Of all the side effects that corticosteroids can cause, excessive weight gain probably concerns patients and families the most. In MD, it can also have a serious adverse effect on motor function.
Nancy Hunter, a registered dietician and nutrition support counselor at Children’s Clinics for Rehabilitative Services in Tucson, Ariz., works with MDA clinic director Tim Miller and routinely sees children taking prednisone.
Weight gain caused by prednisone must be fought the same way all other weight gain is combated — by a healthier diet.
“The primary dietary intervention for kids is the parental focus,” Hunter says. “If the parents make environmental changes and healthy lifestyle changes, managing the amount of and the types of foods they give and rearranging what they used to do, the child will more likely follow healthy dietary recommendations.”
Hunter doesn’t recommend that parents weigh and measure food or count calories. Not only is that a burden to parents, she says, but “it really feels stressful to the child that the parent is measuring every little piece they eat.”
Instead, she focuses on making the right foods available and controlling portions.
“We use the plate method. Half of a standard 7-inch plate should be vegetables; one-fourth is carbs and one-fourth is protein. So you get the bulk of your plate from things that are not as calorically dense. The plate method works better than counting calories.”
Hunter teaches parents strategies for managing “hunger episodes” with small, frequent servings of fibrous foods that are low in calories, like fruits and vegetables.
“You can also do low-calorie or no-calorie drinks, or any kind of sugar-free dessert item, like diet gelatins, diet puddings, in certain portions; chewing gum; anything that will keep them kind of on the full side but not give them a significant amount of calories.”