Nutritional Considerations While on Corticosteroids

by Margaret Wahl on May 1, 2007 - 3:01pm

Side effects of prednisone and other corticosteroids include increased appetite and weight gain, as well as osteoporosis (porous and weakened bones). Appropriate nutritional supplements while being treated with prednisone include calcium and Vitamin D.

Meal planning suggestions

Weight gain is a side effect of prednisone regardless of how much a person eats. However, since many people on prednisone also have an increased appetite, they may gain additional weight from overeating. This weight gain may result in further difficulties with mobility.

Therefore, recommendations for individuals taking prednisone suggest following a healthy eating plan to maintain your weight, avoiding excess weight gain, and avoiding high blood sugar. It may be helpful to develop an eating schedule, so that you won’t overeat from becoming excessively hungry.

One of the culprits in this weight gain is fat. Fat is a concentrated source of calories and can add unwanted pounds quickly. Therefore, your intake of fat should be limited (to less than 30 percent of total calories consumed).

Furthermore, if you’re watching your weight, you’ll want to limit your intake of sugar. Sugar and concentrated sweets are usually high in calories and low in vitamins and minerals.

Low-fat, low-sugar foods

Breads:	whole wheat breads, long grain rice, whole wheat tortillas, pita bread carrot/bran muffin, wheat English muffin, wheat crackers granola bars without frosting, rice or corn cereal without sugar fiber cereals, grain cereals without frosting
Meats:	lean turkey, fish, chicken, beef, pork, tuna in water, eggs (no more than 3 per week). These should be steamed, baked, broiled, grilled, not fried.
Dairy:	skim or 1 percent milk, low fat or nonfat cheese, ice milk, low fat frozen yogurt, lite cream cheese
Vegetables:	all fresh or frozen that are unbreaded, including starchy vegetables, such as peas, lima beans, corn, squash, lentils, beans vegetable soups
Fruit:	all fresh or frozen fruits Limit fruit juice to less than 4 ounces per day.
Fat:	low calorie salad dressing, lite mayo Limit to three teaspoons of added fat per day.

Healthy, low-calorie snacks

To decrease the hunger urge, consider between-meal snacks with low-calorie, higher-fiber snack foods.

raw veggies
fresh fruit
canned fruit
dry cereal
low fat crackers
lite popcorn
pretzels
lite yogurt
graham crackers
open-face sandwich
animal crackers
ginger snaps
fat-free pudding
fruit juice Popsicle
wheat tortilla
cheese

Calorie-free foods

broth
club soda/soda water
tea
coffee
chicory and grain coffee substitute (Postum)
diet drinks
sugar-free Kool-Aid
sugar-free Jell-O
pickles
unsweetened cranberries
celery
unsweetened rhubarb
sugar-free Popsicles

Calcium and vitamin D

Adequate calcium and vitamin D intake may decrease the possibility of developing osteoporosis. Since many calcium-containing foods are dairy-based, dairy foods chosen should be low in fat, to avoid excessive calorie intake.

To ensure adequate intake of both calcium and vitamin D, a vitamin supplement may best meet your needs.

Low-fat foods high in calcium and vitamin D

milk
yogurt
ice cream
cheese
tofu
cooked soybeans
boiled white beans
salmon
sardines
corn tortillas
almonds
broccoli
calcium-fortified juice
calcium-fortified bread
calcium-fortified soy milk
calcium-fortified health bars
calcium-fortified cereal
Instant Breakfast

Calcium requirements by age

mg = milligrams

Age	Calcium Requirements
0-6 months	210 mg
7-12 months	270 mg
1-3 years	500 mg
4-8 years	800 mg
9-13 years	1,300 mg
14-18 years	1,300 mg
19-30 years	1,000 mg

Adapted from material of the Children’s Clinic for Rehabilitative Services, Tucson, Ariz., 2006.

Daily meal plan

DAY	1	2	3
BREAKFAST	1/2 c unsweet cereal 1/2 banana 1% milk	1/2 bagel with jelly mixed fruit 1/2 c yogurt or 1% milk	English muffin 4 oz Jc Jelly 1% milk
LUNCH	Ham sandwich 8 crackers Frt cup 1/2 c Water	Turkey sandwich Carrot sticks apple 1 Water	1 c Soup Salad 8 crackers Water
SNACK	Diet Drink 1 small Tortilla 1 TB peanut 1 sl cheese	Diet Drink 1/2 c Cereal Butter and 4 crax	Diet Drink Sugar Free/ 3 oz 1% milk
DINNER	Chick breast 1/2 c Rice Salad/lite dressing Water or 4 oz 1% Milk Flavored water	Steak 1/2 c Potato Green Beans Water or 4 oz 1% Milk Flavored water	1 sl meatloaf 1/2 corn Carrots 1/2 c Beans Water or 4 oz 1% Milk Flavored water
SNACK	Fruit/Diet Jell-O	Fruit/Diet Jell-O	Fruit/Diet Jell-O

