Eat Well with Berna Harmse

Nutrition and white blood cells

Can your choice of diet impact your white blood cell (WBC) count? Dietitian, Berna Harmse, answers this question, and gives some dietary advice.

White blood cells (WBCs), also called leukocytes, are an important part of the immune system. These cells help fight infections by attacking bacteria, viruses and germs that invade the body. WBCs originate in the bone marrow, but circulate throughout the bloodstream. There are five major types of white blood cells: neutrophils, lymphocytes, eosinophils, monocytes and basophils – each with properties of their own.

A WBC count is a test that measures the number of white blood cells in your body. Your blood contains a percentage of each type of white blood cell.

Low WBC counts, also known as leukopenia, can occur at certain times throughout chemotherapy. Most of the time, blood counts will return to normal before a person starts the next round of chemotherapy, and also after cancer therapy is completed.

WBCs and all other blood cells are made in the bone marrow, so radiation to bones, especially as a child, can cause chronic suppression of blood cell production and low counts. Most people living with cancer, however, will recover their WBCs much more quickly. Keep in mind that the amount of time it takes for WBCs to return to normal varies from person to person.

While no specific foods or diet changes are proven to increase production of WBCs; if you have leukopenia, it is very important to practice good hygiene, hand-washing, and food safety practices.

Those with leukaemia or lymphomas are also more susceptible to neutropenia, which is simply low levels of neutrophils. These are the cells that fight bacterial infection. Neutropenia occurs when your absolute neutrophil count (ANC) falls below 1500. When this happens, you are more susceptible to infections.

If your ANC is low, you can minimise your risk of infection by using antibacterial soap and warm water, and scrubbing your hands for 15-30 seconds several times per day, and every time before you prepare food.

If you have neutropenia, you should avoid:

  • Raw meat, eggs and fish.
  • Mouldy or expired food.
  • Unwashed or mouldy fruit and veg.
  • Unpasteurised beverages, including fruit and vegetable juice, beer, milk, as well as unpasteurised honey.

You do not need to avoid fresh fruit and vegetables, because this practice has not been shown to reduce the number of major infections. However, you should wash these foods thoroughly before you eat them.

Good quality protein is important for cancer patients to include in their diet, because our bodies need the building blocks (amino acids) from the protein we eat to make new WBCs.

If possible, consult with a registered dietitian (RD) for an individualised nutrition plan to address your needs during cancer treatment. The dietitian can review your food intake and ensure you are getting adequate protein and other nutrients during and after treatment. Also, always talk to your doctor or dietitian before you take any dietary supplements, because some of these products should not be taken with certain chemotherapy treatments.

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Meet our expert - Berna Harmse

Berna Harmse is a private practicing dietitian in Cape Town, she holds a MSc in Dietetics and has a special interest in oncology nutrition. She is also an external lecturer at Stellenbosch University Division of Human Nutrition.