Polymyalgia Diet to Reduce Inflammation: A Practical, Steroid-Smart Plan

Medications control polymyalgia rheumatica (PMR). Food helps you feel better while treatment works — supporting energy, sleep, weight, blood sugar, blood pressure, bones, and heart health. Think patterns, not miracle foods.

This guide gives you a clear plate model, shopping list, sample menus, and “real-life” tactics that actually stick when you’re on steroids.

The Big Idea (in one plate)

The PMR Plate (Mediterranean-style, steroid-smart):

• ½ plate plants: vegetables and fruit (aim for 2–3 colours/day)
• ¼ plate protein: fish, poultry, eggs, tofu/tempeh, beans or lentils
• ¼ plate slow carbs: intact grains (oats, brown rice, quinoa), beans/lentils, potatoes with skins
• + a thumb of healthy fat: extra-virgin olive oil, nuts, seeds, avocado
• Drink: water or unsweetened tea/coffee

Why this works:

• Plants deliver fibre and polyphenols that nudge down background inflammation.
• Adequate protein tamps down steroid-driven appetite and protects muscle.
• Slow carbs steady blood sugar—especially important on prednisone.
• Olive oil, nuts, fish supply heart-healthy fats linked with lower inflammatory markers.

Steroid-smart guardrails (the few rules that move the needle)

1. Kick sugary drinks (soda, sweet tea, juice). Swap for water/sparkling water; whole fruit beats juice.
2. Tame sodium to ease puffiness and blood pressure: prefer home-cooked; scan labels; ask restaurants for “no added salt.”
3. Protein at every meal (about a palm-sized portion): fish, eggs, Greek yogurt, tofu/tempeh, legumes, poultry.
4. Fibre goal: 25–35 g/day. Build from vegetables, beans, oats, berries, chia/flax.
5. Fish twice weekly (salmon, trout, sardines, mackerel) or consider an omega-3 supplement if appropriate.
6. Bone basics: calcium (diet first; supplement if short) + vitamin D per your clinician.
7. Alcohol: thoughtful and modest, especially if you take methotrexate or have abnormal liver tests—clear limits with your clinician.

What to eat more of

• Vegetables and fruit: at least 5 servings/day; include leafy greens, crucifers (broccoli, cabbage), tomatoes, berries, citrus.
• Legumes: lentils, chickpeas, black beans 4–7 times/week—protein + fibre in one.
• Whole grains: oats, barley, brown rice, quinoa, farro; limit white breads and sugary cereals.
• Nuts & seeds: almonds, walnuts, pistachios, chia, flax (1 small handful or 1–2 tbsp/day).
• Fermented and cultured dairy (if tolerated): plain yogurt/kefir for protein + probiotics.
• Herbs and spices: turmeric, ginger, garlic, cinnamon, rosemary—flavour without sodium.

What to ease back on (without food guilt)

• Added sugars (especially beverages and desserts-as-habit)
• Ultra-processed snacks/meals (chips, candy, packaged pastries, many frozen entrées)
• High-sodium choices (canned soups, deli meats, take-out sauces)
• Refined starches (white breads, crackers) as daily staples
• Deep-fried foods as routine

A 7-day starter menu (plug-and-play)

Breakfasts (rotate):

• Steel-cut oats cooked in milk/fortified alternative; top with berries + walnuts
• Greek yogurt parfait with chia, banana, and cinnamon
• Veggie omelette + side of tomatoes + whole-grain toast
• Tofu scramble with spinach and peppers + avocado

Lunches (rotate):

• Lentil-vegetable soup + olive-oil side salad
• Tuna-white bean salad (olive oil, lemon, parsley) over mixed greens
• Chickpea “power bowl” (roasted veg, quinoa, tahini-lemon drizzle)
• Leftover salmon + farro + arugula with olives

Dinners (rotate):

