a microwave for cooking; it can be used to heat food or defrost frozen food. Cook food thoroughly; pay special attention to larger portions and thicker cuts of meat. When warming pre-prepared food, check that the temperature inside the product is the same. Never reheat preheated food. Never re-freeze thawed frozen food
Eating out	It is safer to avoid eating and drinking outside while on a clean food diet. If you have to eat out, use sauces, condiments, salt and sugar only in disposable bags. Check that the toilets are clean and that there is soap to wash hands. Avoid iced drinks of unknown origin