Weight gain on prednisone

Weight Gain: The Unwanted Side Effect of Prednisone for UC

If you have ulcerative colitis (UC), you’re likely familiar with corticosteroid drugs like prednisone, powerful anti-inflammatories that are very effective at reducing inflammation quickly during a flare.

But prednisone comes with a range of unwelcome side effects, one of which is weight gain.

According to a review published in August 2013 in the journal Allergy, Asthma & Clinical Immunology, weight gain from prednisone can appear as fat deposits on various parts of your body, such as at the base or back of your neck, around your abdomen, or as what’s called “moon face,” when changes in where fat lies make your face appear rounder and wider.

The Connection Between Prednisone and Weight Gain

Weight gain in people taking prednisone is linked to how long you take the drug, says Rudolph Bedford, MD, gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California. The longer you’re on prednisone, the more likely you are to gain weight. Why does this happen? First, says Dr. Bedford, prednisone increases your appetite. A report published in December 2013 in the Journal of Pharmacology & Pharmacotherapeutics states that 70 percent of patients taking corticosteroids report boosted appetite.

Prednisone also causes fluid retention, which leads to swelling, often of the hands, legs, and feet, along with the face. Prednisone may also interrupt a normal sleep-wake cycle, leading to inadequate sleep and a disruption of the hormones that help regulate appetite, says Kate Scarlata, RDN, a Boston-based dietitian.

If weight gain is particularly bothersome to you, talk to your doctor about modifying your drug regimen. You should never stop taking the drugs on your own. Steroids need to be tapered slowly under your doctor’s guidance. According to the Hospital for Special Surgery, rapid withdrawal of steroids my cause fatigue, joint pain, muscle stiffness, or fever.

Your doctor may be able to prescribe a different corticosteroid, like budenoside. This alternative is “quickly metabolized by the liver, thereby reducing corticosteroid-related side effects, and appears to be as effective as prednisone,” says Bedford.

How to Control Weight Gain on Prednisone

Employing a few simple nutritional strategies while you’re on prednisone can help you avoid the worst of the weight gain — and stay healthier overall, says Scarlata.

Reduce sodium intake. Minimizing canned and processed foods, soy sauce, cold cuts, chips, and other salty snacks is smart because high-sodium foods contribute to water retention.

Choose low-calorie sources of calcium. Another prednisone side effect is the risk for bone mineral loss, so boosting calcium intake is important. But be careful about which calcium-rich foods you’re consuming. Some, like whole milk, also contain a lot of fat. Instead, try lower-calorie sources of calcium, like low-fat dairy, broccoli, kale, and chia seeds, says Scarlata, and consider a supplement.

Consume more potassium. “Increased potassium intake can combat water retention,” notes Bedford. Good sources of this important mineral include oranges, grapefruit, bananas, kiwifruit, spinach, collard greens, and tomatoes.

Opt for healthy fats. Don’t fall into the trap of low-and-non-fat-everything, Scarlata says. Small portions of healthy fats boost nutrition and help control hunger between meals. “Include a small handful of nuts, seeds, olive oil, fatty fish — like salmon or tuna — or avocado at every meal, as tolerated.”

Finally, says Scarlata, be aware that steroids’ hormonal regulation of hunger cues may make you feel hungry even when you’re not. For this reason, you should try to eat regularly-timed meals, she says. “If you let yourself get over-hungry, you’ll feel less in control and more likely to overeat.”

Rheumatoid Arthritis Foundation

Body Fat Redistribution

Prednisone not only causes weight gain, it can result in a phenomenon known as fat redistribution. This means fat deposits collect in unusual areas, such as the back or base of your neck, according to the Johns Hopkins Vasculitis Center. These can sometimes be mistaken for lymph nodes on the neck. If you experience this weight gain type, speak to your physician. Your physician may recommend decreasing your dosage, which can reduce the redistribution effect.

Significance

Weight gain with Prednisone often is related to how long you have been taking the medication and how much you are taking, according to the University of California San Francisco Medical Center. This is because taking Prednisone can increase your appetite. As you eat more over time, you gain more weight. Also, your body retains more fluid while taking Prednisone, causing you to experience water retention and swelling. If you have an inflammatory condition that may restrict movement, this can mean you are inactive for a period of time, resulting in added weight gain.

