Weight loss and carbs for PMR

[Ndnd]

I’m looking for any advice or recommendations please for losing weight whilst on Predisnolone. I am currently slowly tapering from 15mg last July when first diagnosed with PMR to 8.5mg now. I have been overweight for many years & although I have managed not to put on any more weight I cannot lose any & I know I would benefit from losing at least a couple of stones. (I have had 2 hip replacements & my knee is not too great ) I also suffer with IBS so try to follow a low FODMAP diet and can’t tolerate a lot of fruit & vegetables. I know that low carb seems to be the way to go but I struggle to find enough food to stop me from being hungry, & bread is certainly one of my downfalls. I don’t fully understand whether carbs make PMR worse as regards to symptoms, or is it the effect on weight? I would be so grateful for any advice or books, diets, sources of recipes etc as I have lost weight successfully in the past prior to surgery but sadly it has crept back . Thanks in advance

[Yellowbluebell]

Carbs dont make pmr worse but do affect our weight. I was very naughty at the beginning and became best friends with my fridge and 2months after diagnosis in 2018 it was Christmas and i ate a lot of advent calendars!! I put on over 2 stone. I have now cut a lot of carbs and have lost half a stone since christmas 2019. You need to cut out the carbs and remember that fruit includes a lot. Berries are the best fruit to avoid too many carbs. A diabetic diet is also a way of avoiding too many carbs. I hxve a link somewhere so will hunt it down. Good luck. YBB

[Ndnd in reply to Yellowbluebell]

Thank you. Sadly too many berries upset my tum, but I think maybe high protein diet might be worth a try as it would be more filling. Thankfully all Xmas chicks & treats have gone now! I do love chocolate but just don’t buy it . My husband can eat anything so I only buy chocolate bars that I don’t like. Well done for your weight loss.

[SnazzyD]

Presumably you’ve been down the checking for problems with gluten road?

[Ndnd in reply to SnazzyD]

Yes, no problems with gluten. I rend to eat sourdough bread anyway as it’s more filling so I can eat less of it.

[TheMoaningViolet]

As soon as steroids were mentioned as a required treatment for my condition back in September 2019 (and cheered on by my husband who worried about steroid-induced diabetes) I cut out sugar and slowly extended this to all fast-metabolising carbs such as potatoes, white rice etc. Since the beginning of January I cut out all gluten as well, but I was already avoiding wheat which I had a noticable intolerance to for a while. I thought I was unable to lose weight before, but on this regime I lost 10 kg over a 3-month period. I stick to 12 hours without any calories (8pm to 8am) and occasionally skip a meal (usually lunch) or eat very small portions. If I want a treat, I eat a banana smoothie (with protein in the shape of non-dairy milk, nut butter, seeds and usually some berries) and I have made desserts with Palmyra tree blossom sugar when I feel particularly decadent. I stick to small amounts of non-cow dairy for now. My weight has been stable inspite of the steroids and I don't feel an increased desire to eat.

One of the forum members (thank you again tangocharlie) recommended Michael Mosley books which were informative and entertaining, so I would recommend them. I read 4 different ones and while there is a degree of overlap and repetition I didn't mind that too much.

I would try not to think of it as a diet, think of it as medicine. Make your meals the way your get your tablets ready every morning, as a ritual which will help you recover. For me that change in attitude was essential to help me maintain motivation.

I wish you luck in taking control of your recovery. Whether any positive dietary changes are going to affect our PMR no one knows for sure, but anything that is good for our body is going to help us in the long run.

[PMRpro Ambassador]

If I eat carbs, especially sugars, then I do notice I don't feel as good. Lots of people have said the same - carb binges often result in flares. But the main reason is weight - pred changes how we process carbs and also causes random spikes of glucose to be released by the liver - that triggers insulin release but there isn't enough carb to use it up, that makes your blood sugar level fall, you crave carbs to bring it back up, more insulin, more hypoglycaemia - it becomes an even more vicious circle. You gain weight' Cutting the carbs reduces that effect and also reduces the risk of developing pred-related diabetes.

Someone else posted about low carb being difficult with low FODMAP - and I looked it up. A low FODMAP diet and a low carb diet have many similarities when you look at what you CAN eat rather than at what you CAN'T eat.

healthline.com/nutrition/lo...

healthline.com/nutrition/fo...

I think this was the article I found that showed that quite clearly:

verywellhealth.com/foods-on...

You should be cutting those fruits anyway, fructose is a carb. You should be cutting the grains. These days lactose-free products of the dairy listed are all fairly easily available if you look. I don't eat many legumes at all - I do like them but my husband doesn't so they don't figure much in my kitchen day to day. Except hummus.

I would miss some of the veggies - the sprouts and cauliflower and asparagus especially. But broccoli florets are low FODMAP and I eat far more of that anyway. The other high FODMAP veg in that list only appears in my diet very occassionally and for most of the year there is no asparagus as it is a very seasonal product. But I have a rainbow coloured low carb diet and the cheese I eat is all low in lactose - some is naturally so so it is worth looking which are OK. And fish, meat, eggs - no carbs to be a problem.

[annz1971 in reply to PMRpro]

thats all interesting info thanks i am overweight and have been for years but havent gained and cant seem to loose and tried most things but always fail due to boredom of foods to eat or unable to afford special foods or lack of ideas i have just been diagnosed with GCE so they think quiet possibly PMR yet to have the biospy done but know its one of the 2 and just browisng round getting some info would like to try change my lifestyle nd not get bigger or sicker .....any thoughts? tips ? ideas??

[PMRpro Ambassador in reply to annz1971]

When it comes to diet for PMR/GCA and being on pred I have only one mantra: cut carbs. Drastically.

Remove all processed carbs and added sugar and limit fruit - it may be perceived as healthy but fruit has a lot of carbs, especially things like grapes, bananas and apples and even oranges - which people tend to eat a lot. Some of us are unlucky and have to cut more than others - Snazzy and I have to get down to 20g usable carbs to lose weight - and if you eat a banana that takes you to 20g in one fell swoop without anything else for the day. No bread, no cakes, no bicuits, no snacks - keep an honest food diary and you will be amazed where the carbs hide and how they mount up.

dietdoctor.com/

is a good and clear explanation of low carb with easy to understand pictures to show good and less good choices.

[annz1971 in reply to PMRpro]

so thats where i get stuck eoth wt=hat to eat as i said im usuless with recipes and figuring things out and always fail dont want to fail this time any easy cheap basic recipes??

[PMRpro Ambassador in reply to annz1971]

Look at the diet doctor site - I don't use recipes, just because of how we eat. Or google low carb recipes

[tangocharlie in reply to annz1971]

Easy guidance is meat and (at least) two veg (that grow above ground). For example my dinner tonight will be some roast chicken with cauliflower mash and broccoli. You can have most veg apart from peas and carrots. Dessert a bit of marscapone with a few blueberries and one piece of 70% cocoa dark choc broken up on top. Michael Mosley's books are very easy to read and give loads of ideas. And I've just heard he's going to give a talk for PMRGCAuk members