3+ Foods to Avoid While on Prednisone

This article continues the prednisone weight gain series.  In the past, I shared how prednisone causes weight gain. We’ve also talked about the consequences of weight gain. Today, I am going to share which foods to avoid while on prednisone to prevent prednisone weight gain.

Find out one surprising food group NOT on this list!

Watch my video and learn about foods to avoid.

Watch Which Foods to Avoid While on Prednisone now!

Sometimes it feels like no matter what we eat while on prednisone, we will gain weight. But that’s not true. Some foods are worse than others for people taking prednisone. Some foods are practically poisonous for prednisone patients. (That’s a lot of P’s!)

First of all, if you remember for the last few weeks the #1 problem that prednisone is causing the metabolic change, the change in your metabolism is that prednisone is causing your sugar to be retained. Lots of different ways but the #1 problem is high blood sugar and that is what causes the weight gain. So what do we do to prevent that? What food should you avoid while on prednisone?

Foods to Avoid While on Prednisone:

#1 Sugar

First of all, we focus on sugar and avoiding it.  Sugar is basically poison to people taking prednisone; especially simple sugar like white sugar, white rice, white flour, those refined carbohydrates that your great-great-grandmother has never heard of. She has never seen things like candy in wrappers. We need to focus on foods that she would recognize. We need to stay out of the middle of the grocery store and focus on traditional foods that people have eaten for millennia. Only the real foods, whole foods: that is how we can avoid having too much sugar. So what exactly aside from flour and sugar am I talking about?

I am talking about things that come out of the bakery like bread, rolls, boggles, donuts, or all those good delicious things. Especially, when they’re made of white flour.  They’re really bad for us especially when we are on prednisone. They turn right into sugar and straight into fat and all of those horrible consequences of high blood sugar.

• Food Examples

• Bakery: Cookies, Cakes, Bread, Donuts, Rolls
• Candy
• Soda Pop
• Syrup, Jelly
• Chips, Crackers
• Instant Boxed Dinner
• Pasta
• “Fat-Free”

#2 Salt

Next, is sodium which we usually call salt or table salt. It can also be found in monosodium glutamate or MSG. Those food are really hard for our kidneys while we are on prednisone.

Prednisone causes your body to retain sodium and get rid of potassium. Eating extra sodium in your diet makes it hard for your kidneys to keep up. Too much salt leads to sodium retention and water weight.

Food Examples

• Bread
• Chips, Crackers
• Instant Boxed Dinner
• Pasta, Sauce
• Preserved Meat
• Canned Food
• Pizza
• Processed Cheese
• Frozen Meals

#3  Caffeine

There is no high evidence that caffeine can cause prednisone weight gain, so you may take this “with a grain of salt.”  The reason why this is mentioned because caffeine can increase your risk for osteoporosis and prednisone is the #1 cause of osteoporosis. There are only a few side effects to prednisone that are permanent. Prednisone-induced osteoporosis is one of the few permanent side effects.  That Bone Loss will never come back!

So it’s best to prevent it and having caffeine, like coffee or caffeinated soda pop, is likely detrimental to your bone health.

Food Examples

• Coffee
• Soda

Food Examples

• Caffeine can worsen bone loss, which is one of the most permanent and irreversible side effects of prednisone.
• Most caffeinated beverages are also high in sugar, which is the #1 food to avoid.

#4  Alcohol

The last food to avoid while on prednisone is alcohol. Just like caffeine, there is no high evidence for this as well but it causes two theoretical problems.  Alcoholic beverages like beer are also high in sugar that can lead to prednisone weight gain. So it’s best to avoid caffeine and alcohol.

Food examples

• Alcohol can decrease bone mass.
• Beer contains carbs which can lead to weight gain.

Why?

• Alcohol can decrease bone mass.
• Beer contains carbs which can lead to weight gain.

Surprise Foods

What is NOT listed to avoid while on Prednisone?

Therefore, it is not about the high-fat foods, but we need to be concerned with the sugary things! That’s what we need to worry about: high blood sugar. I hope you can eat more healthfully now that you know which foods make prednisone weight gain worse!

Fat

• Unsaturated
• Saturated

Food examples

• Butter
• Uncured Meats
• Coconut Milk
• Olive Oil

Avoid: vegetable oils, margarine, fat substitutes

Which food should I avoid while on Prednisone? Video Transcript

Transcription autogenerated from the video above so some errors are possible.

