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Stories for Reprint
Diet Counseling Works for
Kids on Prednisone
By Ferdous Al-Faruque, MARRTC Staff
What happens if the drug you must take to stay healthy makes you constantly hungry? For many children who take the drug prednisone, significant weight gain is unfortunately a common outcome.
Healthcare professionals often prescribe prednisone to people with a rheumatic disease to help control their disease. For many patients with such diseases prednisone can be a life-saver. However, a major side effect of the drug can be an increased appetite, which can then lead to weight gain. Children who have to take the drug because of a rheumatic disease are caught between fighting their disease and keeping a healthy weight.
Jenny Tekano is a clinical nurse at the British Columbia Children's Hospital in Vancouver, Canada. Over the past 17 years, she has seen many children deal with their rheumatic disease and the weight gain from the drugs meant to help them. Tekano says that the children often tell her the weight gain is worse than the disease. "It can be devastating for these kids, especially the teenagers," she said. Though the drugs often help with the disease, the weight gain can be harmful to their self-image and self-esteem.
After seeing what these children have to go through, Tekano wanted to find an effective way to help them decrease the amount of weight they would gain as a result of prednisone. She and her colleagues conducted a study to see if having a dietician counsel families and children in a restricted diet, low in fat and salt, would reduce weight gain. They set about doing this by recruiting children on prednisone from their own hospital. However, since the Pediatric Rheumatology Clinic at the British Columbia's Children's Hospital did not have their own diet counselor, they brought in a dietician, Parveen Khattra, to advise the children.
Khattra looked at foods the children ate on a regular basis and made suggestions on ways to cut down on fat, salt and sugars. However, the researchers were realistic about the kinds of changes they asked of the children. Tekano says they took into consideration that children, especially in their teenage years, go out to eat with friends, often at fast food places. The diet guidelines were flexible enough to let the children be social but at the same time, foods that could contribute to their weight gain were reduced. "We wanted this to be a dietary change that they could follow (easily), because they had to follow this for a year," said Tekano. Besides eating healthy the children were also asked to stay physically active.
So far 10 children on prednisone between the ages of 6 and 16 have completed the study, and another 10 are still taking part. Though the study is ongoing, results show that children on prednisone who received dietary counseling gained less weight than children who did not get diet counseling. "So far we are very excited because we have found that the diets have made a significant difference," said Tekano. She and her co-investigators plan to finish the research by next year.
Tekano says the research is a message to children on prednisone and their families that there is hope. She adds, a greater message to healthcare professionals is that providing diet counseling to children on prednisone is an important way to improve their patients' care. Tekano says that bringing in Khattra to counsel their patients has done exactly that. "One thing it's proved for our practice is we need a dietician," she adds. "For us it's made a huge difference."
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