Prevention

You can take steps to prevent prednisone-related weight gain. Avoid foods that are high in sodium, such as fast foods, chips, prepackaged foods and canned and frozen foods because these cause you to retain water. Increased potassium intake can combat water retention. Choose foods such as baked potatoes, bananas, dates, grapefruits, oranges, raisins, stewed tomatoes and tomato juice. Eating several smaller meals per day can help you feel fuller, longer. Increasing your protein intake — foods like skinless chicken, fish and soy — also can help you feel fuller, longer.

Warning

Taking Prednisone over a long period of time can decrease your adrenal gland production of steroids. This means if you cease taking or skip a dosage of Prednisone, you could experience serious side effects. If you are concerned about your weight gain related to taking Prednisone, talk to your physician about your medication options and concerns. Your physician also may recommend a specific diet and exercise program tailored to helping you maintain a healthy weight.

Myths and Misconceptions of Steroid Shots

Steroids, (short for corticosteroids), are very commonly used to treat inflammation in the body. Steroids are prescribed for a variety of illnesses including asthma, acute illnesses such as strep throat and for joint problems including arthritis. In general, steroids decrease the body’s immune responses which in turn, work to decrease inflammation.

Steroids can be taken by mouth, injected into a muscle, or injected directly into a joint, depending on the diagnosis from a physician. Steroids, when taken orally, distribute very small doses of the medicine throughout the body over time. However, by injecting the steroids, a powerful dose of medication is directed either into the bloodstream or sometimes directly at the source of the inflammation. Because of the strong, quick effects, steroid shots are often the preferred treatment to alleviate pain and inflammation more rapidly.

Corticosteroids are different from anabolic steroids. Anabolic steroids are synthetic variations of testosterone. This type of steroid has often been linked to misuse by athletes looking to boost their performance. Because of these negative implications, this sometimes leads to confusion and misconceptions about the use of corticosteroids.

We asked Dr. Benjamin Barlow, our Chief Medical Officer to help us clear up some of these myths and misconceptions about the use of steroid shots.

Myth #1:

Steroid shots are dangerous.

Steroid injections are generally very safe when used under a doctor’s supervision. Your physician knows the limits of how often steroid shots can be given. He/she will also offer advice on the use of steroid shots if you have specific medical problems that might interfere with the injection (for example – steroids can temporarily increase blood sugar levels in a patient with diabetes).

Myth #2:

Steroid shots are more painful than other shots.

No one enjoys getting an injection, but usually steroid shots are no more painful than any other type of injection. If the needle is to be injected into a joint due to arthritis pain or swelling, oftentimes a local anesthetic is applied to help minimize any discomfort. The pain-and symptom-relief benefits of a steroid injection generally outweigh the temporary discomfort that the shot may cause.

Myth #3:

Steroid shots make you gain weight.

Long-term, high-dose steroid use can lead to weight gain, however, this side effect is more likely to occur while taking oral steroids rather than injections. When taking steroid injections under a physician’s supervision the side effects are generally very minimal.

At American Family Care, our mission is to provide the best healthcare possible. Our dedicated and knowledgeable staff is here to help with any of your questions and medical needs. Visit https://www.afcurgentcare.com/locations/ to find a location near you!

by Janet Segall, IPPF Executive Director

In order for patients with pemphigus and pemphigoid to get control of their disease, there are certain drugs that patients must take. Prednisone is the first drug of choice for treating these diseases. Immunosuppressive drugs are often given as well to help patients reduce the doses of corticosteroids (prednisone/prednisolone).

Prednisone (prednisolone) is one of the most successfully and one of the most commonly used drug for treating a variety of diseases, but it can have many side effects. Some of the effects of long-term steroid use on our health are: weight gain, increased appetite, loss of muscle mass and bone density, increased fatty deposits, reduction in zinc, Vitamin D, and C levels; loss of potassium, fluid retention, gastric problems, hypertension, high cholesterol, and hampering the body’s ability to handle blood sugars.

An important fact to remember, however, is that although there are many problems and side effects that can occur when using steroids (prednisone/prednisolone), not everyone will experience the same ones. As significant as these side effects can be, there are things we can all do nutritionally that might help lower these effects.

