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Nutrition and daily life

Strawberry — fruit card: delicious, but with care

Strawberries are among the best-loved berries. But their surface is uneven and they grow close to the soil, so during neutropenia they need special care. This card explains how to eat strawberries during treatment.

Last updated: ~1 min read
A bowl of red strawberries on a dark board.
Figure 1.Fresh strawberries — Strawberry — fruit card: delicious, but with care

01Short answer

Strawberries are rich in vitamin C, folate and anthocyanins. The seeds on the surface and closeness to the soil let germs linger. Many teams limit or forbid raw strawberries during neutropenia. Without neutropenia, wash them carefully under running water, then remove the cap. During neutropenia choose strawberry jam or compote. Cook frozen strawberries.

02Simple explanation

Strawberries: vitamin C.

Uneven surface: germs linger.

During neutropenia: cooked.

Remove the cap after washing.

03Scientific explanation

Berries and viruses: fresh and frozen berries have been linked to hepatitis A and norovirus outbreaks; heat treatment lowers the risk (see “Frozen foods — food card: freshness in store”).

WHO: at least 400 g of fruit and vegetables a day is recommended; during treatment the amount may vary with appetite and your doctor’s advice.

FDA: wash produce under running water before cutting or peeling, because a knife can carry germs from the skin into the flesh.

04What happens in the body?

Washing

Wash with the cap on under running water; removing it first lets water in.

Strawberry jam bubbling in a wide pot.
Figure 2.Strawberry jam cooking.

Cooked

Jam, compote and baking are safer choices during neutropenia.

Raw strawberries on the left, hot compote on the right.
Figure 3.Cooked during neutropenia.

Washing and peeling

Wash your hands, rub the fruit under running water, dry it with a clean towel, then peel or cut it. Soap or bleach solutions are not needed.

Cut fruit

Keep cut fruit in the fridge and eat it within 1 day; do not leave it at room temperature for more than 2 hours.

05Fruit: four steps

Whole fruit, swap bruised, wash and peel, eat cut fruit soon.

Whole fruit — No spots.1Whole fruitNo spots.
Not bruised — Fresh and whole.2Not bruisedFresh and whole.
Wash and peel — Running water.3Wash and peelRunning water.
Eat soon — Fridge, 1 day.4Eat soonFridge, 1 day.
VitaminsA natural source.
FibreFor the gut.
SafetyWashing.

06Key points at a glance

TopicIn brief
WashingWash with the cap on under running water; removing it first lets water in.
CookedJam, compote and baking are safer choices during neutropenia.
Washing and peelingWash your hands, rub the fruit under running water, dry it with a clean towel, then peel or cut it. Soap or bleach solutions are not needed.
Cut fruitKeep cut fruit in the fridge and eat it within 1 day; do not leave it at room temperature for more than 2 hours.

07Key terms

Anthocyanins
Red pigments.
Norovirus
A virus causing vomiting and diarrhoea.
Neutropenia
Low neutrophils, raising infection risk.
Potassium
A mineral for the heart and muscles.
Fibre
The part of plants that helps the gut work.

08Key points

  • Wash strawberries carefully.
  • Cooked during neutropenia.
  • Cook frozen ones.
  • Wash under running water.
  • Eat cut fruit soon.

09Frequently asked questions

Can I eat raw strawberries during neutropenia?

Many teams say no; ask yours.

Can strawberries cause allergy?

In some people; stop if a rash appears.

Does this fruit treat leukemia?

No. It is a pleasant part of eating, not a treatment.

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 eat raw strawberries during neutropenia?

  2. Can strawberries cause allergy?

  3. Does this fruit treat leukemia?

My questions

12Sources

  1. Leukemia & Lymphoma Society. Diet Guidelines for Immunosuppressed Patients
  2. U.S. FDA. Selecting and Serving Produce Safely
  3. NHS. 5 A Day: what counts?
  4. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  5. USDA. FoodData Central
  6. NHS (UK). Dehydration
  7. European Food Safety Authority (EFSA), 2010. Scientific Opinion on Dietary reference values for water
  8. National Center for Complementary and Integrative Health (NCCIH). Cancer and Complementary Health Approaches: What You Need To Know
  9. National Center for Complementary and Integrative Health (NCCIH). St. John’s Wort
  10. National Center for Complementary and Integrative Health (NCCIH). Turmeric
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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