You Too Can Prevent Kidney Stones

This week, NPR broadcast an excellent story on how to avoid kidney stones. I was pleased to see that the reporter quoted a researcher whose work showed that eating and drinking dairy foods can actually lower your chances of getting a kidney stone. Other research studies over the past ten years have shown the same thing but few doctors have really picked up on this and still tell their patients to avoid milk, cheese, and yogurt if they've had kidney stones. Not only is avoiding milk bad news for your bones and blood pressure, cutting out milk doesn't lower your chances of forming stones.

We're not exactly sure just how milk lowers kidney stone formation but the belief is that the calcium in the milk binds with oxalates - natural phytochemicals in foods that can cause kidney stones. But the research does not show the same results with using calcium supplements. So I always recommend that my patient with a hisotry of stone formation get more of their calcium from milk and milk foods and not rely too heavily on calcium supplements. Eating a more plant based diet may also help you keep kidney stones away.

You can read the NPR story here: "This Too Shall Pass: Avoiding Kidney Stones Through Diet".

Beth Kitchin, MS, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Got Beer? Beer and Bone Health.

I just love “feel good” research – when a vice turns out to be good advice. Recently, a friend of my mother emailed me with a question about beer and bone health. She had read that some types of beer are high in silicon, which could help make the bones stronger. This of course begs the question: is beer the new milk? There’s already good evidence that moderate drinkers of any type of alcohol (one to two drinks a day or fewer) may have stronger bones. But what about beer and silicon specifically? Being a beer lover myself, I was intrigued and did a quick search of the scientific literature. Here’s what I found out:

• Beer is a major source of silicon. Silicon may help bone formation.
• While drinking moderate amounts of any type of alcohol can help the bones, beer and wine seem to have the most benefit.
• Too much alcohol (more than 1 to 2 drinks a day) can make the bones weaker. A drink is generally defined as: 5 ounces of wine, 12 ounces of beer, 1 ½ ounces of liquor.
• Drinking too much also increases the likelihood of falling – increasing your chances of breaking a bone!
• There’s no daily recommendation for silicon but the average intake is about 20-50 mg.
• A recent study looked at how much silicon is in various types of beer. It ranged from 6 mg up to 56 mg. Ales, lagers, and IPA’s were the highest with IPA’s the highest of all. Why the difference among the brews? The more malt and hops, the more silicon. Wheat based beers are much lower in silicon since the silicon is higher in barley and hops.

So does this mean you should take up beer drinking for better health? The evidence is still lacking as to how much benefit you get and whether drinking beer lowers your chances of breaking a bone. But, if you like beer and keep it moderate – no more than one a day for the women and two for the men –you may be getting some bone building from this tasty beverage! I certainly won’t tell my patients to stop drinking beer as long as they do it safely.


As for me, I may have to do some personal research on this intriguing topic. Now which bar, I mean laboratory, should I use for my experiments?


Beth Kitchin MS RD
Assistant Professor of Nutrition Sciences
University of Alabama at Birmingham


Sources:

Tucker KL, Jugdaohsingh R, Powell JJ, Qiao N, Hannan MT, Sripanyakorn S, Cupples LA, Kiel DP. Effects of beer, wine, and liquor intakes on bone mineral density in older men and women. Am J Clin Nutr. 2009;89:1188096.


Casey TR, Bamforth CW. Silicon in beer and brewing. J Sci Food Agric. 2010;90:784-788.

Can You Drink Too Much Water?

It’s hot. You need to drink more water, right? Most of us do need more water at this time of the year but surprisingly you can drink too much. What happens when people drink too much water is that it dilutes out the sodium in the blood to a level that is too low. This very low level of blood sodium can cause nausea, vomiting, headaches, convulsions, and even the brain to swell. Some of these symptoms are the same as dehydration, which is also dangerous. So how do you know if you’re drinking enough, but not too much, water?


Water & fluid guidelines:

 Follow your thirst. Thirst is actually a pretty good indicator of whether or not you need fluids. An exception to this is older people who may not know their bodies need fluids & can become fluid deficient pretty quickly, particularly in hot weather.

 Drink fluids during activity. Whether you’re out walking, gardening, or running a marathon, you should drink fluids before & during activity – roughly 4 to 6 ounces every 20 minutes. You don’t need gallons of water during activity – which is where some people have gotten into trouble with over hydration.

 Weigh yourself after activity. If you sweat a lot during physical activity, you can lose a lot of water weight. Drink 16 ounces of water for every pound lost during exercise.

 Check your urine. When you are well hydrated, your urine should be pale to clear. This is the best way to tell if you have had enough water. Don’t drink excessive fluids beyond this. If your urine is dark or very small in volume, then you need more fluids!

 The 8-cups of water myth. While the average fluid lost from our bodies does turn out to be around 8 cups a day, you don’t need to replace all of it with plain old water. We get water replacement from fruits, vegetables, and other beverages such as milk, tea, soda, and yes, even coffee! However, water is the best fluid for boosting body fluids because it is absorbed the fastest of all the fluids!

Beth Kitchin MS RD
Assistant Professor, Nutrtion Sciences
University of Alabama at Birmingham

Sodas: Bad to the Bone?

Every Wednesday I teach a bone health education class at the UAB Osteoporosis Clinic. We serve lunch and yes, diet and regular cokes are among the drinks I make sure we have in plenty. The question then comes: “Beth, I can’t believe you’re serving us cokes? Aren’t they bad for the bones?”


