Mediterranean diet adherence and risk of incident kidney stones

Abstract

Background Diet plays an important role in kidney stone formation. Several individual components have been associated with the risk of kidney stone formation, but there is limited evidence regarding the role of healthful dietary patterns. Objective To prospectively study the association between adherence to the Mediterranean diet and the risk of incident kidney stones. Methods We conducted a longitudinal study using 3 different cohorts: the Health Professionals Follow-up Study (n = 42,902 men), the Nurses’ Health Study I (n = 59,994 women), and the Nurses’ Health Study II (n = 90,631 women). We assessed diet every 4 y using an FFQ and calculated adherence to a Mediterranean diet using the alternate Mediterranean diet score (aMED). A subgroup of 6077 participants provided ≥1 24-h urine sample, and urinary solute excretion was analyzed. We used Cox proportional hazards regression to examine the independent association between the aMED and incidence of kidney stones, adjusting for potential confounders. We used adjusted linear regression models to study the relation between aMED and urine composition. Results During 3,316,633 person-years of follow-up, 6576 cases of incident kidney stones were identified. For participants in the highest aMED score category, the risk of developing a kidney stone was between 13% and 41% lower compared with participants in the lowest score (pooled HR: 0.72, 95% CI: 0.59, 0.87; P value for trend <0.001). A higher aMED score was associated with higher urinary citrate, magnesium, oxalate, phosphate, uric acid, volume, and pH, and lower urinary sodium, resulting in lower supersaturation for calcium oxalate, calcium phosphate, and uric acid. Conclusion Adherence to a Mediterranean diet is associated with a lower risk of developing a kidney stone.

Idiopathic Osteoporosis and Nephrolithiasis: Two Sides of the Same Coin?

“…With regard to dietary patterns, a Western type of diet, characterized by a significant share of highly processed and refined foods and high content of sugars, salt, fat and animal protein, has been recognized as an important factor contributing to the development of metabolic disorders such as osteoporosis and nephrolithiasis [70,71]. On the contrary, there is growing evidence that a higher adherence to a Mediterranean-type of diet significantly reduces the incidence of nephrolithiasis [72][73][74] and is associated with a reduced risk of bone fractures as well as with a higher mean bone mineral density [75,76]. The principles underlying the Mediterranean diet, recognized by UNESCO as an intangible cultural heritage of humanity [77], can be summarized as follows: high consumption of fruits, vegetables, cereals (especially whole seeds), legumes, and nuts; relatively high fat consumption (up to 40% of total energy intake), mainly as monounsaturated fatty acids from extra-virgin olive oil, the main fat used for seasoning and cooking; moderate to high consumption of fish; moderate dairy product consumption, usually in the form of yogurt and cheese; low red meat and meat product consumption; moderate alcohol consumption, mainly in the form of red wine during meals; low consumption of simple sugars (pastries, soft drinks, etc.…”

Nephrolithiasis: A Red Flag for Cardiovascular Risk

“…This would allow for treatment with either dietary and lifestyle interventions or, in more severe cases, with drugs. Regarding diet and lifestyle, the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet, whose beneficial effects on CV risk are well known, have been shown to decrease the incidence of nephrolithiasis [ 126 , 127 ].…”

泌尿系结石及结石成分的流行病学研究进展

“…以往的研究表明，与泌尿系结石形成相关的危险因素可 分为两大类，包括内在因素和外在因素 [2][3][4][5] 。前者包括年龄、 性别、种族和遗传因素等，而后者则包括社会经济状况、饮 食 / 水习惯和生活方式、气候环境、职业和教育水平等 [3,6] 。 2.1 年龄 根据流行病学报告 [3] ，尿路结石的发病率随着年龄的增…”