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Findings Suggest Heart-Healthy Diets May Reduce Risk of Kidney Stones

Mike Mitka
JAMA. 2009;302(10):1048-1048. doi:10.1001/jama.2009.1298
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A diet that is intended to improve blood pressure and cardiovascular health may also reduce the risk of kidney stone formation.

A new study found that individuals whose food consumption best reflected the Dietary Approaches to Stop Hypertension (DASH) diet were up to 45% less likely to develop kidney stones compared with those whose eating habits were least reflective of DASH (Taylor EN et al. J Am Soc Nephrol. 10.1681/ASN.2009030276 [published online August 13, 2009]). The DASH diet, which is associated with reduced risk of stroke and cardiovascular disease, emphasizes eating high levels of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains, and low levels of salt, sweetened beverages, and red and processed meats.

Lead author Eric N. Taylor, MD, of Harvard Medical School in Boston, said physicians have traditionally advised patients with nephrolithiasis to consume more or less of certain nutrients rather than adopt a total dietary approach. But the success of such a scattershot approach might be limited if, for example, patients who stop eating animal protein to decrease kidney stone risk instead consume higher levels of sucrose or fructose, which increase risk.

Because patients who develop kidney stones have high rates of hypertension, Taylor and colleagues decided to study the effect of a DASH-type diet because it lowers blood pressure and contains foods—fruits, vegetables, and dairy products—known to reduce stone formation risk. However, they “could not anticipate the effects of the diet because it is also higher in certain factors thought to raise risk—oxalate and vitamin C,” said Taylor.

In a prospective analysis of data from the Health Professionals Follow-up Study (involving 45 821 men and 18 years of follow-up) and the Nurses' Health Study I (94 108 older women and 18 years of follow-up) and II (101 837 younger women and 14 years of follow-up), Taylor and colleagues assessed the relationship between a DASH-type diet (a DASH “score” was assigned based on intake of 8 diet components) and incident symptomatic kidney stones. Despite having higher levels of oxalate and vitamin C, men and women with higher DASH scores were significantly less likely to develop kidney stones compared with those having lower DASH scores.

The researchers noted that a randomized trial is needed to determine the efficacy of a DASH-style diet compared with current therapies to reduce kidney stone formation. They also pointed out that their study could not link the DASH-type diet to specific stone types. Taylor added, “This is very promising, but you still need to tailor individual treatments to individual patients based on stone type and 24-hour urine composition.”

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