The Foundation has published articles in the newsletter on the subject of diet and pemphigus. There are some indications that foods in the Alium group of vegetables (onions, garlic and leeks) might have an effect on triggering pemphigus for some individuals. The researchers add in many other foods that might also be thought of as trigger foods. We suggest that you be aware of these possible trigger foods when picking foods for your diet. It is prudent to remember, though, that most of the connections between diet and pemphigus are theoretical.

Although many of these side effects can be controlled with medication, there are many good foods that might help reduce the devastating effects of steroids.

Potassium is a very important nutrient in maintaining the level of fluid inside a cell. Steroids can deplete potassium. There is a delicate balance between potassium and sodium in and outside the cell that are critical for heart functions, nerve impulse transmission and muscle contractions. Foods high in potassium are: all fruits especially bananas, apricots, prunes, oranges, tomatoes and raisins. Vegetables such as potatoes, artichokes, and spinach as well as squash are also high in potassium. Beans and almonds are good sources as well.

There is some research that indicates that potassium can also help reduce blood pressure. Watch salt intake to reduce blood pressure and reduce fluid retention. Sometimes a person will think that fluid retention is akin to weight gain. Fluid retention can cause weight gain but as steroids are reduced, fluids will usually reduce as well, along with some of the weight gain. Drinking plenty of water and exercising can help with fluid retention.

Weight gain and increase in appetite – Sometimes if you are also taking an immunosuppressive, the appetite might be decreased. Your metabolism is how you burn fat. As you age, your metabolism tends to slow down. Prednisone can have a negative effect on metabolism. Cravings seem to be heightened so drinking water, eating fruits and vegetables can help. Sometimes fruit or vegetable smoothies can fill us up. Protein in the morning (eggs and cheese – flavored soy cheese is good) might help with cravings during the day. Keep some almonds around for to snack.

Loss of muscle mass – Exercise is very important for keeping muscle mass. While on prednisone, try to exercise within your own range. Men have a better chance of building up their muscles after the age of 50 than woman do because of testosterone, but exercise can help woman as well. Proteins (amino acids) are the building blocks of muscles. Protein repairs and builds muscle tissue. Extra corticosteroids in the body can break down amino acids. These amino acids then go and make glucose in the liver instead of building up muscle mass. Eating extra protein (check with the doctor regarding amounts) might help build muscles. Foods high in protein are: fish, eggs, meat, milk, cheese, baked-beans, and soy products. Remember, though, you don’t want to raise your cholesterol so low-fat meats, milk and cheese are recommended. Fish is not only a great source of protein, but also a great source of Omega-3 fatty acids. (check out our article in the Fall 2001 Quarterly on why Omega-3 fatty acids are important).

A decrease in bone density is extremely common when taking prednisone. Eating extra calcium and taking calcium supplements are very important for anyone taking prednisone. It is known that women and men with thin bones have a higher rate of osteoporosis. It is recommended that everyone get a bone density test when they first start taking prednisone as a baseline for bone density loss. The doctor and nutritionist can advice on the correct amounts of calcium a person should get daily and how much extra someone should take. Calcium rich foods are: milk, cheese, yogurt, greens, broccoli, sardines, canned salmon with bones, dried beans and peas, calcium-fortified foods such as calcium-fortified orange juice, and tofu.

Vitamin D helps the absorption of calcium. It is found in fortified milk and cereals. Your body can make its own Vitamin D when your skin is exposed to sunshine. Getting Vitamin D from the sun is very helpful but it is recommended to have limited sun exposure with an autoimmune disease. Remember though, when you go out in sun to wear a hat especially if you have lesions.

Weight bearing exercises (walking, jumping, dancing) are helpful in keeping bones healthy.

Another result of taking prednisone for a long time is the increase in cholesterol. There are two basic types of cholesterol that are measured – High Density Lipoprotein (HDL) and Low Density Lipoproteins (LDL). HDL measures “good” cholesterol and LDL measures “bad” cholesterol. Tryglicerides may also be watched as well. It is important to have high HDLs and low LDLs for health. Often cholesterol lowering drugs are called for, but often it is possible to change these factors with diet

It is possible to lower cholesterol naturally. Eating more servings of fruits and vegetables can help provide a greater drop in the cholesterol count because these foods are a good source of soluble fiber. Soluble fiber lowers the LDL or “bad” cholesterol. The specific foods that are particularly high in soluble fiber are apples, citrus fruit, berries, carrots, apricots, prunes, cabbage, sweet potatoes and Brussels sprouts. 1/2 cup is considered a serving size is. All of the beans or legumes also provide soluble fiber. Foods with Omega-3 fatty acids – salmon, sardines, tuna can work wonders in raising HDL levels.

