Overhead view of a large group of all sort of food for a well balanced and healthy diet

Nutritional Considerations While on Corticosteroids

By MDA Staff | Thursday, October 12, 2023

It’s important to follow a healthy meal plan while on prednisone or deflazacort. A diet that is rich in nutrition and low in fat and sugar can counteract some of the side effects of these drugs.

Corticosteroids and neuromuscular disease

Corticosteroids are anti-inflammatory drugs. Prednisone is commonly prescribed for inflammatory conditions, such as dermatomyositis. In Duchenne muscular dystrophy (DMD), prednisone and deflazacort have been found to stabilize or improve muscle function, often allowing people to remain ambulatory for a longer time.

Side effects of corticosteroids include increased appetite and weight gain, as well as osteoporosis (porous and weakened bones). Calcium and vitamin D supplements may be recommended while being treated with corticosteroids. Speak with your MDA Care Center team to be sure you are optimizing your bone health.

Meal planning suggestions

Swelling in the extremities and weight gain are side effects of both prednisone and deflazacort, regardless of how much a person eats. However, since many people on these types of corticosteroids also have an increased appetite, they may gain additional weight from overeating. This weight gain may result in further difficulties with mobility.

Therefore, individuals taking corticosteroids should follow a healthy meal plan to maintain their weight, avoid excess weight gain, and avoid high blood sugar. It may be helpful to develop an eating schedule so they don’t become excessively hungry and overeat.

One of the culprits in this weight gain is foods high in fat. Fat is a concentrated source of calories and can add unwanted pounds quickly. Therefore, individuals on corticosteroids should limit their fat intake to less than 30% of their total calories.

They should also limit their sugar intake. Sweetened foods are usually high in calories and low in vitamins and minerals.

Low-fat, low-sugar foods

Grains:	Whole wheat breads, whole wheat tortillas, pita bread Long grain rice Wheat crackers Carrot or bran muffin, whole wheat English muffin Granola bars without frosting Rice or corn cereal without frosting Fiber cereals, grain cereals without frosting
Meats:	Lean turkey, chicken Fish, tuna in water Beef, pork Eggs (no more than three/week), egg whites Meats should be steamed, baked, broiled, or grilled, not fried.
Dairy:	Skim or 1% milk Low-fat or nonfat cheese Light cream cheese Ice milk, low-fat frozen yogurt
Vegetables:	All fresh or frozen veggies, unbreaded, including starchy vegetables, such as peas, corn, squash Beans, lentils Vegetable soups
Fruit:	All fresh or frozen fruits, no added sugar Limit fruit juice to less than 4 oz per day.
Fat:	Light salad dressing, light mayonnaise Canola or olive oil spray Limit to three teaspoons of added fat per day.

Healthy, low-calorie snacks

To decrease hunger, consider between-meal snacks with these low-calorie foods that have the added benefit of fiber:

Raw vegetables
Fresh fruit
Canned fruit in juice
Non-frosted breakfast cereal
Rice cakes
Low-fat crackers
Cheese-flavored puffs (such as Pirate’s Booty)
Light popcorn
Pretzels
Graham crackers
Animal crackers
Ginger snaps
Light yogurt
String cheese
Fat-free pudding
Wheat tortilla
Deli meat roll-ups
1/2 sandwich

Consider supplementing a snack or meal with these low-calorie options:

Mustard
Ketchup
Light salad dressing (such as Bolthouse Farms yogurt dressings)
Pickles
Celery
Broth
Club soda/soda water
Unsweetened tea
Coffee
Chicory and grain coffee substitute (such as Postum)
Diet drinks
Fruit juice Popsicle
Sugar-free Kool-Aid
Sugar-free Jell-O
Unsweetened cranberries
Unsweetened rhubarb

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, choose dairy foods that are low in fat to avoid excessive calorie intake.

To ensure adequate intake of both calcium and vitamin D, consider a vitamin supplement.

Here are some low-fat foods that are high in calcium and vitamin D:

Milk
Yogurt
Cheese
Tofu
Cooked soybeans
Boiled white beans
Salmon
Sardines
Corn tortillas
Almonds
Broccoli
Mushrooms grown in the sun
Calcium-fortified juice
Calcium-fortified bread
Calcium-fortified soy milk
Calcium-fortified health bars
Calcium-fortified cereal

Calcium requirements by age

mg = milligrams

Age	Calcium Requirements
0-6 months	200 mg
7-12 months	260 mg
1-3 years	700 mg
4-8 years	1,000 mg
9-18 years	1,300 mg
19-50 years	1,000 mg

Adapted from the National Institutes of Health.

