Study: Patients with nephrolithiasis ate fewer vegetables, drank more diet soda
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Key takeaways:
- People with kidney stone history drank more diet soda, less alcohol and ate fewer vegetables than people in the control group.
- Researchers said future studies should include objective nutritional biomarkers.
People with a history of kidney stones had a similar diet overall to those who have never had nephrolithiasis but drank more diet soda and ate fewer vegetables, according to a study in a Swiss population.
Participants with kidney stones were also more likely to consume nuts, seeds and fresh cheese, as well as local cakes and biscuits, researchers wrote in the Journal of Renal Nutrition.
“Kidney stones are associated with high morbidity (potential complications include ureteral obstruction or kidney failure) and high costs,” Constance Legay, MMed, MD-PhD, of the department of biomedical sciences at the University of Lausanne in Switzerland, and colleagues wrote. “Kidney stone prevalence reaches 5% to 10% in Europe and has been increasing worldwide during the last decades.
“Primary and secondary prevention based on efficient dietary recommendations has a major role to play to fight this public health problem,” they wrote.
Describing the study as “a first step toward understanding kidney stone formers’ diet specificities,” Legay and colleagues wrote that mitigating kidney stone formation involves encouraging patients to pursue “a diet rich in vegetables, dairy products and limited in meat and salt,” as well as taking in a high volume of beverages – preferably water or something unsweetened – to dilute stone-forming components in the urine.
Patient selection
Dietary data on people who form kidney stones in the study were drawn from the Swiss Kidney Stone Cohort. Participants (n = 261) were selected if they were adults with more than one stone episode, or one episode with other risk factors, including occurrence of stone formation before the age of 25 years and a family history of nephrolithiasis.
A control group of participants with no kidney stone history (n = 197), validated by CT scan, was recruited from the general adult Swiss population.
Both groups completed two consecutive 24-hour dietary recalls, quantifying food and beverages consumed during the last 48 hours. Researchers calculated each participant’s mean consumption between the two recalls, and they used separate statistical models to associate kidney stone status with probability of consumption and reported quantity consumed.
Coffee, vegetables
Compared with individuals with no kidney stone history, results showed that people with a history of nephrolithiasis reported consuming smaller amounts of the following:
- vegetables (B coefficient = –0.23; 95% CI, –0.41 to –0.06);
- coffee (B coefficient = –0.21; 95% CI, –0.37 to –0.05);
- teas (B coefficient = –0.52; 95% CI, –0.92 to –0.11); and
- alcoholic beverages (B coefficient = –0.34; 95% CI, –0.63 to –0.06).
Individuals with kidney stone history were more likely to consume cakes and biscuits (OR = 1.56; 95% CI, 1.03-2.37) and soft drinks (OR = 1.66; 95% CI, 1.08-2.55).
People with kidney stone history were less likely to consume:
- nuts and seeds (OR = 0.53; 95% CI, 0.35-0.82);
- fresh cheese (OR = 0.54; 95% CI, 0.30-0.96);
- teas (OR = 0.50; 95% CI, 0.3-0.84); and
- alcoholic beverages (OR = 0.35; 95% CI, 0.23-0.54).
Participants who formed kidney stones had a lower probability of alcoholic beverage intake, including less consumption of wine (OR = 0.42; 95% CI, 0.27-0.65), but not beer.
Researchers debated the impact of the finding that participants who formed kidney stones had lower consumption of tea and other oxalate-containing food vs. the control group, writing that some participants may have already been avoiding those items to prevent stone formation. They also highlighted reliance on 24-hour dietary recalls as a limitation of the study, noting patient recollections are “subject to errors and biases and have been shown to poorly estimate total energy intake.”
The authors concluded that future research should employ objective biomarkers of nutrition – such as sodium, potassium or urea levels in 24-hour urine collections – along with self-reports to determine risk of kidney stone formation.
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