In some recent studies ingredients known as stanol esters and plant sterols that block the absorption of cholesterol from the intestines, have shown to be effective in reducing cholesterol as well. Some foods with sterols are beans, seeds, and cereals – oats and bran especially. Soy products as well have sterols and traces can be found in fruits and vegetables. There are currently several butter substitute products out that contain sterols and research has shown some indication that these products help also in lowering cholesterol.

Lecithin might be helpful in lowering cholesterol as well, Lecithin is a fatlike substance reduced by every the liver and found in varying quantities in body cells and organs. Lecithin helps to emulsify fats and contains the B vitamin choline, from which the body manufactures one of several nerve transmitters. Lecithin metabolizes fat in the liver. In the bloodstream, lecithin prevents fats from accumulating on the walls of arteries. In the intestinal tract, lecithin enhances the absorption of vitamins A, D, and possibly E and K.

Steroids can also slow down the normal repairing of skin cells by one’s own body. Vitamin E is needed for normal body metabolism. It helps in the protection and healing of body tissues and skin. Eating foods with Vitamin E can possibly help your skin. Foods that are good sources of Vitamin E are vegetable oils, nuts, and green leafy vegetables. Fortified cereals are also a good source. Keep the body hydrated by drinking a lot of water. Keep the skin moist with lotions. As we age the skin the skin repairs itself more slowly.

One of the leading problems with steroid use is steroid-induced diabetes. The pancreas produces insulin. Insulin helps the body burn sugar for energy. Sugar is fuel for your cells. Insulin takes the sugar from the blood and delivers it into the cells. When blood sugar goes up the cells may be starved for energy. This can eventually cause problems with the kidneys, nerves, heart and eyes. Diabetes is the pancreas’ inability to produce insulin. Corticosteriods interferes with the production of insulin. If the pancreas is working normally, it will increase the insulin produced normally when steroids are added in. When the body’s pancreas is not strong enough to increase the insulin levels on its own, it will not keep a normal level of blood sugar, and the blood sugar increases. This is steroid-induced diabetes. If this occurs, it is often necessary to take medication that will help the pancreas monitor the blood sugar levels. If the blood sugar levels are borderline with steroids, lowering, dramatically, the intake of carbohydrates can often keep a hold on blood sugar levels.

Ulcers and gastric problems can accompany the use of steroids. The stomach produces a protective mucous layer that helps it defend itself against the acid it produces. Corticosteroids suppress the growth of gastric mucin, cells that produce mucous. This suppression interferes with production of the mucous layer. In addition, corticosteroids inhibit the production of mucous in the cells that remain. Eventually, this leads to a thinning of the protective layer and a greater risk of ulcer. There are many good medicines used today both over-the-counter and with prescription that have virtually no side effects and can help reduce the problems. Some good suggestions to relieve symptoms of ulcers or gastritis – eat smaller meals. Milk may give some initial relief. Add protein to your diet. If possible, avoid cafeinated coffee, large amounts of chocolate, citrus and tomato products. Try not to snack at bedtime as this can cause gastric acid secretions during the night. Ginger tea (even ginger candies) is a wonderful way to reduce stomach discomfort. Some people find Peppermint helps. Others find that Peppermint can give them heartburn.

Basically, what is best for people taking steroids is to eat as healthy as possible. Keeping your weight down is so important. As weight can exacerbate some steroid side effects such as steroids-induced diabetes, high-blood pressure, and high cholesterol, losing weight while there is control of the disease and the steroid doses are down, can make a significant difference. Add extra protein, cut out simple sugars, and add in more fruits and vegetables. There are wonderful recipes in books and online that can make the change in our eating habits more enjoyable. Seek the help of a therapist to deal with the many issues that surround disease and drug side effects.