• Salmon, tray-baked vegetables, and small potatoes (skins on)
• Chicken thighs with rosemary + barley + green beans
• Tofu-veggie stir-fry over brown rice; finish with sesame seeds
• Turkey or bean chili; side cabbage-apple slaw
• Whole-wheat pasta with sardines, garlic, chili, broccoli rabe; olive-oil finish
• Baked cod with tomato-olive relish + quinoa tabbouleh
• “Breakfast for dinner”: eggs, sautéed greens, mushrooms, tomatoes

Snacks (choose 1–2/day):

• Fruit + handful of nuts
• Hummus with carrots/cukes
• Plain yogurt with flaxseed
• Cottage cheese + pineapple
• Apple + peanut/almond butter

Shopping list (one week, 1–2 people)

• Produce: leafy greens, broccoli/cauli, peppers, tomatoes, onions/garlic, carrots/cukes, berries, bananas, citrus, apples, avocado, lemons.
• Proteins: salmon (2 fillets), white fish or cod, chicken thighs, eggs, Greek yogurt/kefir, tofu/tempeh, canned tuna/sardines, canned beans (lentil, chickpea, black), cottage cheese.
• Pantry: extra-virgin olive oil, oats, brown rice/quinoa/farro, low-sodium beans/soups or dry lentils, crushed tomatoes, nuts/seeds (walnut, almond, chia, flax), herbs/spices, low-sodium broth.
• Extras: whole-grain bread/tortillas, tahini, vinegar, olives, dark chocolate (fine in modest portions).

Meal-prep shortcuts (for low-energy days)

• One sheet pan: protein + two veg + olive oil + spices → 25–30 minutes.
• Grain bucket: cook a pot of brown rice or farro; cool and refrigerate for quick sides.
• Protein in batches: roast chicken thighs or bake tofu slabs for 3–4 lunches.
• Cut once, use thrice: pre-chop onions/peppers/carrots on day 1.
• Emergency kit: tuna/sardines, canned beans, jarred roasted peppers, microwavable grains.

If blood sugar is your pain point (Prednisone edition)

• Protein first: start meals with protein + veg; add carbs after.
• Pair carbs with protein/fat (e.g., oats + yogurt + nuts; crackers + hummus).
• Earlier eating window: heavy dinners late at night worsen sleep and glucose.
• Walk 10–15 minutes after meals when you can—small, reliable impact.

If fluid retention/blood pressure is your pain point

• Cap sodium (<2,300 mg/day unless told lower) and watch breads/soups/sauces.
• Cook at home most nights; “no added salt” at restaurants.
• Hydrate regularly; elevate legs when resting; keep moving gently.

Supplements: keep it minimal, make it safe

• Vitamin D and calcium if diet falls short—dose per clinician.
• Omega-3 (EPA/DHA) if you rarely eat fish; choose third-party-tested brands.
• Magnesium glycinate/citrate can help sleep or bowel regularity for some; avoid high doses with kidney disease.
  Always check for drug interactions (anticoagulants, methotrexate, others) before adding supplements.

Eating out without derailing the plan

• Scan for grilled/baked mains, vegetable sides, olive-oil dressings.
• Ask for sauce on the side; split salty or heavy dishes.
• Default drink: sparkling water with citrus.
• Treat dessert as occasional, shared, and portioned.

Track one thing for 14 Days (so you know it’s working)

Pick one: minutes of morning stiffness, average sleep hours/awakenings, weekly weight/waist, or home BP average. Keep the habits that improve your number by ≥20–30% and feel sustainable; drop the rest.

Common myths

• “A special food will cure PMR.” No food cures PMR; medications do. Food makes the journey safer and smoother.
• “All carbs are bad.” Not true. Intact, fibre-rich carbs are part of the plan; sugary drinks and refined starches are the problem.
• “I must avoid fruit.” Whole fruit is fine; juice is the issue.

Bottom line

A Mediterranean-style, steroid-smart pattern — plants, lean proteins, slow carbs, and healthy fats — reduces metabolic stress while your medications control PMR.

Keep it simple: the PMR Plate, a few strong guardrails, easy batch-cooking, and one metric to track. Small, steady changes compound into better days and steadier tapers.