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Nutrition and daily life

Juice and smoothies: calories and fluid, made safely

When appetite is low or swallowing is hard, juice and smoothies are an easy way to get calories, vitamins and fluid. But fresh juice from street stalls and smoothies with raw berries can be risky during neutropenia. This section covers the safe options.

Last updated: ~2 min read
Orange juice, a banana smoothie and fruit on a dark table.
Figure 1.Juice and smoothies.

01Short answer

Juice and smoothies can help when appetite is poor. During neutropenia avoid fresh-squeezed juice from stalls and cafés; choose sealed pasteurised juice. If you make smoothies at home, use a clean blender, washed and peeled fruit, pasteurised yogurt or milk, and drink straight away. Do not add raw frozen berries. Juice is low in fibre and high in sugar. Grapefruit juice affects medicines.

02Simple explanation

Choose pasteurised juice.

Street juice during neutropenia: no.

Smoothies: clean blender, drink at once.

Grapefruit juice: no.

03Scientific explanation

FDA: unpasteurised juices have caused E. coli and Salmonella outbreaks; people with weak immunity are at risk.

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?

Smoothies at home

Banana, cooked or canned fruit, pasteurised yogurt and oats. Take the blender apart and wash it right after use.

A juice stall in shadow behind, a sealed bottle in front.
Figure 2.Pasteurised instead of street juice.

Sugar and fibre

Whole fruit gives more fibre; limit juice during steroid treatment.

Banana and yogurt in a clean blender.
Figure 3.A clean smoothie at home.

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
Smoothies at homeBanana, cooked or canned fruit, pasteurised yogurt and oats. Take the blender apart and wash it right after use.
Sugar and fibreWhole fruit gives more fibre; limit juice during steroid treatment.
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

Unpasteurised juice
Fresh-squeezed juice without heat treatment.
Smoothie
Fruit and dairy blended together.
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

  • Sealed pasteurised juice.
  • Drink smoothies straight away.
  • No raw frozen berries.
  • Wash under running water.
  • Eat cut fruit soon.

09Frequently asked questions

Is juice squeezed at home allowed?

From washed fruit, with a clean juicer, drunk at once: many teams allow it; ask yours.

Can a smoothie replace a meal?

Sometimes, when appetite is poor; add yogurt or milk for protein and talk to a dietitian.

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. Is juice squeezed at home allowed?

  2. Can a smoothie replace a meal?

  3. Does this fruit treat leukemia?

My questions

12Sources

  1. U.S. FDA. Talking About Juice Safety: What You Need to Know
  2. Leukemia & Lymphoma Society. Diet Guidelines for Immunosuppressed Patients
  3. U.S. FDA. Selecting and Serving Produce Safely
  4. NHS. 5 A Day: what counts?
  5. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  6. USDA. FoodData Central
  7. World Health Organization (WHO). Listeriosis — fact sheet
  8. NIH Office of Dietary Supplements. Dietary Supplement Fact Sheets
  9. U.S. Food and Drug Administration (FDA). What You Need to Know About Egg Safety
  10. U.S. Food and Drug Administration (FDA). Raw Milk Misconceptions and the Danger of Raw Milk Consumption
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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