Tips for a salt-free and low sugar diet during general corticosteroid therapy

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Tips for a salt-free and low sugar diet during general corticosteroid therapy These fact sheets were written in collaboration with the Reference Centre for Autoimmune Bullous Diseases and the Pemphigus-Pemphigoïde France patient association. Dear Sir or Madam, If the treatment of your bullous disease requires general corticosteroid therapy in large doses (usually tablets or more rarely injections), your doctor will probably advise you to follow a salt-free, sugar-poor diet, adapting it to your age, and your other possible associated health problems. Here are some tips to help you follow this diet. N.B.: Only your doctor can decide whether a salt-free or sugar-poor diet is necessary. Tips for a salt-free diet General advice - Do not use salt for cooking. - Do not add salt at the table. - Check the labelling of the food products you consume. Several terms are used for salt: sodium (1g sodium = 2.54g salt), sodium bicarbonate or benzoate (E211 or E20), NaCl, glutamates etc. - Eliminate all commercially prepared dishes: canned or frozen etc. - Avoid seasonings rich in sodium or that have salt in their name: soy sauce, onion sauce, celery sauce, garlic sauce etc. - Add flavour to foods with herbs: parsley, tarragon, chives, garlic, thyme, rosemary, bay leaf, basil, oregano, mint etc. - Vary your diet despite dietary constraints: o Some caterers offer every day salt-free meals. o In diet stores, you will find salt-free condiments, salt-free vegetable broths, soups and salt-free preserves. Many diet salts are rich in potassium, check with your doctor that this is not a problem. When eating a meal in a group, it is possible to order a salt-free meal.

Prohibited foods - Salted, smoked, dried, breaded meats. Commercially prepared meats, frozen or other. Kidneys, roast or other barded meat, ham. - Salted, dried, smoked, breaded, canned, in oil or cooked, frozen fish. - Shellfish and crustaceans. Surimi, lump eggs, caviar etc. - Salted bread, salted rusks, salted toast in all its forms. - Any commercial preparation: canned, semi-preserved, frozen. Commercial ready-made or pre-cooked dishes. - All canned vegetables, even rinsed, cooked vegetables, sauerkraut, cassoulet. Instant soup in sachets, tetra-brick or canned. Instant purée, commercial chips, all pre-cooked potatoes. - Semi-salted and salted butter, lard, vegetable. - Salted dried and oleaginous fruits (hazelnuts etc.). - Seasonings: salt, mixed spices, commercial seasonings (pickles, olives, capers, mustard etc.). - Commercial sauces: mayonnaise, ketchup, tomato sauce, vinaigrette etc. as well as sauces in dehydrated form. - Broths in tablets, sachets for short broth. - Aperitif biscuits, store-bought pastries, salted dry biscuits, baking powder, pie dough, pastries. - Salted carbonated mineral waters (i.e. the great majority of them) such as: Vichy, Badoit, Quezac, San Pellegrino etc. Perrier and Salvetat are allowed because they contain no or little salt. - Salted cheeses.

Recommended foods - Salt-free cheeses. - Fresh or frozen uncooked meat (veal, beef, pork, mutton, lamb, horse, poultry, offal). Ham and other deli meats are allowed if guaranteed saltfree. - Fresh or frozen uncooked sea or river fish. Tuna and sardines in oil and without salt. - Eggs (hard, soft, soft, soft-boiled). - All fresh, frozen or vacuum-packed vegetables not cooked, preserved homemade unsalted. Homemade soups without salt. - Fresh or vacuum, steamed, sautéed, roasted, mashed potatoes (proprietary mashed potatoes). Unsalted homemade French fries. - Pasta, rice, semolina, tapioca, dried vegetables, peas (fresh or frozen). - Bread, rusks and toasted bread without salt. - Butter and fresh cream (preferably raw and in moderate quantities). Saltfree vegetable margarine with corn or sunflower. Olive or rapeseed type oil. - In moderate quantities: unsalted homemade pastries, unsalted homemade fruit pies, low-salt biscuits (Petit Beurre etc.), baker's yeast. - Coffee, tea, herbal teas. Tap water, spring water or mineral water, natural. Non-carbonated waters with low salt content (Salvetat, Perrier). Pulco, Agruma (to avoid if oral lesions). Coca Cola, Orangina, Nestea, Schweppes (favour light sodas). - Diet salts on medical advice (Xal or Bouillet brands). Unblended spices (curry, pepper if tolerated). Herbs, garlic, onions, shallots if tolerated.

Some tips and tricks To develop the maximum flavour of food, it is important to choose the right cooking method. FOR MEAT AND POULTRY - Grilled, roasted, sautéed, on skewers with thyme, parsley, garlic, onion or shallot. - Marinated in olive oil with aromatic herbs, onion, cloves. FOR FISH - In the oven with tomatoes, mushrooms, herbs, shallot or onion. - Floured and fried in a pan. - In a homemade court-bouillon (onions, thyme, carrots, bay leaves), with a salt-free sauce (tomato, béchamel, cream). - Marinated in flavoured oil. FOR PASTA AND RICE - Cook in flavoured water (thyme, bay leaf, onions) then cook with basil, tomato, curry or saffron (if tolerated). FOR POTATOES - Baked in the oven. - Sautéed or fried. - Boiled in the water with thyme, bay leaf, onion, parsley and then served flavoured with nutmeg. TO SPICE UP DISHES - For raw vegetables: parsley, tarragon, chives, garlic, onion (if tolerated). - On grilled meats: thyme, rosemary, shallot (if tolerated). - With poultry: rosemary, curry, mushrooms, onion or shallot (if tolerated). - With braised, stewed meats: thyme, bay leaf, onion, shallot, mushrooms. - With eggs: herbs, chives. - On vegetables: thyme, bay leaf, basil, garlic, onion, shallot (if tolerated).

Tips for a sugar-free diet These tips are in addition to your salt-free diet. The basic principle is to eliminate all rapidly absorbing sugars. Recommended foods - Milk products (yoghourts, fromage blanc, petit suisse): plain or sweetened yoghurts with 0% fat. - Unsweetened desserts. - Sweeteners such as Carte Blanche, Canderel etc. - Van Houten cocoa powder or sugarfree colt. - Sugar-free homemade cakes. - Sugar-free homemade fruit pies - Sugar-free diet products: jam, compote, cereals etc. Prohibited Foods - Flavoured milk, concentrated, sweetened concentrate. - Milk and sweet desserts. - Sugar and its derivatives (honey, jam, chocolate, nougat, maple syrup etc.) - Candy, chocolate bars etc. - Commercial biscuits and pastries. - Viennese pastries. - Sweet preserves: fruit in syrup. - Dried fruit. - Unsweetened drinks, light drinks with sweetener. For more information on this subject This website provides answers to any questions that you may have during corticosteroid treatment: http://www.cortisone-info.fr