Nutritional Considerations While on Corticosteroids

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

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

Adapted from the National Institutes of Health.

Sample daily meal plans

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.