What foods can I eat while on Prednisone?

If you’re prescribed prednisone and you want to know “can I eat eggs, coffee, chocolate, yogurt?” 

I’m Dr. Megan, your Prednisone Pharmacist and I’ve personally taken prednisone and I’ve been helping people on prednisone for years now. So I’d like to answer that question first with a general recommendation.

Finally, with specific answers to your food questions, and then conclude with the best way to really take prednisone.

 So the general recommendation, according to this scientific article that was published in 2022, nutritional recommendations for people who have to take prednisone a long time, it says that the most important thing is a decreased consumption of ultra processed foods. 

What does that mean?

It means to eat less of foods that are processed in a plant. Basically, if you are buying food and it comes in a package from the perimeter of the grocery store. You don’t want that. 

You don’t want the foods that’s in the interior portion of the grocery store. So boxed cereals, boxed pasta, basically anything in a box. All of those types of things.

And then we don’t want chips, cookies, bakery foods that are ultra-processed. 

If you can find something that’s straight “freshly ground whole grain wheat”, then great. But if it’s white bread with sugar added. We want to completely avoid that type of food because that’s ultra-processed. It removes all of the extra parts of the bran of the wheat, all of the extra parts of the sugar and it’s just very few nutrients that you’re getting. 

We want to avoid ultra-processed foods. So essentially to sum that all up, avoid sugar and avoid salt. Because those are high in ultra-processed foods. 

So no more Oreos. No more bags of chips.

Even though that’s actually what our bodies crave when we’re on prednisone.

Our bodies are being driven to get high-calorie, highly palatable, delicious foods. It’s a false signal that we’re receiving because our bodies are taking prednisone. Prednisone mimics a hormone art that’s naturally occurring called cortisol that is normally only in high amounts during complete emergencies like a famine or a war.

Since you’re not and either famine or a war, you don’t need to be stockpiling all of these calories. Right? You’re in a healthy safe place. 

What else should we avoid while on prednisone?

We should avoid sugar, salt, and coffee because coffee can really be stressful for the adrenals and can worsen osteoporosis. 

And same with alcohol. We want to avoid alcohol while on prednisone.

 I have a whole video blog post all about that if you wanna learn more specifically about alcohol and prednisone and all of the complications of taking the combination. 

So then let’s move on to specific food questions you may have when it comes to, “can I take prednisone with this food?”

Can I take prednisone with bananas?

Yes, you can take prednisone with bananas. Bananas are a great food to eat while on prednisone. Since they’re high in potassium, fiber and they’re kind of filling as far as a fruit goes. We don’t want to only eat fruit, we want to balance it out. But bananas are a great food to eat with prednisone. 

Can I eat prednisone with eggs?

Yes, you can eat prednisone with eggs. Eggs are a great food to eat with prednisone. They are high in protein, good fats, and lot of other nutrients that you need while on prednisone. 

So yes, go ahead and eat prednisone with eggs. The one thing is you want to avoid a lot of extra salt when you’re making your eggs. Just use the minimum amount of salt possible while preparing your eggs.

Can I eat prednisone with caffeine?

We want to avoid caffeine. Coffee things if at all possible while on prednisone. With the understanding that you might be rather exhausted if you’re tapering and going through withdrawals, so you wanna stay alive.

And if caffeine is the only thing keeping you awake, then it’s understandable. But try to minimize it at all possible. Along with the caffeine, most sources of caffeine are highly processed, ultra-processed foods like Coke, or any carbonated beverage. Those are ultra-processed made with high fructose corn syrup often, or even the low versions are really not good for people on prednisone either.

So if at all possible, stay off caffeine, soda carbonation, soda pop, whatever you call it while on prednisone. 

Can I take prednisone and eat milk with it?

Yes, you can drink milk when you’re taking prednisone. It’s best to use, but keep milk in moderation. Have other beverages preferably water in addition, but milk is just fine.

And one great thing about milk is the calcium. Because when we’re on prednisone, we are losing calcium. And so there is calcium and milk.

Can I eat yogurt with prednisone?

Yes, you can eat yogurt with prednisone. Yogurt is a great source of protein, fat, calcium and probiotics. Those are all good things, as long as you’re using the most minimally processed yogurt possible.

