M Toronto Myositis Centreat St. Michael's Hospital
Patient guide

Diet & nutrition.

Inflammatory muscle disease places unusual demands on the body. The right food supports muscle repair, works against inflammation, and offsets the side effects of common medications. These guides were written by the Centre.

Why it matters

Food is part of the treatment.

In myositis, muscle is being damaged by inflammation and rebuilt at the same time. That dual process raises the body’s need for high-quality protein and specific amino acids, especially leucine, which drives muscle protein synthesis. At the same time, medications add their own nutritional demands: corticosteroids affect bone and blood sugar, and methotrexate depletes folate.

The aim is simple: enough protein to rebuild muscle, anti-inflammatory nutrients to calm disease activity, and foods that counter medication side effects, prepared in ways that work around weakness and fatigue.

Nutritional priorities

Six things the plan is built around.

Protein (1.2 to 1.5 g/kg/day)

Muscle is actively being rebuilt, so protein needs run above the general recommendation. Salmon, eggs, chicken, and sardines feature across the meals.

Leucine and BCAAs

Leucine activates the mTOR pathway central to muscle repair, the same pathway myositis disrupts. Fish, eggs, chicken, and dairy are rich sources.

Anti-inflammatory omega-3s

EPA and DHA work against the inflammatory signals in muscle tissue. Salmon, sardines, and flaxseed provide them.

Folate

Methotrexate depletes folate, which can cause fatigue and mouth ulcers. Lentils and spinach are among the richest food sources.

Calcium and vitamin D

Long-term corticosteroids raise osteoporosis risk. Sardine bones, eggs, salmon, and dairy help supply both.

Soft-texture options

Some myositis subtypes cause swallowing difficulty. Several recipes are soft by design or include softer modifications to reduce aspiration risk.

The recipes

Two guides, ten complete meals.

Each meal lists ingredients, step-by-step method adapted for limited hand strength, the protein and calories per serving, and the specific reason it helps in myositis.

Standard guide

5 muscle-supportive, anti-inflammatory meals

Built around salmon, eggs, chicken, lentils, spinach, and sardines. Includes a no-cook option.

Vegetarian guide

5 high-protein vegetarian meals

Deliberate protein combining with tofu, edamame, eggs, ricotta, chickpeas, and quinoa to hit the same protein targets.

!

General guidance, not a personalised plan. If you have swallowing difficulty, kidney disease, diabetes, or other conditions, check with your team before changing your diet. A dietitian can tailor protein and nutrient targets to you.