Drug-Induced Hypertension

Corticosteroids

All corticosteroid drugs, including prednisone, can cause sodium retention, resulting in dose-related fluid retention. Corticosteroids with strong mineralocorticoid effects, such as fludrocortisone and hydrocortisone, produce the greatest amount of fluid retention. However, some corticosteroids that lack significant mineralocorticoid activity (e.g., dexamethasone, triamcinolone, betamethasone) may produce minor fluid retention. Corticosteroid-induced fluid retention can be severe enough to cause hypertension, and patients with preexisting hypertension may develop a worsening of blood pressure control when these drugs are initiated. The principal mechanism of corticosteroid- induced hypertension is the overstimula- tion of the mineralocorticoid receptor, resulting in sodium retention in the kidney. This results in volume expansion and a subsequent increase in blood pressure. Corticosteroid-induced hypertension may respond to diuretic therapy. The smallest effective dose and shortest duration of steroid therapy should be used in order to decrease the development of this adverse effect.

Fludrocortisone causes significant blood pressure increases and, thus, is useful in treating patients with postural hypotension. In a study of 64 elderly patients receiving an average dose of 75 mcg of fludrocortisone for approximately five months, four patients had to withdraw because of druginduced hypertension. The study investigators concluded that fludrocortisone therapy was poorly tolerated in elderly patients, even at low doses.

ILD Nutrition Manual: Prednisone and Weight Gain

Increased Calorie Intake

Prednisone increases appetite, resulting in increased calorie intake. This increased appetite can be difficult to control. Below are a few tips for controlling the amount of calories and the quality of nutrients you eat:

Eat small, frequent meals of high nutritional value.

Eat a high-protein, low-carbohydrate diet. There is evidence that a low-carbohydrate, high-protein diet is at least as effective for losing weight as a traditional low-calorie diet that’s low in fat and portion-controlled. A high-protein diet may also help suppress appetite.

Eat carbohydrates in the form of fresh fruits and vegetables. Prednisone has a tendency to raise the level of glucose, or sugar, in the blood, which can cause increased body fat or diabetes in some people. It is important to avoid “simple” carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, chips, breads, candy and other highly processed foods. This helps keep blood sugar low.

Limit saturated fat and cholesterol. Choose lean meats, poultry and fish. Avoid fried foods and foods with extra oil, butter, margarine, mayonnaise and the like.

Eat foods rich in calcium. Prednisone may alter your body’s ability to use calcium. Try to get four servings of calcium-rich foods per day to help prevent osteoporosis. Check with your doctor to see if you would benefit from calcium supplements.

Foods rich in calcium include:

  • Calcium-fortified orange juice
  • Cheese (American, Swiss, Colby, Cheddar and Jack)
  • Cottage cheese
  • Milk
  • Non-fat dry milk powder
  • Oranges
  • Sardines (canned, with bones)
  • Shrimp
  • Yoghurt

Decreased Physical Activity

Having a lung disease makes physical activity more difficult. A daily exercise program such as walking, working out at a gym or at home or practicing tai chi will burn calories, help prevent muscle and bone loss and improve your sense of well-being.

Your exercise program should include aerobic exercises, which burn calories and improve cardiovascular fitness, and moderate weight training, which strengthens muscles and slows bone loss. Start with a simple walking program. If you’re ever too fatigued to exercise, try harder tomorrow. Eat your main meal early in the day so you’ll have more energy throughout the day and if you need it, be sure to wear your oxygen.

The key is to have a program of regular exercise. A pulmonary rehabilitation program is an excellent way to learn how to exercise despite shortness of breath and fatigue — plus you’ll learn about lung disease and get lots of encouragement.

For more information on eating healthy with chronic lung disease, please see our General Guidelines.

ILD Nutrition Manual Index:

  • ILD Nutrition Manual: General Guidelines for Eating Healthy
  • ILD Nutrition Manual: Body Mass Index
  • ILD Nutrition Manual: Increasing Protein in Your Diet
  • ILD Nutrition Manual: Tips for Gaining Weight
  • ILD Nutrition Manual: High-Calorie, High-Protein Sample Menu
  • ILD Nutrition Manual: High-Calorie Shakes and Smoothies
  • ILD Nutrition Manual: Tips for Losing Weight
  • ILD Nutrition Manual: Plate Method for Healthy Meal Planning
  • ILD Nutrition Manual: Prednisone and Weight Gain

LifeCoach: How to avoid weight gain on steroids

Have a word with your GP again about how likely he felt TA was a part of the problem in your case. If unlikely, it should be possible to continue to drop the steroid dose gradually with a good chance of coming off it altogether by next year if not this one. Bear in mind, though, that your dose is already reasonably low, so if you are strict with your diet and maximise your exercise you should still be able to gain the upper hand on the weight problem.

