The Impact of Diet on Urinary Risk Factors for Cystine Stone Formation

Despite the importance of dietary management of cystinuria, data on the contribution of diet to urinary risk factors for cystine stone formation are limited. Studies on the physiological effects of diet on urinary cystine and cysteine excretion are lacking. Accordingly, 10 healthy men received three standardized diets for a period of five days each and collected daily 24 h urine. The Western-type diet (WD; 95 g/day protein) corresponded to usual dietary habits, whereas the mixed diet (MD; 65 g/day protein) and lacto-ovo-vegetarian diet (VD; 65 g/day protein) were calculated according to dietary reference intakes. With intake of the VD, urinary cystine and cysteine excretion decreased by 22 and 15%, respectively, compared to the WD, although the differences were not statistically significant. Urine pH was significantly highest on the VD. Regression analysis showed that urinary phosphate was significantly associated with cystine excretion, while urinary sulfate was a predictor of cysteine excretion. Neither urinary cystine nor cysteine excretion was affected by dietary sodium intake. A lacto-ovo-vegetarian diet is particularly suitable for the dietary treatment of cystinuria, since the additional alkali load may reduce the amount of required alkalizing agents.

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Trends in Dietary Sodium Intake in the United States and the Impact of USDA Guidelines: NHANES 1999-2016

The American Journal of Medicine ◽

10.1016/j.amjmed.2019.04.040 ◽

2019 ◽

Vol 132 (10) ◽

pp. 1199-1206.e5 ◽

Cited By ~ 6

Author(s):

Adam M. Brouillard ◽

Aldi T. Kraja ◽

Michael W. Rich

Keyword(s):

United States ◽

Sodium Intake ◽

The United States ◽

Dietary Sodium ◽

The Impact

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Cystine stones

10.1093/med/9780199592548.003.0203_update_001 ◽

2018 ◽

Author(s):

Michel Daudon ◽

Paul Jungers

Keyword(s):

Amino Acids ◽

Sodium Intake ◽

Stone Formation ◽

Preventive Therapy ◽

Potassium Citrate ◽

Close Monitoring ◽

Urine Ph ◽

Flexible Ureterorenoscopy ◽

Equal Distribution ◽

Cystine Stones

Cystinuria, an autosomal recessive disease (estimated at 1:7000 births worldwide), results from the defective reabsorption of cystine and dibasic amino acids (also ornithine, arginine, lysine, COAL) by epithelial cells of renal proximal tubules, leading to an abnormally high urinary excretion of these amino acids. Due to the poor solubility of cystine at the usual urine pH, formation of cystine crystals and stones ensues. Incidence of homozygotes is estimated at 1 in 7000 births worldwide, but is lower in European countries and much higher in populations with frequent consanguinity. Cystine stones represent 1–2% of all stones in adults and 5–8% in paediatric patients, with an equal distribution between males and females.Cystinuria is caused by inactivating mutations in the gene SLC3A1 or SLC7A9, both encoding proteins contributing to the function of the heterodimeric transport system of cystine.Cystine nephrolithiasis may present in infants, most frequently in adolescents or young adults, sometimes later. Cystine calculi are weakly radio-opaque. Stone analysis using infrared spectroscopy (or X-ray diffraction) allows immediate and accurate diagnosis. Urinary amino acid chromatography quantifies urinary cystine excretion, needed to define the therapeutic strategy.Urological treatment of cystine stones currently uses extracorporeal stone wave lithotripsy or flexible ureterorenoscopy with Holmium laser, that is, minimally invasive techniques. However, as cystine stones are highly recurrent, preventive therapy is essential.Medical treatment combines reduced methionine and sodium intake, to lower cystine excretion; hyperdiuresis (> 3 L/day) to reduce cystine concentration; and active alkalinization preferably using potassium citrate (40–80 mEq/day) to increase cystine solubility by rising urine pH up to 7.5–8. If these measures are insufficient to prevent recurrent stone formation, a thiol derivative (D-penicillamine or tiopronin), which converts cystine into a more soluble disulphide, should be added. Close monitoring and adherence of the patient to the therapeutic programme are needed to ensure life-long compliance, the key for successful prevention in the long term.

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Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.2.105 ◽

2015 ◽

Vol 87 (2) ◽

pp. 105 ◽

Cited By ~ 69

Author(s):

Domenico Prezioso ◽

Pasquale Strazzullo ◽

Tullio Lotti ◽

Giampaolo Bianchi ◽

Loris Borghi ◽

...

Keyword(s):

Risk Factors ◽

Urinary Excretion ◽

Renal Stone ◽

Sodium Intake ◽

Stone Formation ◽

Urinary Stone ◽

Fruit And Vegetables ◽

Calcium Excretion ◽

Urinary Oxalate ◽

Stone Formers

Objective: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease. Materials and Methods: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori. Studies were screened by titles and abstracts for eligibility. Data were extracted using a standardized form and the quality of evidence was assessed. Results: Evidence from the selected studies were used to form evidencebased guideline statements. In the absence of sufficient evidence, additional statements were developed as expert opinions. Conclusions: General measures: Each patient with nephrolithiasis should undertake appropriate evaluation according to the knowledge of the calculus composition. Regardless of the underlying cause of the stone disease, a mainstay of conservative management is the forced increase in fluid intake to achieve a daily urine output of 2 liters. Hypercalciuria: Dietary calcium restriction is not recommended for stone formers with nephrolithiasis. Diets with a calcium content ≥ 1 g/day (and low protein-low sodium) could be protective against the risk of stone formation in hypercalciuric stone forming adults. Moderate dietary salt restriction is useful in limiting urinary calcium excretion and thus may be helpful for primary and secondary prevention of nephrolithiasis. A low-normal protein intake decrease calciuria and could be useful in stone prevention and preservation of bone mass. Omega-3 fatty acids and bran of different origin decreases calciuria, but their impact on the urinary stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. Hyperoxaluria: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults) reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. Hyperuricosuria: In patients with renal calcium stones the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not clearly demonstrated. Hypocitraturia: The administration of alkaline-citrates salts is recommended for the medical treatment of renal stone-formers with hypocitraturia, although compliance to this treatment is limited by gastrointestinal side effects and costs. Increased intake of fruit and vegetables (excluding those with high oxalate content) increases citrate excretion and involves a significant protection against the risk of stone formation. Citrus (lemons, oranges, grapefruit, and lime) and non citrus fruits (melon) are natural sources of dietary citrate, and several studies have shown the potential of these fruits and/or their juices in raising urine citrate levels. Children: There are enought basis to advice an adequate fluid intake also in children. Moderate dietary salt restriction and implementation of potassium intake are useful in limiting urinary calcium excretion whereas dietary calcium restriction is not recommended for children with nephrolithiasis. It seems reasonable to advice a balanced consumption of fruit and vegetables and a low consumption of chocolate and cola according to general nutritional guidelines, although no studies have assessed in pediatric stone formers the effect of fruit and vegetables supplementation on urinary citrate and the effects of chocolate and cola restriction on urinary oxalate in pediatric stone formers. Despite the low level of scientific evidence, a low-protein (< 20 g/day) low-salt (< 2 g/day) diet with high hydration (> 3 liters/day) is strongly advised in children with cystinuria. Elderly: In older patients dietary counseling for renal stone prevention has to consider some particular aspects of aging. A restriction of sodium intake in association with a higher intake of potassium, magnesium and citrate is advisable in order to reduce urinary risk factors for stone formation but also to prevent the loss of bone mass and the incidence of hypertension, although more hemodynamic sensitivity to sodium intake and decreased renal function of the elderly have to be considered. A diet rich in calcium (1200 mg/day) is useful to maintain skeletal wellness and to prevent kidney stones although an higher supplementation could involve an increase of risk for both the formation of kidney stones and cardiovascular diseases. A lower content of animal protein in association to an higher intake of plant products decrease the acid load and the excretion of uric acid has no particular contraindications in the elderly patients, although overall nutritional status has to be preserved.

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Lifestyle Cancer Survival Predictors: Influence of Vegetarian Diet on the Relapse of Endometrial Cancer

10.3233/shti210597 ◽

2021 ◽

Author(s):

Georgy Kopanitsa ◽

Oleg Metsker ◽

Ekaterina Bolgova ◽

Sergey Kovalchuk

Keyword(s):