Sample daily meal plans

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 with jelly 4 oz juice 1% milk
LUNCH	Ham sandwich 8 crackers Fruit cup Water or flavored water	Turkey sandwich Carrot sticks Apple Water or flavored water	1 c soup 8 crackers Salad with light dressing Water or flavored water
SNACK	1 small tortilla 1 slice cheeseFlavored water or flavored club soda	1/2 c unsweetened cereal 1 TB peanut butter and 4 crackersFlavored water or flavored club soda	3 oz 1% milk Flavored water or flavored club soda
DINNER	Chicken breast 1/2 c rice Salad with light dressing 4 oz 1% Milk	Steak 1/2 c potato Green beans4 oz 1% Milk	1 slice meatloaf 1/2 c corn or carrots 1/2 c beans 4 oz 1% Milk
SNACK	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream

DAY	4	5	6	7
BREAKFAST	1/2 c oatmeal 1 slice toast Fruit 1% milk	1 small muffin Fruit 1/2 c low-fat cottage cheese4 oz juice	2 pancakes Low-sugar syrup 1% milk	2 eggs Turkey bacon 1 slice toast with jelly
LUNCH	PB&J sandwich Pretzels 8 oz 1% Milk	1 slice pizza Salad with light dressingWater or flavored water	Roast beef sandwich Fresh veggies Light salad dressingWater or flavored water	1 Lean Pocket frozen sandwich Banana Water or flavored water
SNACK	1 oz Pirate’s Booty or Skinny Pop Low-fat puddingFlavored water orflavored club soda	2 oz yogurt tube Flavored water or flavored club soda	1 cheese stick Flavored water or flavored club soda	Flavored water or flavored club soda
DINNER	1 c chili 8 crackers Salad with light dressing 4 oz 1% Milk	Pork chop 1/2 c potato Salad with light dressing 4 oz 1% Milk	4 oz hamburger with one slice of cheese on a whole wheat bun 5 wedge fries Salad with light dressing 4 oz 1% Milk	1 taco 1/2 c rice 1/2 c beans 4 oz 1% Milk
SNACK	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream

DAY	8	9	10	11
BREAKFAST	1/2 c unsweetened cereal 1/2 banana 1% milk	1/2 bagel with jelly Mixed fruit 1/2 c yogurt or 1% milk	English muffin with jelly 4 oz juice 1% milk	1/2 c oatmeal 1 slice toast 1 fruit 1% milk
LUNCH	Burrito Salad with light dressing Water or flavored water	4 oz hamburger with one slice of cheese on a whole wheat bun Grapes Water or flavored water	Turkey sandwich Carrots Graham crackers Water or flavored water	Ham Sandwich Fruit Carrots Water or flavored water
SNACK	Popcorn 1 tortilla with cheeseWater	1/2 c unsweetened cereal Water	Pretzels 3 oz 1% milk	1 oz Pirate’s Booty or Skinny Pop Water
DINNER	1 c spaghetti 3 meatballs Salad with light dressing 4 oz 1% Milk	1/2 c mac ‘n cheese 3 oz meat Mixed Veggies Fruit Flavored water or flavored club soda	Baked chicken 1/2 c rice Salad with light dressing Flavored water or flavored club soda	1 c beef stir fry 1/2 c rice Broccoli Fruit Flavored water or flavored club soda
SNACK	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream

DAY	12	13	14
BREAKFAST	1 small muffin Fresh fruit 1/2 c low-fat cottage cheese 4 oz juice	2 pancakes Low-sugar syrup 4 oz 1% milk	2 eggs Turkey bacon 1 slice toast with jelly 4 oz 1% milk
LUNCH	PB&J sandwich 8 crackers AppleWater or flavored water	Quesadilla Salsa Fruit Water or flavored water	Hot dog Pretzels Fruit Water or flavored water
SNACK	1/2 c low-fat pudding Flavored water or flavored club soda	2 oz yogurt tube Flavored water or flavored club soda	Flavored water or flavored club soda
DINNER	1 tostada with lettuce and tomato 1/2 c rice Flavored water or flavored club soda	1 slice pizza Salad with light dressing Fruit Flavored water or flavored club soda	4 oz turkey 1/2 c mashed potatoes Steamed vegetables Fruit Flavored water or flavored club soda
SNACK	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream	1/2 c applesauce or fruit with 2 T low-calorie whipped cream

Adapted from the National Institutes of Health.

If you need help personalizing a diet plan or brainstorming ideas that would work for your or your child’s individual preferences and needs, make an appointment with a registered dietician. Your MDA Care Center may have a dietician on their multidisciplinary care team or can refer you to one.