Tips for managing pangs

Prednisone and weight gain

Immediately after your transplant, among other medications, you will be on high doses of corticosteroids called prednisone or prednisolone to keep the new graft safe.

Prednisone typically increases appetite, which can result in increased calorie intake. Even if you’re not on large doses of prednisolone, you may find your appetite improves naturally because you no longer feel sick.

In the short-term (days to weeks) after your transplant, this may not be too much of a concern as your body needs extra energy and nutrients to heal and begin rehabilitation.

In the longer term, weight gain is a known side effect of prednisone use. Although different for different people, most commonly prednisone can cause a redistribution of fat on the face, stomach and back of the neck.

If increases in appetite have been subtle, you may not even realize this is an issue. Being aware of your increased appetite is the first step.  

Weight gain from fluid retention in the body can sometimes be caused by prednisone. Reduce salt intake if you are building up fluid.

Managing hunger cravings

  • Wholegrain cereals, fresh fruit and vegetables, nuts, seeds, lean meat and dairy will help keep you feeling fuller for longer and manage your hunger cravings
  • Make sure you’re well hydrated. Often we mistake thirst for hunger
  • Choose more fresh, minimally-processed foods in place of processed foods (bacon, sausages and packaged foods) to ensure you’re satisfying your appetite whilst avoiding excessive intake of unhealthy fats, added sugars and excessive salt
  • Be mindful of portion sizes and pay attention to the nutritional quality of the food you eat. A main adult meal should consist of a palm-sized portion of protein, fist-sized portion of starch and two handful-portions of vegetables or salad
  • Eat slowly and with minimal distraction. Focus on what you’re eating and listen to your body. Stop when you’ve had enough and try to be disciplined
  • Snack on fresh fruit, vegetables, nuts and reduced fat dairy products which are highly nutritious and are not excessive in calories
  • Avoid skipping meals and always start your day with breakfast
  • Increase physical activity. You might feel that you can’t do enough to burn calories, but it’s important to do something rather than nothing. With advice from your transplant team, build an exercise routine that takes your abilities into consideration and can fit into your day. See our section on transplant sports for information on recipient-friendly exercises.
Healthy Food

Ready-to-eat healthy snacks

Prepare in advance: plan! Adjust recipes to incorporate lean cooking, more vegetables and fibre.

  • Keep a container in the fridge of snacks like carrot sticks, celery sticks, cherry tomatoes, raw mushrooms, snow peas, raw beans and low calorie dips like tomato salsa, hommus or tatziki
  • Cut up fruits to have ready for snacks or after dinner
  • Make only the amount needed for the meal, or pack leftovers straight into the freezer in portion sizes
  • Keep a regular supply of fresh fruits and vegetables in the house
  • Stock cupboard with small supply of low-fat crackers and pretzels
  • Nut snack packs are available in major supermarkets and are a healthy option to have in stock

Make sure you know when you’re most likely to get hungry (e.g. soon after you’ve had your dose of prednisone), and ensure you have healthy food at hand to prevent you from impulse buying less nutritious snacks.

Visit our recipe section for healthy snacks and meals ideas.

Healthy Snacks

Healthy snack options

  • Mini pizza on a grainy English muffin. Add ham, pineapple, tomato, capsicum and grated low-fat cheese
  • Fruit smoothie made with berries and low-fat milk, add plain yoghurt
  • 1 piece of fruit. For example: apple, pear, nectarine with skin on
  • 1 handful of strawberries, berries or grapes
  • 1 cup reduced-fat milk
  • 1 tub (200g) yoghurt
  • 1 cheese stick
  • Plain crackers such as Corn Thins, Cruskits, Vita-Weet with protein topping (cheese or tuna), tomato or vegemite
  • Air-popped popcorn
  • Vegetable sticks (carrot, celery, cucumber, capsicum, cherry tomatoes) with a reduced-fat dip (hummus, tzatziki, cream cheese, cottage cheese, salsa)
  • 1 cup vegetable soup + 1 slice multigrain bread
  • 1 boiled egg, small tin of tuna or small (130g) tin of baked beans on 1 slice multigrain bread or ½ an English muffin
  • Boiled egg on half a multigrain English muffin

Battling the effects of prednisone

Acknowledgements

Transplant Australia gratefully acknowledges the valuable contribution of the following experts in reviewing this material:

Carissa Maroney

Dietitian
Cardiothoracic Medicine, Surgery & Intensive Care, Heart & Lung Transplant, Cardiology
St Vincent’s Hospital

Sheridan Collins

Dietician
Nutrition & Dietetics
The Children’s Hospital at Westmead