Risk Factors ◽

Endometrial Cancer ◽

Cancer Survival ◽

Dietary Habits ◽

Progression Free Survival ◽

Vegetarian Diet ◽

Cancer Risk Factors ◽

Promising Tool ◽

Gynecological Tumor

Endometrial cancer (EC) is the most common gynecological tumor in high-income countries, and its incidence has increased over time. The most critical risk factor for EC is the long-term unopposed exposure to increased estrogens both exogenous and endogenous. Machine learning can be used as a promising tool to resolve longstanding challenges and support identification of the risk factors and their correlations before the clinical trials and make them more focused. In this paper we present the results of the research of the correlation analysis of Endometrial cancer risk factors. The study was performed with EC patients of the Almazov center in Saint-Petersburg, Russia. All women involved in the current study underwent radical surgical intervention due to EC. After initial cancer treatment, they were referred to the Almazov center outpatient specialists for follow-up visits. Many of them were readmitted of the inpatient clinic due to relapse. We extracted a variety of parameters related to lifestyle, dietary habits, socioeconomic, and reproductive features from the inpatient and outpatient databases of Almazov center. The medical records of the women with enough data were included in the study. Prediction of Progression-free survival (PFS) and overall survival (OS) were analyzed respectively. The AUC of ROC was calculated for PFS = 0.93 and for OS = 0.94.

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School nursing intervention for COVID-19-related mental health issues in the school health office

British Journal of Child Health ◽

10.12968/chhe.2021.2.5.218 ◽

2021 ◽

Vol 2 (5) ◽

pp. 218-222

Author(s):

Gabrielle Ochinegro ◽

Sydney Doyle ◽

Tracy Perron ◽

Evelyn Ehasz ◽

Mary Grace Chaiko ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Children And Adolescents ◽

School Health ◽

Dietary Habits ◽

Nursing Intervention ◽

Health Issues ◽

Health Trends ◽

Optimal Health ◽

The Impact

The purpose of this review is to discuss the impact of coronavirus disease 2019 (COVID-19) on the mental, physical and social health of children and young people aged 0–18 years, better understand the risk factors for these issues and explore available interventions to promote optimal health in this population globally. The risk factors, including increased screen time, economic instability, pre-existing mental illness and isolation, are explored in relation to their impact on paediatric health and wellbeing. Current mental health trends, including elevated rates of anxiety, depression, and suicide, and gaps in the available literature are discussed. The impact of the pandemic on overall health, nutrition, physical activity, household environments and sleep are also analysed in relation to possible school nurse interventions for children, parents, and communities in developing solutions to improve the health of children and adolescents. As a result of this review, the authors found significant negative correlations between children and adolescents' mental health and COVID-19 restrictions, such as altered social interaction, disturbed sleep, changes in level of exercise, and altered dietary habits.

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Sodium and Potassium Content of Foods Consumed in an Italian Population and the Impact of Adherence to a Mediterranean Diet on Their Intake

Nutrients ◽

10.3390/nu13082681 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2681

Author(s):

Marcella Malavolti ◽

Androniki Naska ◽

Susan J. Fairweather-Tait ◽

Carlotta Malagoli ◽

Luciano Vescovi ◽

...

Keyword(s):

Mediterranean Diet ◽

Dietary Habits ◽

Sodium Intake ◽

Northern Italy ◽

Potassium Content ◽

Dietary Recommendations ◽

Diet Patterns ◽

Potassium Intake ◽

The Impact ◽

Sodium And Potassium

High sodium and low potassium intakes are associated with increased levels of blood pressure and risk of cardiovascular diseases. Assessment of habitual dietary habits are helpful to evaluate their intake and adherence to healthy dietary recommendations. In this study, we determined sodium and potassium food-specific content and intake in a Northern Italy community, focusing on the role and contribution of adherence to Mediterranean diet patterns. We collected a total of 908 food samples and measured sodium and potassium content using inductively coupled plasma mass spectrometry. Using a validated semi-quantitative food frequency questionnaire, we assessed habitual dietary intake of 719 adult individuals of the Emilia-Romagna region. We then estimated sodium and potassium daily intake for each food based on their relative contribution to the overall diet, and their link to Mediterranean diet patterns. The estimated mean sodium intake was 2.15 g/day, while potassium mean intake was 3.37 g/day. The foods contributing most to sodium intake were cereals (33.2%), meat products (24.5%, especially processed meat), and dairy products (13.6%), and for potassium they were meat (17.1%, especially red and white meat), fresh fruits (15.7%), and vegetables (15.1%). Adherence to a Mediterranean diet had little influence on sodium intake, whereas potassium intake was greatly increased in subjects with higher scores, resulting in a lower sodium/potassium ratio. Although we may have underestimated dietary sodium intake by not including discretionary salt use and there may be some degree of exposure misclassification as a result of changes in food sodium content and dietary habits over time, our study provides an overview of the contribution of a wide range of foods to the sodium and potassium intake in a Northern Italy community and of the impact of a Mediterranean diet on intake. The mean sodium intake was above the dietary recommendations for adults of 1.5–2 g/day, whilst potassium intake was only slightly lower than the recommended 3.5 g/day. Our findings suggest that higher adherence to Mediterranean diet patterns has limited effect on restricting sodium intake, but may facilitate a higher potassium intake, thereby aiding the achievement of healthy dietary recommendations.

