Diet and Exercise
Diet
As with any illness, it’s important that you try to follow a diet that will give you the energy and essential nutrients your body needs to help you recover. This means basing all your meals on starchy carbohydrates (for example, oats, bread, pasta, rice and potatoes), consuming at least five portions of fruit and vegetables a day (this can include one serving of fresh fruit juice, and then any other fresh, tinned or frozen fruits or vegetables), and small portions of protein (eggs, chicken, fish, meat, cheese, milk, tofu). For example, you might have porridge with a banana and a glass of orange juice for breakfast, a tuna and cucumber sandwich followed by a yoghurt for lunch, and then a chicken breast with peas, carrots and potatoes for dinner. To help you to check you are eating properly, you could record everything you eat for a week and then check that you’ve had three meals a day, and have eaten complex carbohydrates, fruit, vegetables and protein each day.
You may have lost your appetite and you may have lost some body weight. If this is the case, and you are underweight, try to focus on eating foods that you find easy to eat (for example, softer foods like mashed potatoes, soups and custards) and that you like the flavour of. You can also try to start eating slightly bigger portion sizes. Sometimes, eating small portions of lots of different foods with different flavours and textures can help people to get their appetite back. So, if you feel ‘over faced’ by a large plate of food, you could have smaller snacks throughout the day. For example, cheese and biscuits, ice cream, cherry tomatoes, peach slices, a crumpet with butter, a glass of milk, etc. This variety of foods can help you get used to eating properly again.
You may however, find that the steroids you are taking make you feel hungry all the time. If this is the case you may start to gain weight. You can help manage your appetite by trying to stick to eating three filling meals a day, and focus on consuming foods that are low in energy density. Fruit and vegetables are all low energy density foods. They are bulky and make you feel full, but are low in energy (calories). You can add additional fruit and vegetables to each meal. For example, you can add a chopped apple to your cereal, salad onto a sandwich, or double your portion of vegetables with your evening meal. It is easier than we think to form new habits so, after a week or so, you will start to get used to these new changes.
Calcium and Vitamin D
When you’re taking steroids, you need to make sure you are having enough calcium and vitamin D. This is because taking steroids for long periods of time can make you more at risk of breaking a bone if you fall, and calcium and vitamin D help to keep bones strong and healthy. Calcium is found in large amounts in dairy products (milk, cheese, yoghurt) bread, and fish where you eat the bones (such as sardines and pilchards). Cabbage, broccoli and nuts contain some calcium, and foods like soya milk and breakfast cereals are often fortified with calcium. You should try to eat at least one food rich in calcium each day. We get most of our vitamin D from the effect of the summer sun on our skin, but during the winter months, and if you stay out of the sun or cover up your body in the summer, your stores of vitamin D can become low. Vitamin D is found in oily fish (sardines, pilchards, salmon, mackerel, trout and herrings) and eggs. Some breakfast cereals, breads and spreads are fortified with vitamin D. Your doctor may have prescribed a 800-1000 IU (10-10 microgram) vitamin D tablet to take every day, or you can buy these from most pharmacies. Make sure though, that you do not take a supplement of vitamin D in addition to the one that has been prescribed because vitamin D can be harmful when taken in high doses. You can find more about calcium and vitamin D here.
Exercise
When you’ve been feeling unwell for a while, you may not feel like getting up and about as much as you used to. Once you start to feel better, certain exercises can help you feel mobile, strong and able again. There is a list of these exercises, and pictures to show you what to do, on the NHS webpages.