Avoiding the sugar-laden things like yoplait and going for a more simple minimal list of ingredients in yogurt. It’s best if it’s really just milk and the bacteria. If you can do something with just those two ingredients, that’s the best you can make your own yogurt. That’s even better, but having the lowest amount of sugar added. Plain yogurt is the very best way to get yogurt while on prednisone.

Are tomatoes okay while on prednisone?

Unless you have some weird issue that is a dietary problem that I’m not aware of, yes. As far as prednisone goes, tomatoes are a great option. They’re rich in all of the nutrients that we need while on prednisone.

Go ahead and enjoy those fresh garden tomatoes. Mine were also delicious this year. Made some salsa and tomato soup, so yes, go ahead and enjoy fresh garden tomatoes while on prednisone.

Can I eat ice cream while on prednisone?

This is a generally considered ultra-processed, calorie-dense food that you want to crave so much while on prednisone. Ice cream, unfortunately, should be avoided. Because it’s generally just refined milk, refined sugar, all of the ingredients are really refined. If you have a way of eating it that doesn’t include lots of added sugar, that might be better. But generally, we want to avoid ice cream while on prednisone. 

Can I eat chocolate while on prednisone?

 Most sources of chocolate are ultra-processed, highly refined, and not a good choice. But if you can find a type of chocolate, for example; dark chocolate with very minimal added sugar and really high-quality ingredients. 

Generally a more expensive kind, then that’s possible to take with prednisone. But usually chocolate is like a gateway drug to other highly refined foods that we love to eat and we’re craving even more than usual while on prednisone. So it’s best to avoid chocolate. 

 But if you can find a really high-quality one, and that works with your body; your doctor and decide whether that’s best for you.

If there are any other foods you’re wondering, “can I take prednisone with blank?” 

I would love to know what other food you’re wondering about and answer those questions. 

The final conclusion is; now that we know all of this after covering all of these food-related questions when it comes to prednisone.

What is the best way to take prednisone? Should I eat food with it or not?

When I went through pharmacy school, the general advice given to pharmacists to share with patients taking prednisone is, “Always take prednisone with food”. 

The point of that is that theoretically taking prednisone with food would decrease your risk of gastric ulcers like holes in your gut.

But the evidence hasn’t actually shown that to be true. It’s probably more likely to be a drug interaction between prednisone and ibuprofen. 

Avoiding ibuprofen is probably a good idea, but if taking prednisone with food is causing you to delay taking the prednisone, then we want to avoid that. 

Going back to the fact that prednisone is mimicking our natural hormone cortisol and your body actually normally makes cortisol in a beautiful rhythm throughout the day, and usually, it gets higher and higher and higher as the sun is about to come up. And then usually the highest moment is at sunrise and then it slowly decreases throughout the day. 

I’m gonna quote a scientific article about this. 

“To mimic the normal diurnal rhythm that’s like that circadian rhythm cycle of it being high in the morning and low at night one would ideally take prednisone immediately before waking. Which is not possible. Taking prednisolone after breakfast causes an unnecessary delay and does not improve absorption. We would advise taking prednisone immediately upon waking before breakfast to produce a detectable concentration of prednisone as early as possible.”

You can’t actually take prednisone before waking, because you’re asleep

Another study I read said food does not affect either tablet with respect to mean plasma prednisolone concentrations. Taking it with or without food doesn’t increase the amount of prednisone you’re getting.

There’s no point according to the absorption of the drug itself. We don’t need to do that. 

So I’m gonna repeat that again, “taking Prednisolone after breakfast causes an unnecessary delay and does not improve absorption”.

It’s very best to take prednisone immediately upon waking.

If that means putting the pill bottle right by your bed and the glass of water ready in the morning, take that prednisone, and swallow it. That’s the very, very best way to take it. 

But every single person is different. Every person’s disease situation is different. 

There are some people who need to take it at bedtime, and that is something you need to work out with your doctor.

But for the general population, you should take it first thing in the morning immediately upon waking with some water to swallow it and then eat a healthy breakfast thereafter. That is how to take prednisone. 

And if you’re wondering;

Now I know what foods to avoid, what nutrients do I need?

I have a download of all of the nutrients that you need while on prednisone.

It’s a one page printable and you just click the link below and I will email it to you immediately and you’ll know exactly what nutrients you do need instead of what to avoid while on Prednisone signing off as Dr. Megan, your Prednisone pharmacist.