SARA STANNER WRITES:

A Unfortunately, one of the recognised side effects of prednisolone is increased appetite leading to weight gain, so finding ways to curb your appetite is important.

Including bulky foods rich in fibre (vegetables, whole-grain cereals, bread, brown rice, pulses) and lean protein (chicken, fish, eggs, nuts, tofu) with each meal will help to keep you feeling fuller for longer. Also, make sure that you stay well hydrated.

Studies have shown that people tend to consume about the same amount (weight) of food each day, but not necessarily the same amount of energy (in calories). So it is possible to trick ourselves into consuming less energy, without feeling hungrier, by eating foods with a low energy density (low calorie content per gram of food). These include foods with a high water content (soups and stews), foods that absorb water during cooking (pasta, rice), and foods that are naturally high in water (fruit and vegetables). High-fibre and lower-fat foods also tend to have a lower energy density. High-energy density foods tend to include those that are high in fat and have a low water content (biscuits, crisps, peanuts, butter and cheese). So make sure that you aren’t eating many of these.

It is easy to calculate the energy density of foods – all you need to know is the weight of a serving of the food (in grams) and the number of calories that serving contains. The energy density is the number of calories divided by the weight. High energy density foods contain more than four calories/gram while low energy dense foods contain 1.5 calories/gram or less. By eating a lower calorie diet that satisfies your appetite you should be able to prevent future weight gain.

TONY GALLAGHER WRITES:

A Hopefully exercise still can have a place in your regular routine. As you know, this steroid can lead to a redistribution of body fat to the face, back of the neck and abdomen and is an unwelcome effect of this necessary medication. Your polymyalgia rheumatica, meaning “pain in many muscles” in Greek, can lead to just that – especially in the shoulders, upper arms and hips. It is also associated with thinning of the bones. As patients with PMR are frequently elderly, many have mobility problems and have challenges with many aspects of their daily living. Low levels of energy can be a problem, too.

Physiotherapy can improve the function of the muscles once the pain and stiffness have subsided which, hopefully, is the case with you now that you are on medication. Exercising little and often will make your muscles strong, helping reduce any wastage, keep appearances up, maintain balance and co-ordination and increase your energy levels.

Some days will probably feel better than others, so you will have to decide how much exercise is enough for you. With your appropriate medication and relevant nutrition you will be optimising your management of the situation.

Keeping flexible is important for general range of movement so try to perform regular stretches, and include simple mobility exercises such as arm rotations. Try small squats to strengthen your knees. Practice arising from a seated position to standing without the use of your hands or arm rests. This is useful for balance and it strengthens the legs and buttocks. A daily walk of 10 to 15 minutes would be good if you can manage it.

One sufferer, in her seventies, reported that she found it hard to believe that PMR and exercise could exist in the same sentence but that she seemed to have turned a corner after 18 months of being unable to contemplate any more movement than was absolutely necessary to get her about. After that time, she reported feeling more able. She tried an exercise bike for 10 minutes and it felt good – not pain free, but bearable, and she was going to get herself down to a pool for a gentle swim.

Q My hay fever symptoms have worsened this week. I’ve tried many different treatments in the past. I heard recently that acupuncture can work well, but don’t want to spend lots of money on expensive sessions.

Are there any existing products that use a similar method to treat hay fever? Leah, by email

DR DAN RUTHERFORD WRITES:

A Some people say acupuncture helps their hay fever but others say it does not. Published analysis of the available medical literature also shows inconclusive results (take a look at www.ncbi.nlm.nih.gov/pubmed/19441597).

If by similar method you mean a complementary remedy, herbal treatment is an alternative you may wish to try. Off-the-shelf examples are: Butterbur (Petasites hybridus), Aller-7 (an Indian herbal combination), Guduchi (Tinospora cordifolia), Green Shiso (Perilla frutescens) and Nettle (Urtica dioica). For more specific advice, find a medical herbalist on www.nimh.org.uk.

