A Science-Backed Guide to Managing Kidney Stones Through Diet and Supplements by Tony Tiller Clinical Lead for Body Fabulous Health Clinic

Kidney stones can be incredibly painful, and once you've had one, you're at higher risk of experiencing another. Managing kidney stones is not just about dealing with the immediate pain and discomfort—they require ongoing attention, particularly when it comes to your diet and supplementation. Making the right dietary adjustments and incorporating certain supplements into your routine can help prevent the formation of new stones and reduce the likelihood of recurrence. Here’s a comprehensive, science-backed guide to help you manage kidney stones effectively.

1. Hydration: The Foundation of Kidney Stone Prevention

Water Intake: The most crucial strategy in preventing kidney stones is staying hydrated. Aim to produce at least 2.5 litres of urine daily, which typically requires drinking about the same amount of water. Proper hydration helps to dilute the substances in your urine that can lead to the formation of stones.

Citrate-Rich Beverages: Adding lemon or lime juice to your water can provide citrate, a compound that helps prevent stones, particularly calcium oxalate stones. Citrate works by binding with calcium in the urine, reducing the risk of stone formation.

2. Dietary Calcium: Get It from Food, Not Supplements

Adequate Calcium Intake: Contrary to the old belief that calcium should be limited, current research suggests that dietary calcium is actually beneficial. Aim for 1,000-1,200 mg of calcium daily from food sources such as dairy products. Calcium binds with oxalate in the gut, which reduces oxalate absorption and, consequently, the risk of stone formation.

Avoid Calcium Supplements: While dietary calcium is beneficial, calcium supplements can increase the risk of stone formation unless specifically recommended by your healthcare provider. When it comes to calcium, food sources are the preferred choice.

3. Limit Oxalate-Rich Foods

Reduce High-Oxalate Foods: Foods high in oxalates can contribute to kidney stone formation. Common high-oxalate foods include spinach, beets, nuts, rhubarb, chocolate, and sweet potatoes. While you don't have to eliminate these foods entirely, it's wise to limit their intake if you're prone to stones.

Pair Oxalate Foods with Calcium: When you do consume high-oxalate foods, try to pair them with calcium-rich foods. This combination helps reduce oxalate absorption in the gut, lowering your risk of stone formation.

4. Watch Your Sodium Intake

Reduce Sodium: High sodium intake is linked to an increased risk of kidney stones because it raises the amount of calcium in your urine. Aim to limit your sodium intake to no more than 2,300 mg per day. If you are at a higher risk for kidney stones, consider lowering your sodium intake further to 1,500 mg per day.

5. Moderate Your Protein Intake

Moderate Animal Protein: A diet high in animal protein (meat, fish, eggs) can increase the risk of kidney stones by raising calcium levels in the urine and lowering citrate levels. Try to limit your intake to 0.8-1.0 grams of protein per kilogram of body weight per day.

Plant-Based Proteins: Incorporating more plant-based proteins, such as beans, lentils, and tofu, into your diet may help lower your risk of stone formation. These sources of protein are less likely to contribute to stone formation compared to animal proteins.

6. Increase Potassium-Rich Foods

Increase Potassium: Potassium can play a crucial role in reducing the risk of kidney stones. Foods rich in potassium include bananas, oranges, cantaloupe, potatoes, and avocados. Including these in your diet can help keep your kidneys healthy and reduce stone risk.

7. Limit Sugary Drinks and Excess Sugar

Avoid High-Sugar Drinks: Fizzy drinks, especially those sweetened with high-fructose corn syrup, can increase the risk of kidney stones. While such beverages are less common in the UK, it's still important to watch your sugar intake overall, as excessive sugar can contribute to stone formation.

8. Supplement Guidance: Know What Helps and What Hurts

Citrate Supplements: Potassium citrate supplements can be particularly effective in preventing calcium oxalate stones. By increasing urinary citrate, these supplements help reduce the likelihood of stone formation.

Magnesium: Magnesium plays a role in preventing stone formation. A daily supplement of 200-400 mg may help reduce your risk, but it’s important to consult with a healthcare provider before starting any new supplement regimen.

Vitamin B6: Vitamin B6 has been shown to reduce urinary oxalate levels, which can help prevent the formation of stones. A typical supplement dose ranges from 25-50 mg per day, but again, it's best to take this under medical supervision.

Avoid Excess Vitamin C: While Vitamin C has many benefits, high doses (more than 500 mg/day) can increase oxalate production, potentially raising the risk of kidney stones. If you're prone to stones, keep your Vitamin C intake in check.

9. Limit Purine-Rich Foods for Uric Acid Stones

For Uric Acid Stones: If you are prone to uric acid stones, it’s important to limit foods high in purines, such as red meats, organ meats, and shellfish. A low-purine diet can help reduce the levels of uric acid in your urine, lowering your risk of stone formation.

10. Alcohol Consumption: Practice Moderation

Moderation is Key: Excessive alcohol consumption can increase uric acid production, raising the risk of uric acid stones. Moderate alcohol consumption is advisable, particularly if you’re prone to kidney stones.

Managing kidney stones involves a multi-faceted approach that includes dietary adjustments, appropriate supplementation, and regular monitoring. By following these science-backed strategies, you can significantly reduce your risk of developing new stones and improve your overall kidney health. Remember, every individual is different, so it's always a good idea to consult with a health professional to tailor these recommendations to your specific needs.