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Dietary Sodium (salt) Intake and Risk of Colorectal Cancer: A Systematic Review (P05-039-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz030.p05-039-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 2

Author(s):

Mohammad Yawar Yakoob ◽

Naila Baig-ansari

Keyword(s):

Colorectal Cancer ◽

Dietary Habits ◽

Sodium Intake ◽

Case Control ◽

Dietary Sodium ◽

Processed Meat ◽

Cross Sectional ◽

High Sodium ◽

High Sodium Intake ◽

Increased Risk

Abstract Objectives Studies have shown conflicting findings for association of processed meat with risk of colorectal cancer (CRC); with some studies showing an increased risk while others having no associations. Few studies have been done to study this association with salt (sodium) intake that is high in processed meats. Methods A comprehensive, systematic literature search was conducted on PubMed and Google.com to identify observational studies on dietary salt (sodium) intake for prevention of CRC. 1933 titles were identified and screened of which 86 abstracts were selected for full-text review; finally, 7 studies were included. Results In case-control studies from Jordan on 169 CRC cases (248 matched controls), from Siberia on 185 cases (210 matched controls), and from Greece on 250 cases (250 controls), high sodium intake was significantly associated with an increased CRC risk (highest to lowest quartile, OR = 3.42, 95% CI: 1.59–7.38; high vs. medium salt in food, OR = 3.45, 1.68–7.1; and added table salt yes vs. no, OR = 1.62, 1.05–2.49, latter got attenuated when adjusted for overall dietary habits, OR = 1.41, 0.90–2.20; respectively). However, in another case-control study from Australia on 715 cases (727 matched controls), high sodium intake was not associated with CRC (RR = 1.23, 0.9–2.4, P = 0.11). Similar for sub-group of colon cancer but significant only for rectal cancer (RR = 1.61, 1.1–2.3, P = 0.006). In a prospective cohort study from Japan on 81,578 subjects free of cancer/CVD at baseline, no association was found for sodium and CRC (highest vs. lowest quartile, HR = 1.10, 0.85–1.42, P-trend = 0.51). Other study designs have also shown increased risk. A cross-sectional study from Oman on 405 participants showed that eating food high in salt (26.8%) was a risk factor for stomach and colorectal cancer with significant associations in young age groups and with higher education. Lastly, in a comparative ecological study from South Africa, sodium intake was higher in West coast fishermen (6 CRC cases over 5 years/120,000) vs. urban Cape Town inhabitants (677/2 million). Conclusions Majority of studies were case-control design, most of which showed positive association between sodium intake and CRC. Cross-sectional/ecological studies support this. Meta-analysis needs to be done to increase sample size and explore potential heterogeneity. Funding Sources None.

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Use of Response Surface Methodology to Investigate the Effects of Sodium Chloride Substitution with Potassium Chloride on Dough’s Rheological Properties

Applied Sciences ◽

10.3390/app10114039 ◽

2020 ◽

Vol 10 (11) ◽

pp. 4039 ◽

Cited By ~ 1

Author(s):

Andreea Voinea ◽

Silviu-Gabriel Stroe ◽

Georgiana Gabriela Codină

Keyword(s):

Response Surface Methodology ◽

Rheological Properties ◽

Response Surface ◽

Wheat Flour ◽

Sodium Intake ◽

Dietary Sodium ◽

World Health ◽

Bakery Products ◽

Health Organization ◽

The Impact

Bakery products are one of the main sources of dietary sodium intake of the world’s population. During the last decade, sodium intake has increased worldwide and nowadays the World Health Organization recommends reducing sodium intake by up to 2 g Na/day. KCl is the leading substitute for reducing sodium in bakery products. Therefore, the main purpose of our study was to investigate the impact of sodium reduction on dough’s rheological properties by reformulating the dough recipe using two types of salts, namely NaCl and KCl, with different amounts added to wheat flour. In order to establish their combination for obtaining the optimum rheological properties of dough, the response surface methodology (RSM) by the Design Expert software was used. The effect of combined NaCl and KCl salts were made on mixing, viscometric and fermentation process by using Farinograph, Extensograph, Amylograph and Rheofermentometer devices. On dough’s rheological properties, KCl and NaCl presented a significant effect (p < 0.01) on water absorption, stability, energy, dough resistance to extension, falling number and all Rheofermentometer-analyzed values. Mathematical models were achieved between independent variables, the KCl and NaCl amounts, and the dependent ones, dough rheological values. The optimal values obtained through RSM for the KCl and NaCl salts were of 0.37 g KCl/100 g and 1.31 g NaCl/100 g wheat flour, which leads to a 22% replacement of NaCl in the dough recipe.

