water | Your Guide to a Healthier Life

What are kidney stones?

One of the most common disorders of the urinary tract.
Kidney stones affect about 12% of men and 5% of women by the time they are 70 years old.
Men are about twice as likely to form kidney stones as women.

Why Dietary Control is Important

Those who have formed one calcium oxalate stone have a 50% chance of forming additional stones within 10 years
With appropriate education, patients can exercise some control over stone disease and reduce their chances of forming stones through dietary modifications and medication.

Metabolic Causes of Kidney Stones

Hypercalciuria – Calcium is absorbed from food in excess and is lost into the urine. This high level of calcium in the urine causes crystals of calcium oxalate or calcium phosphate to form in the kidneys or elsewhere in the urinary tract.
Hyperuricosuria – Uric acid metabolism (gout). Meat, fish, chicken are restricted due to breakdown products that produce uric acid crystals.
Hyperoxaluria – the body produces too much oxalate, a salt. When the urine contains more oxalate than can be dissolved, the crystals settle out and form stones.
Cystinuria – too much of the amino acid cystine, which does not dissolve in urine, is voided, leading to the formation of stones made of cystine.
Renal tubular Acidosis a condition in which the kidneys are unable to excrete normal amounts of acid.

Dietary Causes of Renal Stones

High	Low
Dehydration	Water intake
Foods rich in Oxalate	Calcium than Recommended
Animal protein – Meat, Egg, Chicken	Low Magnesium
Salt – Sodium	Potassium than Recommended
Phosphate – Aerated carbonated drinks	Citrate or Citric Acid (Vit C)
Obesity – Weight Gain	Dietary Fiber

Water

Someone who tends to form stones should try to drink enough liquids throughout the day to produce at least 2 litres of urine in every 24-hour period.
It is not the quantity of fluid consumed that is important, but rather the fluid voided that should be measured. Patients living in hot or dry conditions, or who exercise and perspire significantly, will need to drink even more liquid to maintain adequate urine output.

Oxalate combines with calcium – insoluble Calcium Oxalate crystals
Less than 50 mg of oxalate per day in the diet.

Foods high in Oxalate Content
Almonds	Peanuts
Amla	Phalsa
Amaranth, tender	Rhubarb
Beets	Soy products (tofu)
Blackberries	Spinach
Chocolate/cocoa /chocolate drink mixes	Strawberries
Cashew nuts	Swiss chard
Okra	Tea
Gooseberries	Wheat bran
Grapefruit	Raspberries (black)

Myth – Dietary Calcium & Kidney Stones

A recent study conducted Brigham and Women’s Hospital and Harvard Medical School on more than 90,000 women, showed “that women with the highest intake of dietary calcium had the lowest risk of kidney stones.”Calcium is believed to neutralize the absorption of oxalate, has been linked to kidney stone formation.”For those taking calcium supplement the risk of kidney stones increased slightly. “Calcium supplements are often not taken in conjunction with meals, limiting the calcium’s ability to neutralize the absorption of oxalate.” This is why diet to increase calcium intake, and avoid supplements.

Dietary Protein and Kidney Stones

A small amount of dietary protein can be converted to oxalic acid in the body and excreted as such in the urine. In addition, dietary protein is known to enhance calcium excretion in the urine.
When the average dietary protein was reduced from 86.5 to 54 g/day there was a reduction in urinary calcium excretion of nearly 50% (from 9.35 to 6.45 mmol/day).
Most protein-rich foods may also increase urinary uric acid levels. This is because most high-protein foods (except milk) usually contain a large amount of purines that breakdown into uric acid.
The risk of kidney stone formation seems greater from animal than vegetable proteins

Animal Protein

The higher sulfur amino acid content of animal compared to vegetable proteins may increase calcium excretion. In addition, excess sulfur-containing amino acids will increase a rare form of kidney stones (containing cystine) in people with an inherited metabolic defect.

Magnesium

Take a magnesium supplement of at least the US RDA of 300-350 mg/day (more may be desirable in order to maintain an ideal 1:2 balance of magnesium to calcium)
A vitamin B6 and magnesium deficiency may also cause stone formation. A Swedish research group found that taking both daily stopped stone formation in 90% of their patients. Magnesium, like calcium, can bond with the oxalate and acts as a inhibitor of the formation of calcium oxalate crystals in the urine.
The mean stone episode rate decreased from 0.8 to 0.08 stones/year on Magnesium supplement and 85% of the patients remained free of recurrence during follow-up, whereas 59% of the patients in the control group continued their stone formation. (Johansson and Backman U)

Sodium

Diets low in sodium are effective in reducing stone formation by decreasing the excretion of calcium. Because calcium and sodium compete for reabsorption in the renal tubules, excess sodium intake and consequent excretion result in loss of calcium in the urine.
High-sodium diets are associated with greater calcium excretion in the urine (Lemann, 2002).
Aim for < 3000 milligrams of sodium per day.