Daily Meal Plan continued

DAY	4	5	6	7
BFAST	1/2 c oatmeal 1 toast 1 fruit 1% milk	1 small muffin Fresh fruit 1/2 LF Cott cheese 4 oz jc	Pancake 2 Low sugar syrup 1% milk	Eggs (2) Turkey bacon 1 toast jelly
LUNCH	PB & J sandwich pretzels 1% Milk 8 oz	1 sl Pizza Salad Diet Drink Lite Salad dress	Roast Beef Swch fresh veggies Diet Drink Lite Salad Dress	1 Lean Pocket Banana Diet Drink
SNACK	Diet Drink 1 oz Cheetos Low Fat Pudding	Diet Drink 1 Gogurt	Diet Drink 1 cheese stick	Diet Drink
DINNER	1 c Chili Crackers Salad/lite dressing Water or 4 oz 1% Milk Flavored Water	Pork Chop 1/2 c Potato Salad/lite dressing Water or 4 oz 1% Milk Flavored Water	Cheeseburger 5 wedge fries Salad/lite dressing Water or 4 oz 1% Milk Flavored Water	1 Taco 1/2 c Rice + 1/2 c Beans lettuce, tomato onion Water or 4 oz 1% Milk Flavored Water
SNACK	Fruit/Diet Jell-O	Fruit/Diet Jell-O	Fruit/Diet Jell-O	Fruit/Diet Jell-O

Daily Meal Plan continued

DAY	8	9	10	11
BFAST	1/2 c unsweet cereal 1/2 banana 1% milk	1/2 bagel w/ jelly mixed fruit 1/2 c yogurt or 1% milk	English muffin 4 oz Jc Jelly 1% milk	1/2 c oatmeal 1 toast 1 fruit 1% milk
LUNCH	1 burrito Salad Lite Dressing Diet Drink Water	1 chzburger lettuce/tomato Grapes Diet Drink Water	Turkey sdwch Carrots gram crax Diet Drink Water	Ham Sdwch Fruit Carrots Diet Drink Water
SNACK	Diet Drink Popcorn 1 Tortilla	Diet Drink 1/2 cereal W/ cheese	Diet Drink Pretzels 3 oz 1% milk	Diet Drink 1 oz Cheetos
DINNER	1 c Spaghetti 3 meatballs Salad Lite Dressing Diet drink, water or 4 oz 1% Milk	1/2 C Mac n Chz 3 oz Meat Mixed Veggies Fruit Diet Drink or Water	Baked chicken 1/2 c Rice Salad Lite Dressing Diet Drink or Water	1 C Beef Stir Fry 1/2 C Rice Broccoli Fruit Diet Drink or Water
SNACK	Diet Jell-O	Diet Jell-O	Diet Jell-O	Diet Jell-O

Daily Meal Plan continued

DAY	12	13	14
BREAKFAST	1 small muffin Fresh fruit 1/2 LF Cott cheese 4 oz jc	Pancake 2 Low sugar syrup 1% milk	Eggs (2) Turkey bacon 1 toast, jelly 4 oz 1% milk
LUNCH	PB & J 8 crax apple Diet Drink Water	Quesadilla salsa Fruit Diet Drink Water	Hot Dog Pretzels Fruit Diet Drink Water
SNACK	Diet Drink Diet Pudding 1/2 c	Diet Drink 1 Gogurt	Diet Drink
DINNER	1 Tostado 1/2 c Rice Lettuce, Tomato Diet Drink or Water	1 sl Pizza Salad Lite dressing Fruit Diet Drink or Water	4 oz Turkey 1/2 c Mashed Potato Steamed Vegetable Fruit Diet Drink or Water
SNACK	Diet Jell-O	Diet Jell-O	Diet Jell-O

Source: Children’s Clinic for Rehabilitative Services, Tucson, Ariz., 2006.

Housing		Independence
Personal Stories		Psychological Factors
Service Animals		Safety
Legislation and Policy		Taxes

College And Beyond		Learning Disabilities
IEP and 504 Plans		MDA Summer Camps
Transition Programs

Diagnosis and Genetics		Drugs
Insurance and Costs		MDA Clinics
Medical Procedures		Exercise and Sports
Nutrition

Adolescents and Young Adults		Children with an MD
Parents with an MD		Siblings

Research Administration		Endocrine Myopathies
Metabolic Diseases of the Muscle		Motor Neuron
Muscular Dystrophies		Neuromuscular Junction
Other Myopathies		Research Updates
General Research		Diseases of the Peripheral Nerve
Inflammatory Myopathies		Clinical Trials and Studies