Diet, exercise play a role in reducing stone formation risks

Overweight, obesity, poor diet and the lack of physical exercise may play a role in increasing the risks for stone formation and experts say that there are links between good lifestyle habits and kidney stone disease.

“Balanced diet, appropriate fluid intake, reduction of overweight and physical activity are among the recommendations for patients to avoid the risks of stone formation,” said Roswitha Seiner (AT) during her lecture on dietary and lifestyle habits at the 3rd Meeting of the EAU Section of Urolithiasis (EULIS) in Alicante, Spain.

Seiner noted that studies showed the increasing prevalence of kidney stones in many countries. In Germany, for example, the incidence of stone disease over two decades grew from 0.5% to 1.5%, while the prevalence rate grew to 4.7% in 2001 from 4% in 1979. In comparison, the prevalence rate in the US in the period 1988 to 1994 was recorded at 5.2%, which jumped to 8.8% in the period 2007 to 2010.

Developed or affluent countries are known to record a range of lifestyle diseases among their populace due to changes in diet and the lack of physical exercise. Moreover, in studies among women with recurrent stone disease, experts have noted that their diet lack a regular intake of fruits and vegetables.

“A diet high in fruits, fibre and vegetables may reduce stone risk by increasing urinary citrate,” said Seiner adding that other researchers also found out that the high intake of dietary calcium appears to decrease the risk for symptomatic kidney stones.

Doctors also advise patients to increase their fluid intake to around 2.5 litres of water a day and minimise, if not eliminate, the intake of high-calorie beverages. Moreover, Seiner said regular physical exercise helps or complements a balanced diet and healthy lifestyle.

Compliance among patients to follow a healthy lifestyle is difficult since there are stone formers who do not show the signs of the disease, or so-called asymptomatic stone formers. Treatment of these stones may then require more invasive procedures since the stones form, undetected, over several years.

In a related lecture, nephrologist R. Unwin (GB) examined the role of genetic predisposition among stone formers and discussed the role of specific genes that studies indicate may help explain why some people are prone to develop the disease.

Unwin, however, said these studies are still ongoing and more data need to be collected for them to have a role in meaningful therapeutic interventions.

“There are still a lot of questions that need to be answered, and the challenge is for researchers to integrate their studies, link up or pool their efforts in order to look into specific patient characteristics,” he explained. He added there are studies ongoing but what is going to advance the work is to have well-defined patient populations and the ability to characterise them in a more refined way.

“There would be study progress in the next few years, but I don’t expect dramatic breakthroughs. What has been limiting these studies is the fact that we’re looking at large populations, when in fact the underlying (patient) populations are more heterogeneous,” explained Unwin.