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Southern Men in Their 40s at Higher Risk for Kidney Stones

Combining ones' genetic predisposition and these factors put people at high risk for kidney stones. Oxalate from foods is usually present in urine. The oxalate forms a salt with calcium that has a low solubility factor (it does not dissolve easily; it does precipitate into crystals easily). Even mild chronic dehydration can increase the likelihood of kidney stone formation. Inactivity has been associated with increased kidney stone formation.

Dietary Recommendations for patients with history of Kidney Stones

Diet can contribute to the formation of kidney stones. Sometimes diet modification may be all that is needed to prevent the formation of stones. Others may need medical treatment in addition to dietary changes. "For years, the focus in dietary prevention has been calcium restriction," said Dr. Yuan. "We have learned that calcium restriction may actually promote stone formation. It's vital that you consult with your physician before making any dietary restrictions." Dr. Yuan makes the following dietary recommendations for general good health and to help in stone prevention:

Fluids

You should drink enough fluid to produce 2-3 quarts of urine daily. The volume of urine output is what matters so if you're sweating a lot, you need more fluids. This is especially true in the summer months.
Most kidney stones form at night when you are more likely to become dehydrated. Stones form and grow best when urine is dark and concentrated. Drink water before going to bed, enough so that you'll have to get up once during the night.
During the day, drink 12 to 16 oz of water when you get up, with each meal, in between meals and at bedtime. If the urine has any color or smell, you need to drink more.
Drink water and avoid large amounts of tea or coffee.

Salt

Salt, sodium chloride is excreted by the kidney in such way that calcium follows salt into the urine. Salt also works to promote stone formation by aggravating other factors already at work in forming stones.
Excess in salt intake is among the most common problems in patients with recurrent kidney stones. Be aware salt is everywhere!!! Most prepared food is already high in salt content without any being added at the table by you.

Calcium

As previously noted, calcium restriction is not needed in most patients with kidney stones. As a matter of fact, calcium restriction may be counterproductive. We recommend you continue with your regular calcium intake unless directed otherwise, assuming that you do not drink a gallon of milk everyday or ingest large number of Tums or Rolaids.
The main sources of dietary calcium include dairy products, meat and dark green leafy vegetables.
Most female patients do not need to interrupt calcium supplement for osteoporosis prevention, check with your physician prior to making any changes.
One should also avoid excessive tanning or sun bathing; tanning promotes dehydration and calcium metabolism by converting excessive vitamin D to the active form.

Protein

Protein, especially animal protein, is very problematic; it promotes stone formation via a variety of mechanisms. Unfortunately, high protein diets of many permutations have ruled the current dietary landscape with no end in sight. A recent study comparing various weight loss diet regimens showed that while the "Low Carb" diet may lead to quicker weight loss than others, over time, the net weight loss effects are equivalent regardless of the initial approach.
My recommendation is to avoid the Atkin's or the South Beach diets and consider a more physiological approach by incorporating a balanced diet with exercise to avoid the pitfalls of high protein intake and kidney stones.
Limit your animal protein intake -- if you love an occasional good steak, please double up on your water drinking.

Oxalate

High level of urinary oxalate is perhaps the worst and the most difficult problem to have. We have only limited means of lowering the oxalate excretion since the bulk of the oxalate in the urine comes from body's own amino acid metabolism.
Dietary sources of oxalate include mega-doses of vitamin C, rhubarb, spinach, beet, peanuts, chocolate, celery, parsley, tea and coffee. You may consume these items in moderation and please avoid binges of excess, stay well hydrated to "flush out" the oxalate that may get into the system following a glass of ice tea or a chocolate dessert.

Citric acid or Citrate

Citrate is extremely beneficial in stone prevention and is safe. The best source of citrate is prescription citrate supplement such as Urocit-K or Polycitra. Natural citrate can be found in orange or grapefruit juice, although it's difficult to obtain enough citrate from natural sources for stone prevention.
For those with normal urinary citrate levels not requiring pharmacological replacement, you may supplement with a large glass of orange or grapefruit juice 2 to 3 times per day including once before bedtime.

Fiber

Bran, especially corn bran, may be added to your diet. Daily intake of 10 to 15 grams have been shown to reduce stone formation. Avoid wheat or rice bran, both contain a fair amount of oxalate.

Magnesium

Magnesium is a stone inhibitor similar to citrate; dietary sources of magnesium overlap those of calcium that makes natural sources impractical. You may obtain over the counter magnesium supplement and follow the direction on the bottle. Do not over consume to avoid potential magnesium toxicity.