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Nutrition and daily life

Milk and dairy — food card: calcium, protein and safety

Yogurt, ayran, cheese, cottage cheese — dairy is on our table every day. It provides protein and calcium and is often gentle to eat. This card explains the benefits of dairy and how to choose it safely during treatment.

Last updated: ~2 min read
Pasteurised dairy provides protein and calcium
Figure 1.Pasteurised dairy provides protein and calcium.

01Short answer

Dairy provides protein, calcium and vitamins B12 and B2. Yogurt, cottage cheese and milk are easy to manage with mouth sores and a poor appetite. The key rule is pasteurisation: during neutropenia choose only pasteurised products in sealed packaging. Market milk, homemade cheese and soft mould-ripened cheeses can carry Listeria and other bacteria. Keep opened products in the fridge and check the date.

02Simple explanation

Dairy gives calcium and protein, important for bones and muscles.

Pasteurisation is gentle heating that clears milk of germs.

Raw milk and cheeses made from it can carry Listeria, Salmonella and E. coli.

Hard cheeses (gouda, cheddar) are safer than soft mould-ripened cheeses.

03Scientific explanation

Raw milk: according to CDC, unpasteurised milk can cause serious infections and is especially dangerous with weakened immunity.

Listeria can grow even in the fridge, so soft cheeses and long-opened dairy are risky.

Lactose: after some chemotherapy and antibiotics, milk can cause bloating and diarrhea; yogurt and hard cheese are usually better tolerated.

04What happens in the body?

What does milk provide?

A glass of milk (250 ml) gives about 8 g of protein and 300 mg of calcium. Yogurt and cottage cheese are even richer in protein.

Three glowing spheres rise from a glass of milk towards the outline of a bone.
Figure 2.Milk is a source of calcium for bones.

How to choose

Look for the word "pasteurised" on the label. Buy sealed, in-date products from a chilled shelf.

On the left a bucket of raw milk in shadow, on the right a sealed milk carton and glass in warm light.
Figure 3.Pasteurised milk is safer than raw milk.

Cheeses

Hard cheeses and factory-made pasteurised white cheese are safer. Set aside blue-veined and white-rind soft cheeses.

Yogurt, ayran, kefir

Shop yogurt and ayran are made from pasteurised milk. Ask your team about live cultures.

On hard days

Cool yogurt, milk porridge and cottage cheese irritate the mouth less and give protein.

05Dairy: four steps

Choose pasteurised, swap mould cheese, warm if you like, return opened packs to the fridge.

Pasteurised — Sealed, in date.1PasteurisedSealed, in date.
Hard cheese — Instead of soft mould cheese.2Hard cheeseInstead of soft mould cheese.
Warm it — Milk in porridge or a hot drink.3Warm itMilk in porridge or a hot drink.
Back to the fridge — Close opened packs.4Back to the fridgeClose opened packs.
CalciumFor bones.
ProteinFor muscles.
Less riskPasteurisation.

06Dairy during neutropenia

ProductRiskierSafer
MilkMarket, rawPasteurised
CheeseMotal, homemade, brieGouda, cheddar, factory white cheese
Cottage cheeseHomemadeShop, pasteurised
YogurtHomemadeShop-bought
Ice creamSoft-serve machineSealed pack

* The table is general information; follow your team.

07Key terms

Pasteurisation
Gentle heating that kills germs.
Listeria
A bacterium that grows even in the cold.
Lactose
Milk sugar.
Live cultures
Beneficial bacteria in yogurt.
Calcium
A mineral for bones and teeth.
Mould-ripened cheese
Cheese ripened with a mould.

08Key points

  • Dairy gives protein and calcium.
  • Pasteurised products only.
  • No market milk or homemade cheese.
  • Set aside soft mould cheeses.
  • Hard cheese is safer.
  • Keep opened packs in the fridge.

09Frequently asked questions

Can I drink ayran?

Shop ayran made from pasteurised milk is usually fine. It is salty, so ask your doctor if you have high blood pressure or kidney disease.

Milk makes me bloated — what should I do?

This may be lactose sensitivity. Yogurt, hard cheese or lactose-free milk may suit you better. Tell your doctor.

Is cottage cheese good?

Yes, it is rich in protein. Choose shop-bought pasteurised cottage cheese.

Does boiling make milk safe?

Boiling kills germs, but buying pasteurised milk is more reliable.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I drink ayran?

  2. Milk makes me bloated — what should I do?

  3. Is cottage cheese good?

  4. Does boiling make milk safe?

My questions

12Sources

  1. NHS. Milk and dairy in your diet
  2. CDC. Raw Milk
  3. CDC. Safer Food Choices for People With Weakened Immune Systems
  4. Leukemia & Lymphoma Society. Diet Guidelines for Immunosuppressed Patients
  5. Memorial Sloan Kettering Cancer Center. Food Safety During Cancer Treatment
  6. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  7. Cochrane Database of Systematic Reviews, 2019. Aerobic physical exercise for adult patients with haematological malignancies
  8. National Cancer Institute. Physical Activity and Cancer
  9. Memorial Sloan Kettering Cancer Center. About Herbs, Botanicals & Other Products
  10. Journal of the National Cancer Institute, 2018. Johnson SB et al. Use of Alternative Medicine for Cancer and Its Impact on Survival
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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