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Relationship between basal sodium intake and the effects of dapagliflozin in albuminuric diabetic kidney disease

Scientific Reports ◽

10.1038/s41598-020-79687-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sho Kinguchi ◽

Hiromichi Wakui ◽

Yuzuru Ito ◽

Yoshinobu Kondo ◽

Kengo Azushima ◽

...

Keyword(s):

Kidney Disease ◽

Diabetic Kidney Disease ◽

Sodium Intake ◽

Secondary Analysis ◽

Dietary Sodium ◽

Creatinine Ratio ◽

Diabetic Kidney ◽

Low Sodium ◽

Induced Changes ◽

The Impact

AbstractWe investigated the impact of basal dietary sodium intake on the dapagliflozin-induced changes in albuminuria and blood pressure (BP) measured at home in patients with diabetic kidney disease (DKD).This was a secondary analysis of the Y-AIDA Study, in which DKD patients with estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73 m2 and urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g creatinine were administered dapagliflozin for 24 weeks, and dapagliflozin significantly improved albuminuria levels and home BP profiles. The effects on UACR, home-measured BP, and eGFR were compared between high- and low-sodium intake groups (HS and LS groups), which were created using baseline urinary sodium-to-creatinine ratio of 84 participants with available basal sodium-to-creatinine ratios. At baseline, clinic-/home-measured BPs, UACR, and eGFR, were comparable in the two groups. After 24 weeks, the reductions from baseline in ln-UACR were comparable in the two groups. In contrast, the reductions in evening home systolic BP and eGFR from baseline were larger in HS than in LS (BP: − 13 ± 2.08 vs. − 6 ± 1.88, P = 0.020; eGFR: − 3.33 ± 1.32 vs. 0.37 ± 1.29, P = 0.049). The home BP-lowering effects of dapagliflozin are larger in HS than LS, concomitant with a larger reduction in eGFR, suggesting a dapagliflozin-induced improvement in glomerular relative hyperfiltration in HS.

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Prevalence and Potential Risk Factors Associated with High Sodium : Intake among Chinese-Haw Tribal in the Rural Area of Chiang Rai Province, Northern Thailand

The Open Public Health Journal ◽

10.2174/1874944502013010022 ◽

2020 ◽

Vol 13 (1) ◽

pp. 22-29

Author(s):

Phatcharin Winyangkul ◽

Lakkana Thaikruea ◽

Penprapa Siviroj ◽

Sakda Pruenglampoo

Keyword(s):

Risk Factors ◽

Potential Risk ◽

Sodium Intake ◽

Demographic Data ◽

Dietary Sodium ◽

Cross Sectional ◽

High Sodium ◽

Factors Associated ◽

High Sodium Intake ◽

Potential Risk Factors

Background: Sodium intake has a known association with increasing hypertension, cause of death from Cardiovascular Diseases (CVDs) worldwide. Ethnic group is increasingly exposed to risk factors to CVD causing of the urbanization and cultural changes. Methods: This cross-sectional study aimed to investigate the prevalence and potential factors associated with high sodium intake in the Chinese-Haw tribe in Chiang Rai province. Stratified random sampling was used to recruit participants. Face-to-face interviews were used for demographic data and assessment of dietary sodium knowledge, self-efficacy and food consumption. For dietary sodium intake, first-morning urine were collected for identifying concentration of sodium in millimoles per litre (mmol/L) using Atomic Absorption Spectrophotometer. Unconditional multiple logistic regression was used for determining risk factors associated with high sodium intake. Results: There were 302 participants of which majority were women (71.9%), with average age of 49.50 years (±12.12 S.D.). The prevalence of sodium intake was 90.70% more than 2,000 mg/day (High). The association between potential risk factors and high sodium intake revealed that men had higher risk than women (Risk Ratio 1.13, 95%CI 1.07 - 1.19). Multivariate analysis revealed only gender can predict a high sodium intake after adjusted for smoking patterns and alcohol consumption (adjusted odds ratio 13.73, CI 1.43 - 131.95). Conclusion: Prevalence of excess sodium intake per day in the Chinese-Haw tribe was high. This might lead to unhealthy effects. The population at risk should receive appropriate intervention urgently.

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