PI no 4

Prinsip : TKTP, Tinggi antioksidan

Syarat :
Energi 36 kkal/kgBB (laki2) dan 32 kkal/kgBB (pr) (kondisi normal)
40 kkal/kgBB (laki2) dan 36 kkal/kgBB (pr) (kurang gizi)
Protein tinggi 1-1,5 g/kgBB, lemak sedang 15-20 % dari keb. energy total
Karbohidrat cukup, sisa dari keb. total
Vitamin dan mineral cukup, terutama vit. A , B kompleks, C dan E. Bila perlu
ditambah dalam bentuk suplemen
Rendah iodium bila sedang menjalani medikasi radioaktif internal
Porsi makan kecil tapi sering
Bila imunitas menurun (leukosit < 10 ul) atau pasien akan menjalani
kemoterapi agresif, pasien harus mendapatkan makanan yang steril
Untuk pasien dengan neutropenia berat harus lebih diperhatikan tingkat
higienitas dan keamanannya mulai dari proses pembelian, penyimpanan,
pengolahan, penyajian bahkan penjamah makanan itu sendiri. Hindari
makanan mentah, berbahan pengawet, setengah matang dsb. Berikut contoh
dari bahan makanan yang harus dihindari bagi penderita neutropenia.
Foods you should avoid
Alternatives
Dairy products
All unpasteurised milk and
Pasteurised milk, soya milk,
other dairy
ultra-highproducts (the label should say
temperature-treated milk (UHT
if it has
milk)
been pasteurised)
Pasteurised yoghurts
Live or probiotic yoghurts
Pasteurised or UHT cream,
Unpasteurised cream and
frozen cream
cream in cream
cakes
cakes
Tubs of ice cream or frozen
Soft-whip ice cream from
yoghurt,
vans or
wrapped bars or lollies
machines
Hard cheeses (eg Cheddar)
Soft unpasteurised
Processed cheeses (eg
cheeses, eg Brie, goats
Dairylea,
cheese, paneer and
Philadelphia)
Halloumi. mozzarella
Camembert
Cottage cheese
Blue-veined cheeses, eg Stilton,
Roquefort
Eggs
Raw or lightly cooked eggs,
Well-cooked eggs, eg
eg soft-boiled
scrambled or
eggs
hard-boiled (cook for at least
Dishes that contain raw or
10 minutes)
slightly cooked
Shop-bought mayonnaise

eggs, eg homemade
Shop-bought ice cream
mayonnaise, egg nog,
souffls, soft meringue,
homemade ice
cream, mousses and hollandaise
sauce
Meat and poultry
Raw or undercooked
Well-cooked meat
Tinned meat
meat/poultry, eg
Vacuum-packed cold meats
meat which is still pink
Ready-cooked hot chicken
and salami
Tinned meat pt or
from
supermarkets
pasteurised meat
Smoked meats, eg Parma
pt in a jar
ham, salami
Pt
Fish
Raw or undercooked fish, eg
Freshly cooked fish, fish
sushi
fingers or
Raw or lightly cooked
fishcakes
Tinned fish, eg tuna
shellfish (eg prawns,
Tinned fish pt
clams, crab, mussels, oysters,
Vacuum-packed smoked fish
scallops) and
Frozen fish (but not frozen
caviar
shellfish)
Well-cooked prawns (eg in a curry)
Fruit and vegetables
Unwashed fruit
Good-quality fresh fruit and
Unwashed vegetables
vegetables,
Any fruit or vegetable with
including mushrooms, if well
damaged skin
washed and
or mould growth
freshly prepared (unless your
neutropenia
is severe when you may be
asked to eat
cooked or peeled fruit and
vegetables only)
Tinned fruit
Tinned or cooked berry
fruits
Frozen or tinned vegetables
Salads
Unwashed lettuce, spinach
Thoroughly washed salad
leaves,
leaves (unless
pre-packed salads (eg bags of
your neutropenia is severe,
leaves)
when it is best
Salad from salad bars in
to avoid salads altogether)

supermarkets or
restaurants

Pre-packed, shop-bought
coleslaw (if
a well-known brand, not from
the deli
counter or salad bar)
Homemade coleslaw if
mayonnaise advice
followed (see under Dairy)

PI no 2 (tambahan jawaban )
DRIs (Dietary reference intakes) : dalam perencanaan menu sebaiknya juga
perlu diperhatikan rata-rata kebutuhan akan zat gizi harian. Dimana terdapat
beberapa guidelines yang bisa digunakan untuk membantu mempermudah
perencanaanya seperti: Food Pyramid, tumpeng gizi seimbang, dsb.
PI no 8 (tambahan jawaban )
Semiselective menu adalah menu yg mempunyai satu atau lebih pilihan
menu kategori. Misalnya pada long-term care facility seperti rumah sakit
kanker (RS Brawijaya) yang menyediakan dua entrees dan dua pilihan
dessert pada makan malam. Tapi untuk kategori sayur dan salad tidak ada
pilihan.
PI no 10 (tambahan jawaban )
Yogurt karena berdasarkan sebuah penelitian dari Simin dan Woel-kyu
menunjukkan bahwa konsumsi yogurt dalam jumlah banyak dan sering
(450/hari) dapat meningkatkan produksi IFN- dari limfosit yang merupakan
salah satu jenis dari neutrofil (sel darah putih). Dimana selain komponen
bacterial ternyata komponen nonbacterial seperti: whey protein, short
peptides, dan CLA diyakini berkontribusi dalam membantu meningkatkan
efek baik dari yogurt (efek imunostimulatori).
Palacio, payne june, monica theis.2010.Food Service Management Principles
and Practices 12th Edition. New Jersey. www.Pearsonhighered.com
Meydani SN, Woel kyu ha.2015. Immunologic Effects of Yogurt.review article.
The American Journal of Clinical Nutrition. 71:861-72. www.ajcn.nutrition.org
Lymphoma association.2012.Food Safety When You are Neutropenic a Guide
for People with Lymphoma. www.lymphomas.org.uk