New England Section of the American Urological Association

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Association Between Nutritional Habits and Nephrolithiasis Among U.S. Adults
Kinan Bachour, BS; Michael E. Rezaee, MD; MPH; Vernon M. Pais, Jr., MD
Dartmouth-Hitchcock Medical Center, Lebanon, NH

Background: Certain nutritional and eating habits, such as fast-food consumption and organic food purchases, may be related to the development of nephrolithiasis. Such associations have not been well investigated to-date.
Methods: Data, weighted to the U.S. population, was abstracted from the National Health and Nutrition Examination Survey (NHANES) for individuals ages 20 to 59 between 2007 and 2010. Descriptive statistics and multiple logistic regression were used to assess the relationship between fast-food consumption and organic food purchases in the last 30 days with nephrolithiasis. Adjustment was performed using age, race, gender, and Body Mass index (BMI).
Results: The weighted national prevalence of nephrolithiasis between age 20 and 59 was 7.3% of a population of over 247.2 million. 51% of the weighted database was female. The average age was 40 years old and the mean BMI was 28.6. A lower prevalence of nephrolithiasis was observed among individuals who bought organic food in the last 30 days compared to those who did not (2.5% vs. 4.8%, p=0.02). After adjustment, individuals who purchased organic food had 23% decreased odds of developing nephrolithiasis compared to those who did not (OR 0.77, 95% CI 0.59 0.99; p=0.04). Nephrolithiasis did not significantly differ among individuals who ate 3 or more fast-food/pizza meals a week compared to those who did not (2.3% vs. 4.9%, p=0.7). However, after adjustment, eating 3 or more fast-food/pizza meals a week was associated with increased odds of nephrolithiasis (OR 1.19, 95% CI 1.00-1.40; p=0.05). Among those uninsured, eating 3 or more fast-food/pizza meals a week was associated with significantly increased odds of nephrolithiasis (OR 1.68, 95% CI 1.18 2.41; p<0.01). Among those insured, purchasing organic food in the last 30 days was negatively associated with nephrolithiasis (OR 0.72, 95% CI 0.55 0.95; p=0.02).
Conclusion: We demonstrate that certain nutritional and eating habits may be associated with nephrolithiasis. Specifically, eating three or more fast-food/pizza meals a week may increase an individual's odds of developing nephrolithiasis, while eating organic food may decrease the odds. Individuals who are more conscientious about their eating habits or have access to healthier diets may be less likely to develop nephrolithiasis. In this analysis, the association between fast food and nephrolithiasis was most pronounced among those uninsured, demonstrating the potential importance of targeting interventions to this high-risk group. Further investigation is warranted to determine whether certain diet recommendations can reduce risk of nephrolithiasis.


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