To reduce the sodium in your diet:

Enjoy your food without added salt. Use vinegar, herbs, & spices to flavor your foods instead of salt.
Cook without salt.
Check food labels. If the food contains more than 250 milligrams of sodium per serving, it contains too much sodium. In general, the more processed a food is, the greater is its sodium content

Potassium and kidney stones

In one study of over 45,000 men, those whose daily intake of potassium was more than 4.3 grams per day were 50% less likely to develop kidney stones than those with potassium intakes of less than 3 grams per day.
Potassium rich foods as fruits and vegetables.

Soft or Carbonated Drinks

Not only dehydrates making one more prone to kidney stones, but also contains phosphates, which is linked to higher kidney stone recurrence.
Any caffeinated beverage is dehydrating,so for every cup of a caffeinated beverage you drink, do drink a glass of water with it
Sugary drinks tend to mess with calcium and magnesium absorption, once again increasing one’s risk for kidney stones.

Weight

Incidence of stone disease were directly associated with weight and body mass index. However, the magnitude of the associations was consistently greater among women
Obesity increases the risk of kidney stones, but it’s theorized that insulin resistance, a common condition in obese people, increases the amount of calcium in the urine. This, in turn, contributes to the formation of crystals that develop into kidney stones.

Dietary Fiber

Fiber is the indigestible part of plants.
There are two types of fiber: soluble (dissolves in water) and insoluble. Both provide important functions in the body.
Insoluble fiber (found in wheat, rye, barley, and rice) help to reduce calcium in the urine. It combines with calcium in the intestines, so the calcium is excreted with the stool instead of through the kidneys.
Insoluble fiber also speeds up movement of substances through the intestine, so there will be less time for calcium to be absorbed.

Sugar

Kidney stones are associated with high sugar intake, so eat less (or no) added sugar

Alcohol

People should have no more than two drinks-two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of hard liquor-a day.
Alcohol per se does not lead to kidney stone formation. It does make stone sufferers pass more urine that can lead to a dehydrated state. Alcohol likewise indirectly inhibits the kidneys’ ability to excrete uric acid from the human body.
Cases of men who regularly drink alcoholic beverages (about two to four bottles a day) like beer upped their risks of suffering from gout, which can lead to stone formation.

Vitamin B

B-6 deficiency produces kidney stones in experimental animals.
B₆ (10 mg a day) lowers the amount of oxalate in the urine.
In high doses, it is also used medically to treat kidney stones.
B-6 deficiency is very common in humans.
B-1 (thiamine) deficiency also is associated with stones (Hagler and Herman,

References:

http://www.uvm.edu/~jmontany/SendDan/healthDan/RoleOfDiet.pdf

http://www.time-to-run.com/nutrition/vitc.htm

http://www.ncbi.nlm.nih.gov/pubmed/572722

http://healthoracle.org/downloads/K/Kidney%20Stones%2001.pdf

http://www.jacn.org/content/25/suppl_3/271S.full

“Oxalate Metabolism, II” American Journal of Clinical Nutrition, 26:8, 882-889, August, 1973)

(J. A. Thom, et al “The Influence of Refined Carbohydrate on Urinary Calcium Excretion,” British Journal of Urology, 50:7, 459-464, December, 1978)

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, andosteoarthritis.

What causes obesity?

Diet: Eating high fat, high calorie foods causes weight gain.
Lack of exercise: Sedentary people don’t burn as many calories as active people.
Genetics: Your genes may influence how much fat your body stores and where it is stored. But genes alone do not mean you will be obese.
Age: People gain weight as they get older, because they tend to be less active and to lose muscle mass.
Psychological issues: Some people overeat when they are upset or stressed.
Medications: Some drugs, such as corticosteroids, blood pressure medication, and tricyclic antidepressants, can cause you to gain weight.
Medical problems: Rarely, obesity is due to a medical problem such as Cushing syndrome (where the adrenal glands produce too much hormone) or hypothyroidism (where the thyroid gland doesn’t produce enough hormone). Conditions such as osteoarthritis cause people to be less active, which can lead to weight gain.
Prenatal environmental factors: Several studies show that adult men and women who were born small for their gestational age are more likely to be overweight or obese than those who were of normal size at birth. Maternal smoking and excess weight gain is also associated with offspring obesity.

Food to limit

Foods rich in saturated and trans fats

This includes fatty red meat, whole milk, heavy cream, poultry skin, butter, margarine, shortening, potato chips and deep-fried foods.

Foods rich in added sugar

Such as cookies, cake, pastries, candy and sugar-containinng soft drinks may also dampen your weight loss efforts.

Food to take

Food that encourage nutrient-rich foods, particularly those that encourage and support calorie reduction.

Healthy foods that includes foods from all necessary nutrient groups

This includes vegetables, complex carbohydrates, lean proteins and modest amounts of healthy fats. Choose primarily fresh, colorful fruits and vegetables, as they tend to provide the richest amounts of vitamins, minerals, fiber and water.