Q Having read recently your advice for reducing thighs, can you suggest exercises for reducing a pot belly? I am 71, in good health, play bowls, walk a lot and do heavy gardening. Pat, by email

TONY GALLAGHER WRITES:

A People who are active and otherwise not overweight can find fat accumulating on their stomachs. These few inches around the waist can increase the risk of damage in the arteries, even if body weight is within the normal range.

For those who are overweight, it is thought that even a small pot belly can increase the risk of heart disease – and a healthy diet won’t always produce the desired results on its own.

Hormonal changes as you age don’t help, since excess calories often head straight for your waist and are stored as fat. Another contributing factor is poor posture, which weakens the stomach muscles which, in turn, causes the stomach to distend. A consistent message, is for people to prevent accumulation of central fat from early on in their lives. Your walking, bowls and gardening are great for your heart but won’t necessarily provide a level stomach.

There is no one magic exercise that I am aware of, unfortunately. Try to target all the major muscles like legs, abdominals, back, arms, chest and shoulders. Your overall body strength will contribute to better posture and muscle balance.

The combination of drinking less alcohol, performing abdominal crunches and avoiding late-night meals will also help tackle this problem.

Additionally, specifically aim to exercise your lower back, since weak back muscles can leave you prone to lordosis, an exaggerated lumbar curve in the spine. The result of this ailment is a protruding stomach. Food sensitivities can also be a contributing factor, so a visit to a nutritionist may help.

Send your questions and comments to The Sunday Telegraph, Life Coach, 111 Buckingham Palace Road, London SW1W 0DT; or email [email protected]

Steroids are extremely effective in relieving pain and inflammation in the body, and they can be life saving.

They are normally administered for conditions such as arthritis, asthma and eczema. However, as with most drugs, they come with side effects, such as weight gain.

What Are Steroids?

Steroids, or corticosteroids, are anti-inflammatory drugs. There are many types and they are sold under various brand names:

  • Prednisone (Deltasone, Sterapred)
  • Methylprednisolone (Medrol)
  • Prenisolone (Prelone, Pediapred)
  • Dexamethasone (Decadron, Hexadron)
  • Hydrocortisone (Acticort, Cortef)

How Do Steroids Cause Weight Gain?

Steroids affect sodium (salt) balance and, hence, increase fluid retention. They cause weight gain by increasing appetite and re-deposition of fat around the neck and abdomen. Because of chronic inflammation and pain, you will be less active and this will also contribute to weight gain.

How Do You Manage Weight Gain?

There is no easy road to losing weight from the side effects of steroids. However, there are six steps you can take to manage it:

Step 1: Plan Your Meals

Be aware of the amount of calories in the food you are eating. You will then be able to reduce the total amount of calories you normally consume by 10-20%. You can search online to obtain the calorie content of the food you normally eat. Counting calories is a method of weight loss.

Step 2: Eat A Healthy Diet

One major side effect is an increase in appetite. So, it is important that you eat a healthy diet of low-calorie but nutrient-dense food. Eat plenty of fruits and vegetables and lean protein. Start the day with a high-protein breakfast to kick-start the body’s metabolism. Take plenty of Omega-3 good fat from olive oil, salmon and other oily fish or Omega-3 supplements.

Step 3: Reduce Sugar

Sugar in the diet increases insulin imbalance and fat deposition. Besides sugary beverages, sugar normally comes from simple carbohydrates, such as starchy food, white rice, potatoes, noodles, cakes, pastries and biscuits. Therefore, ensure you eat more complex carbohydrates from fruits, vegetables, sweet potatoes, tapioca and whole grains.

Step 4: Salt And Water

Drink plenty of water to control fluid retention. Also control the amount of sodium (salt) intake to control fluid retention. Water is also a natural pain-killer: you need an average of 30ml per kilogram of body weight.

Step 5: Exercise

Pain in joints, or any other area, due to inflammation may determine the type of exercise that is suitable to the particular conditions. Walking, swimming and yoga should be considered as they are not high impact and can be low intensity.

If there is no pain, then weight training and aerobic exercise will help to burn fat. The key is to do it regularly – at least five times a week.

Step 6: Detox

Cleanse the digestive system and detox the liver to reduce toxins in the body. Reducing toxin load will help to reduce inflammation and pain, which reduces the requirement for steroids.

Steroids may save lives but the side effects of weight gain must be managed properly. Follow the above steps and you will be on your way towards recovery.

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