Low-Fat Diet Before Extracorporeal Photopheresis (ECP)

Extracorporeal photopheresis (ECP) is a non-surgical procedure to treat graft-versus-host-disease (GVHD). 

Your child must eat a low-fat diet the day before and the day of the ECP procedure. Eating a high-fat meal before the procedure, can keep the ECP machine from working properly.  

If your child is on total parenteral nutrition (TPN) with lipids, the medical team will stop the lipids at least 1 day before the ECP procedure. 

Before the ECP procedure, have your child follow a low-fat diet using the suggestions below. Follow your care team’s instructions for what your child should eat and drink and when it is OK to stop the low-fat diet.  

Foods to eat

Foods with fewer than 3 grams (g) of fat per 100 calories are considered low-fat.

Examples of low-fat foods include:

• Grains: rice, oatmeal, couscous, corn or whole wheat tortillas, whole grain pastas, pita bread, baked crackers, air popped popcorn without butter, most cold cereals, angel food cake
• Dairy Products: non-fat, low-fat or skim milk, low-fat milk alternatives, low-fat cheese, non-fat or low-fat yogurt or non-dairy yogurt, light or fat-free cream cheese, sherbet, sorbet, fat free whipped cream
• Proteins: egg whites, beans, lentils, lean cuts of meat, tofu, tuna packed in water, chicken or turkey with skin removed
• Fruits and vegetables: fresh, frozen, or canned
• Other foods: salsa, low fat salad dressings, sauces made with low-fat or non-fat milk, gelatin

Foods to avoid

Examples of high-fat foods to avoid include:

• Grains: Cookies, cakes, pies, donuts, muffins, biscuits, waffles, pancakes, potato chips, corn chips, tortilla chips, snack crackers
• Dairy Products: whole milk and 2% dairy foods, full fat cheese, ice cream, milkshakes, sour cream, butter, heavy or whipping cream and full fat dairy alternatives
• Proteins: egg yolks, meat with visible fat, bologna, hot dogs, sausage, bacon, spareribs, liver and other organ meat, chicken and turkey with skin, tuna packed in oil, any fried meat, fatty fish such as salmon, cod, trout, or sardines
• Fruits and vegetables:  avocado, coconut, fried vegetables, or fruit dipped in chocolate
• Other foods: chocolate, nuts, peanut butter or other nut butter, mayonnaise, gravy, cream sauces, regular salad dressing, butter, ghee, cooking oils, lard

Tips for low-fat meals and snacks 

• Choose foods that are baked, sautéed, steamed, or grilled instead of fried. 
• Limit toppings such as butter, cheese, sour cream, and gravy,  
• Ask for sauces and salad dressing on the side.
• Trim visible fat from meat and remove the skin from chicken and turkey before cooking. 
• Bake, sauté, steam, or grill foods instead of frying. 
• Allow fat to drip away from meat when cooking.
• Use low-fat or non-fat yogurt instead of sour cream. 
• Replace oil and butter with fat free broth. 
• Make cream-based sauces with low-fat milk or low-fat milk alternative.
• Use low-fat dressing with salads.  
• At snack time, offer fresh fruits and vegetables. Pack fruit cups or pouches or low-fat yogurt instead of chips and crackers.
• For dessert, choose nonfat frozen yogurt, low-fat dairy alternative frozen desserts, angel food cake with fat free whipped topping, low-fat pudding, or fruit.