There is little known about the optimal diet during corticosteroid therapy. Your eating habits should depend on your age, pre-existing conditions you may have (diabetes, etc) and the cortisone prescribed (dose, duration). Your diet will also depend largely on your physician’s expertise based on your personal case.
A low salt diet is sometimes recommended to patients, even though all doctors do not agree because this recommendation lacks a strong scientific backing. The prescription of such a regime depends largely on the experience of your doctor. Nonetheless, most medical professionals agree that a strictly low-salt diet may cause more harm that good. This is of particular concern to elderly patients receiving cortisone at doses of less than 15-20 mg per day.
A low-carb diet is also recommended in order to limit weight gain and the possibility of diabetes caused by cortisone treatment. There is no data on whether only simple sugars (e.g. candy, soft drinks) should be limited or if this recommendation also applies to carbohydrates (e.g. pasta, potatoes). A low-carb diet can be beneficial to certain patients. However, 25-45% of doctors rarely recommend this when prescribing steroid treatment.
A high protein diet may be prescribed. The objective of this change could be to limit the risk of muscle wasting caused by cortisone. No data exists that supports this benefit of increased protein intake. However, it should be taken into consideration depending on the patient.
Reducing overall calorie intake can help you avoid or limit weight gain caused by cortisone use. However, a diet without enough calories is hard to maintain in the medium to long term, particularly because of the hyperphagia triggered by corticosteroids.
If adverse side effects are experienced, your doctor may advise you to alter your diet.
Good to know
- Despite conventional wisdom, there is no diet type that is to be prescribed in association with systemic corticosteroids. The best diet is one that is balanced, complete with three meals daily. Avoid skipping meals and snacking between them.
- If the diet that is prescribed to you seems restrictive and makes you keen to stop or reduce your corticosteroid therapy, please inform your doctor. It is better (and easier) to first alter your diet rather than altering the cortisone treatment as a whole!
- Perdoncini-Roux A et al. Mesures adjuvantes à une corticothérapie systémique prolongée Pratiques des médecins généralistes français Rev Prat. 2009
- Fardet L et al. Mesures adjuvantes à une corticothérapie systémique prolongée : description des pratiques des médecins internistes français. Rev Med Interne. 2008
- Arena C et al. Impact of glucocorticoid-induced adverse events on adherence in patients receiving long-term systemic glucocorticoid therapy. Br J Dermatol. 2010