This is a tough question to answer because the research is inconclusive. Carbonation has not been shown to harm bones so the bubbly part of the soda is not something to worry about. Too much caffeine can make you lose more calcium in the urine, but a typical caffeinate soda has about 50 mg of caffeine in 12 ounces. You’d have to be getting over 200 mg of caffeine a day for it to have an effect on your calcium loss so you can see that a can or two of caffeinated soda a day is no big deal. A cup of coffee has upwards of 100 mg of caffeine for a point of reference.

Some studies show that dark sodas may be related to lower bone strength and a higher chance of breaking a bone. But these studies are not the type that can show cause and effect. In other words, there are no studies that show that dark sodas directly cause bones to break or lower bone strength. What is it about dark sodas that may compromise your bone health? Some researchers think that the phosphorus in the sodas may be bad for bones. But other researchers disagree.

So what should you do? While I don’t think a can or two of coke or other dark soda a day is dangerous, you may want to think about switching to some healthier drinks such as milk and lightly sweetened tea. I had been drinking at least one diet coke a day and decided to drink more iced green tea sweetened with some lemonade concentrate – not because diet coke is bad for me but because tea is good for me. Sometimes we think about our diets as simply getting the bad stuff out. But we also need to think about getting more of the good stuff. Tea is natural and has some components in it that may actually be good for your bones.

Beth Kitchin, MS, RD
Assistant Professor, Department of Nutrition Sciences
University of Alabama at Birmingham

It's Fast But Is It Food?

Yesterday on my way back from Atlanta where I was giving a presentation on children and vitamin D, I stopped at Hardee’s for lunch. That’s a picture of my actual meal from yesterday after the first bite. I don’t eat fast food often but when I do, I relish it. My relationship with fast food is one of dependence and a grudging acknowledgment that it tastes good.  Yes, I actually like the taste of fast food despite being a foodie. I love the phony charred taste of the burgers, lackluster buns, and the fries shiny with grease.  At least I usually do.

Yesterday, after eating my 1/3 pound cheeseburger and curly fries, I didn’t get the same sense of satisfaction I usually do after a fast food meal. I sat down with great anticipation of this rare indulgent and  - nothing. The burger was fairly flavorless and the fries, though plenty curly and tasty, seemed to be missing something.  I left feeling full but at the same time, empty. Had my relationship with fast food changed? I could always count on it for a quick flavorful meal that felt indulgent and a little dangerous – as though I am testing the limits of my body to withstand the assault of cholesterol, fat and salt.  

But yesterday – nothing. No rush.  No great taste. No feeling of triumph that my body could withstand the onslaught of artery hardening, blood pressure pumping nutrients. And as I drove away, trying to analyze my experience, I realized that my disappointment wasn’t just that it didn’t taste as good as I remembered. It was my sneaking suspicion after all these years, that fast food isn’t real food. It’s as though it tricks us into thinking it’s food. But it’s really just a clever cloaked facsimile. Will I eat it again? Probably. Sometimes fast food is truly an act of desperation. But I won’t expect much the next time around.

Beth Kitchin, MS, RD

Assistant Professor, Nutrition Sciences

University of Alabama at Birmingham 

The Research Studies That Need You and How To Find Them

I love it when something that makes sense happens. The National Institutes of Health has created something that makes a lot of sense. It’s called “Research Match”. Research Match is a website that matches people who are interested in being in a study with the researches who need them.


I work at teaching hospital/research university so people ask me all the time “are there any studies at UAB I can be in?” And I never know the answer because there are too many studies going on for me to keep up with. This is a scenario I am sure happens all over the country. Now my university – the University of Alabama at Birmingham – has joined with 51 other institutions across the country to take part in the NIH’s “Research Match”. All you have to do is visit: http://www.researchmatch.org/ and register on their site. They’ll connect you with researchers in your area whose studies you may be want to join. Talk about a win/win that makes good sense!

http://www.researchmatch.org/

Beth Kitchin, MS, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

For Best Results, Just Add Fat

If you snack on carrot sticks or use fat-free dressing on your salads, you’re probably not getting the health benefits you think you are.  Over the years, several studies have shown that the carotenoids – that family of disease fighters that includes beta-carotene and lycopene – need fat to be absorbed. The fat-soluble carotenoids don’t like to go it alone so dip your carrots in some regular or low-fat (but not non-fat) ranch dressing.  Add some cheese or nuts to that afternoon snack of baby carrots. Toss some avocado with your salad. It may be as little as 5 grams of fat that you need to get good absorption. That’s equal to about 1 teaspoon of fat or just a small handful of almonds. 

I think the deeper message here is that we are supposed to eat different foods together for the best results. I often hear of fad diets that tell you to separate out fruit from proteins. Or don’t mix carbs with meat. But it just doesn’t hold up to scientific scrutiny. Our bodies can easily handle mixtures of nutrients. Our intestinal tracts are marvels at orchestrating the vast array of chemical interactions that shuttle the nutrients from meals and snacks into our bloodstreams. There are even times when nutrients help each other out. For instance, getting a good source of vitamin C like sweet peppers or broccoli helps you to absorb a type of iron called “non-heme” iron.

So make the most of those healthy fruits and vegetables by adding in a bit of fat.

Beth Kitchin, MS, RD
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham