[Neil Cuadra]

Originally Posted by sofluoglu

Hi Neil,

Thanks for the reply. He is not allowed to eat any raw food. Everything has to be well cooked. Although getting better he has an occasional diarhea problem. We were told to avoid fruits and vegetable that induce diarhea, such as spinach, green lentil, apricot, prune etc. He is recommended to have a lactose and gluten free diet as much as possible. He was asked to avoid fatty food and sugar where possible due to the GVHD in his liver.

Salih

Salih,

I think you have two separate concerns:

1. Your son has dietary restrictions and you want to make sure he gets enough nutrition.

   Your son can get proper nutrition, even with the restrictions, if you pick the right foods and prepare them appropriately. It's harder to have a proper diet when you have restrictions, but many people (including vegetarians and vegans) learn the ways to keep their diet healthful.
   
   Since your son can't have raw food, consider using canned precooked fruits and vegetables. Also, there are ways to preserve vitamins while cooking; you an find tips on the Internet (example). If you look for these cooking advice sites you'll find recommendations such as steaming vegetables and keeping the lid on a pot while cooking.
   
   Even though raw food can be especially nutritious, avoiding raw food can reduce the chances of an infection. That was probably important in the first months after his transplant and less important now, but it's still nice to avoid infections.
   
   Since your son should avoid certain specific food (spinach, green lentil, etc.) make sure he gets a variety of other choices. This can help provide the best range of vitamins and minerals and also make it less boring. If he gets bored with the restricted diet, remind him that it should be only temporary.
   
   You should review all of these ideas with the dietician and ask if your son still needs vitamin supplements.
   
   Since your son is not eating fatty food and sugar he probably has a healthier diet than most 14-year-olds!

2. Your son has lost 20 pounds.

   If your son lost 20 pounds and is continuing to lose weight then I'd talk to both the doctor and dietician about it. If he lost 20 pounds (maybe because he's not eating junk food!) and then stayed at that weight then I would be less concerned.