Ask the Doctor: Which Foods Produce Gas; Neutropenic Diet

Q. Why do beans and other foods cause gas? Is there any way to reduce gas production?

A. Your body breaks down food in the intestines to use for energy, but certain types of carbohydrates, such as those found in legumes (beans, peas, and lentils) don’t break down completely. The bacteria in your colon ferment these carbohydrates, which causes the formation of gas. It’s normal to experience gas. In fact, the average human produces over two quarts of gas a day.

Other foods can cause more gas in some people. Milk and milk products are problematic for people with lactose intolerance. Other common culprits include sugars found in many fruits, including apples, dates, mangos and cherries, and vegetables, including garlic, onions, mushrooms, and asparagus. Sugar alcohols (sorbitol, mannitol, maltitol, and xylitol), which are found in many sugar-free foods, including gums and candies, also may produce gas.

For gas caused by beans, you can try Beano or another enzyme supplement designed to reduce gas formation. If you are cooking with beans, thoroughly rinsing the beans tends to cause less gas.

Other strategies that may help reduce gas production include:

• Avoiding carbonated beverages
• Avoiding foods and products that contain sugar alcohols, including sugar-free gum
• Keeping a food journal, in which you write down everything you eat and drink and note any “tummy troubles,” to help you pinpoint the foods that are causing distress.

Q. My oncologist mentioned a “neutropenic diet”—what is this?

A. “Neutropenia” means your body has too few neutrophils (cells that help fight infection). A neutropenic, also called “low microbial,” diet is intended to reduce the risk of foodborne illness for people with weakened immune systems. This diet is typically recommended for people undergoing chemotherapy or organ/bone marrow/stem cell transplants. A low microbial diet is usually needed only if a person’s white blood cell or neutrophil counts drop below a certain threshold.

Recommendations for a low microbial diet include the following:

• Avoid raw, undercooked, or “rare” items, especially meat, poultry, and seafood.
• Drink only milk and juice that have been pasteurized.
• Only consume prepared foods that come in sealed packages.
• Wash raw fruits and vegetables thoroughly in water that is safe for drinking.
• Avoid deli meats and cheeses, raw sprouts, raw nuts, cheeses developed using mold (for example, bleu, feta, sharp cheddar, gorgonzola, and brie), all miso products, berries, peaches, plums, grapes, raw honey, and ground pepper.

A registered dietitian can provide additional guidance on reducing the risk of foodborne illness. Many oncology departments have a dietitian on staff; check with your doctor to see if he or she can give you a referral.   

–ORLI R. ETINGIN, M.D., EDITOR-IN-CHIEF

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