Prednisone: What to eat while you are taking prednisone

Prednisone (a steroid drug) is a medication that is prescribed by your doctor to help manage disease. While you are taking prednisone, you will need to be mindful of what you eat and drink.

Prednisone has side effects, such as:

• weight gain
• increased appetite
• higher blood pressure
• higher risk of developing osteoporosis​ or steroid-induced diabetes

This article will help you understand what to eat to reduce the chances of side effects while taking prednisone.

What kinds of foods should you eat while you are taking prednisone?

While taking prednisone, eat a healthy and balanced diet including foods that are:

• low in sodium (sodium is often called salt)
• rich in calcium and vitamin D
• low in added sugar
  

Foods that are low in sodium

Many foods naturally contain sodium, but most sodium in the diet comes from added salt, either as table salt or as a preservative. Sodium is needed for many bodily functions, such as nerve and muscle function. Sodium also helps to control the amount of water in our bodies as well as our blood pressure.

Prednisone can cause your body to hold onto extra water. This causes swelling or puffines, usually around your eyes and ankles, and can also cause high blood pressure. Too much salt in your diet can make this problem worse.

How to lower the amount of sodium in your diet

These suggestions will help lower the amount of sodium in your diet:

• Do not add salt to meals or snacks.
  
• Use less salt when cooking.
• Rinse canned beans or vegetables to decrease the sodium content.
  
• Avoid foods that are processed.
• For example, foods with MSG (monosodium glutamate), hot dogs, luncheon meats, bacon and sausages, canned foods, "TV dinners" and instant meals like soup, noodles and canned or frozen pasta dishes.
• Avoid condiments high in sodium.
• For example, soya sauce, hoisin sauce, steak sauce, ketchup, salad dressing and dips. Choose lower sodium options if available.
• Choose foods that are labelled low salt, sodium free or salt free.
• Use salt alternatives for flavour more often.
• For example, fresh and/or dry herbs; spices, such as pepper, paprika and cumin; citrus, such as lemon or lime juice; and vinegar.
• Choose salt substitutes for flavour.
• For example, Mrs Dash®.

Foods that are rich in calcium and vitamin D

Prednisone increases the risk of developing osteoporosis. Osteoporosis is when bones become weak and have a higher chance of breaking. Including enough calcium and vitamin D in your diet can help maintain strong bones.

Unless fortified, foods are not generally rich sources of vitamin D, so a vitamin D supplement is usually recommended by your health-care team to optimize your vitamin D levels.

How much calcium and vitamin D do you need each day?

* You may need more vitamin D. Your health-care team will let you know how much.

Foods rich in calcium

Eat a variety of foods each day

Eating a balanced diet means eating foods from all food groups (vegetables, fruits, whole grains and legumes) every day and being careful not to eat too much or too little of certain foods. Different foods provide different types and amounts of nutrients needed for growth and development, so variety and balance are important for health.

Prednisone can make you feel hungrier. It is common to gain weight while taking prednisone. While some weight gain is needed for growth, too much weight gain can be harmful and can lead to overweight or obesity, as well as other health problems. This is why it is important to structure meals and snacks throughout the day to prevent eating too much food. Eating too much food (calories), even if it is healthy food, can cause too much weight gain.

How much food should I eat per day?

Canada’s Food Guide no longer recommends a specific number of servings of each food group per day. Instead, Health Canada encourages a colourful plate with recommendations on how to structure meals. Try incorporating these key recommendations at each meal into your daily lifestyle:

• Have plenty of vegetables and fruits (at least half of the plate for each meal and snack).
• Eat protein-rich foods.
• Proteins make up about one quarter of the plate. Choose plant-based proteins more often, such as legumes, lentils, eggs, dairy and even some whole grains like quinoa.
• Choose water to drink.
• Choose whole grains more often.
• Whole grains make up about one quarter of the plate.
• Limit foods with added sugar and processed foods.

Examples of snacks that would meet these recommendations:

• fresh fruit
• yogurt parfait made with Greek yogurt, fresh fruit and granola
• raw vegetables with dip
• grapes and almonds
• whole grain bread with unsweetened nut butter
• whole grain crackers with natural (not processed) cheddar cheese
• plain popcorn

Good food choices

This table provides examples of foods to choose more often and foods to choose less often while taking prednisone.

How to learn more about the sodium, sugar and saturated fat in the foods you eat

Reading food labels

Nutrition Facts label

Food labels will help you learn more about the products you buy and to pick better choices. It is helpful to learn how to read a nutrition label.

Serving size

The serving size on a label tells you how much of that product contains each of the nutrients below. If you eat more or less than the serving size listed, you are eating more or less of all the nutrients listed. Be mindful of serving size listed and the serving size you eat.

Major nutrients

The major nutrients, such as calories or protein, on a nutrition facts label are bolded. The nutrition facts label will tell you how much of the major nutrients there are per serving size listed.

• A low-sodium food contains less than 140 mg of sodium per serving.
• Choose foods with less than 8 g of sugar per serving as part of healthy eating and while taking prednisone.

Percent daily value (% DV)

The % DV is found on the right-hand side of a nutrition facts table. It is a guide to help you make informed food choices. It shows you if the serving size has a little or a lot of nutrient:

• 5% DV or less is a little
• 15% DV or more is a lot

Ingredients

Ingredients are listed in order of weight, from the largest to the smallest amount. When an ingredient is listed near the beginning of the list, it means that the product has a lot of this ingredient. Also, a type of ingredient can be listed more than once using a different word. For example, sucrose, glucose, fructose, dextrose, corn syrup and honey all mean sugar.

So, if the ingredient label lists salt, sodium, fats, oils or sugars near the start of the list or many times, as part of healthy eating, it is ideal to find an alternative to this product or eat the product less often or in limited amounts.

Tips at home

Being mindful when you cook

• Use non-stick pots and frying pans so less (or no) fat or oil needs to be added to prevent food from sticking.
• Avoid frying foods in oil. Instead, use an air fryer, bake, broil, roast or barbecue foods.
• Trim the fat you can see off of your meat.
• Take the skin off chicken and turkey.
• Limit adding sauces, condiments, salad dressings and gravy to your foods.

Be mindful when you eat

• Eat at the kitchen table and not in front of the TV, tablet or other screen.
• Keep the salt, butter and margerine off the table to avoid adding extra to your prepared foods.
• If you are hungry for more food after you finish your meal, have more vegetables or fruit before having a second helping of the meal./li>

Getting enough physical activity

While being aware of a varied balanced diet is important, physical activity is just as important for your health. See Physical activity: Guidelines for children and teens for the amount and types of physical activity that are recommended for your child's age.

Eating healthy together as a family

Support and encourage each other to eat healthy and live a healthy lifestyle with regular physical activity. Get your parents, brothers and sisters, friends, grandparents, babysitters, neighbours and teachers excited about the foods you are eating and the regular physical activity you participate in.

How long will you have to focus on eating foods that are low in sodium?

You need to eat foods that are low in sodium the entire time that you are taking prednisone. Usually, the amount of prednisone you take is slowly lowered and then stopped. When you stop taking prednisone, it is encouraged to continue eating foods low in sodium as this is recommended as part of a healthy eating for your entire family. Your risk of side effects from eating a diet higher in salt are lower when you stop taking prednisone, so your medical team may advise that you can be a little less strict with your salt intake. If you are restarted on prednisone, you may need to reduce the amount of sodium in your diet again.