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    Archive for the ‘kidney stones’ Category

    You Ask, I Answer: Calcium Absorption, Kidney Stone Risk, and Gelatin-Free Vitamin D Supplements

    0904-calcium-supplements1. Is there research that indicates that calcium carbonate’s absorption is superior to that of calcium citrate?

    2. My doctor recently suggested that I supplement my diet with calcium and vitamin D. Is there a heightened risk of developing kidney stones associated with calcium supplementation?

    3. Most of the vitamin D supplements I’ve found contain gelatin as an ingredient. Do you know of any alternative products?

    — Josh Griffin
    (Location Unknown)

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    You Ask, I Answer: Conflicting Kidney Stone Advice

    45015076A friend and I recently developed kidney stones, and we are getting very different advice from our doctors.

    My doctor suggested I consume citrus fruits.  Her doctor said citrus fruits have been linked to kidney stone formation.

    Who’s right?

    — Alice (last name withheld)
    Wilmington, NC

    Both your doctors are partially right (or wrong, depending on how forgiving you want to be).

    All citrus fruits contain citrate, which is important in several ways:

    • It inhibits the growth and formation of calcium oxalate crystals
    • It binds with urinary calcium and makes it unavailable to form calcium oxalate crystals
    • It increases levels of urinary citrate (individuals prone to kidney stone formation have low levels)

    If you don’t like oranges or orange juice, I recommend adding a few squirts of lemon juice to water.

    There is one exception to this citrus fruit rule — grapefruits!  Although the exact mechanism or component has not been identified, something in them increases the incidence of kidney stones.

    While not a citrus fruit, I often see people get confused about the benefits of cranberry juice.

    Pure cranberry juice can be great for treating urinary tract infections, but its high oxalate content makes it a terrible choice for anyone looking to lower their risk of kidney stone formation.

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    In The News: Kidney Believe It?

    This article in The San Francisco Chronicle — courtesy of the Associated Press — sheds light on a disturbing trend among children: higher incidences of kidney stones.

    “At Children’s Hospital of Philadelphia, for example, the number of children treated for kidney stones since 2005 has climbed from about 10 a year to five patients a week now, said Dr. Pasquale Casale.”

    Although pediatric kidney stones are often attached to inborn metabolic defects, the majority of these new cases involve children who test negative for such disorders.

    One very likely culprit? Processed diets (specifically the high levels of sodium they contribute) within the context of low fluid intake.

    This demonstrates, as I have been saying for slightly over a year now, that sodium is well on its way to becoming the next “hot button” ingredient (following in the footsteps of trans fats, high fructose corn syrup, whole grains, and Omega-3 fatty acids).

    Expect even more companies to offer low-sodium varieties of products — particularly ones aimed at children.

    The sugar lobbyists, I’m sure, are popping a bottle of champagne as I type these words!

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    You Ask, I Answer: Airborne

    What do you think of Airborne?

    — Janet Adams
    Philadelphia, PA

    In case you’ve been in a deep slumber for the past ten years, allow me to tell you of the multi-million dollar business that is Airborne.

    Created by a Californian second grade teacher who constantly caught more than just the sniffles from her students, Airborne is billed as a “cold remedy” that should be taken upon the first sign of having contracted a cold.

    The tagline reads, “Sick of getting sick while traveling?” and suggests the enclosed tablets help strengthen your immune system, particularly after exposure to crowded places like airplanes, classrooms, and offices.

    Although the creator has alluded to double-blind studies comparing Airborne to a placebo demonstrating that her product achieves what it promises, a 2006 investigation by ABC News revealed some interesting tidbits.

    Airborne said that a double-blind, placebo-controlled study was conducted with “care and professionalism” by a company specializing in clinical trial management, GNG Pharmaceutical Services.

    GNG is actually a two-man operation started up just to do the Airborne study. There was no clinic, no scientists and no doctors. The man who ran things said he had lots of clinical trial experience. He added that he had a degree from Indiana University, but the school says he never graduated.”

    Interestingly enough, all mentions of that study (prominent on earlier packaging of the product) are now gone.

    A few things stand out to me when I look at the nutritional composition of each tablet:

    1) The presence of ginger, echinacea, forsythia, and isatis root. They give the illusion of homeopathy and alternative medicine, but there is no substantial research to show that any of these help prevent colds — or their duration.

    2) Each tablet contains 16 times the recommended dietary allowance of vitamin C — or 1600% of a day’s worth! This also happens to be exactly the upper tolerable intake (the amount you are recommended NOT to surpass each day) of said vitamin. This is troubling.

    Not only do extremely high levels of Vitamin C raise your risk of developing kidney stones, bind the absorption of minerals like selenium and copper, and cause gastrointestinal distress — they are also unnecessary.

    Remember, Vitamin C is a water-soluble vitamin. This means excess amounts are not stored in our fatty tissue. Rather, they are excreted in the urine. Giving your body 1,000 milligrams of vitamin C when it only needs 90 is like pouring 5 liters of water into a 1 liter bottle. Futile!

    Buyers are instructed to take one tablet every 3 to 4 hours, but not exceed 3 doses a day. That is still a completely unnecessary amount of vitamin C (grand total: 4800% of the daily recommended amount and 4 times the tolerable upper intake limit).

    3) Each tablet also packs in 230 milligrams of sodium. Take one three times a day and you’re up to almost half of the recommended maximum intake of this overconsumed mineral. That’s as much sodium as a tablespoon of soy sauce!

    At $10 per package, I don’t think Airborne is worth it. As I mentioned previously, there are no studies showing that high levels of Vitamin C help prevent or shorten colds.

    The best way to develop a strong immune system is through healthy overall eating patterns. Making fruits, vegetables, whole grains, heart-healthy fats, and legumes (or lean meats) your staples guarantees that you are providing your body with the nutrition it needs.

    Huge amounts of vitamin C will simply end up in the toilet a few hours later.

    Besides, if you generally aren’t providing your body with vitamins, minerals, and phytonutrients, two days of megadosing will give you nothing but stomach cramps — and possibly diarrhea.

    Your best protection against colds? Plenty of sleep and hand-washing.

    I always like to keep a small bottle of hand sanitizer at my work desk and in my coat pocket. That way, after being on a subway or any place where high exposure to germs is likely, I can “wash” my hands.

    Save the $10 and buy yourself a nice scarf to keep warm during these cold months.

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    You Ask, I Answer: Vitamin C

    I know you said Vitamin C supplements don’t do much to prevent colds, but what about once you have a cold?

    Does taking Vitamin C help shorten the duration?

    –Angela Burgos
    Grand Rapids, MI

    When we tell someone we have a cold, the immediate response is usually, “take your liquids and lots of vitamin C!”

    Is this fact or just a propagated myth?

    Well, the latest meta-analysis (review of many existing studies) comes courtesy of Dr. Robert M Douglas of the Australian National University of Canberra’s National Centre for Epidemiology and Population Health, and Dr. Harri Hemila of Finland’s University of Helsinki’s Public Health Department.

    Together, they reviewed 65 years’ worth of studies focusing on the relationship between vitamin C and the common cold. The conclusion? 200 milligrams of Vitamin C (approximately 300% of the daily recommended intake) did not shorten a cold when compared to a placebo.

    Interestingly enough, extremely high doses of Vitamin C (8,000 milligrams) helped shorten the duration slightly.

    Just how extreme is that dose? Eight thousand milligrams constitutes 11,400% of the daily recommended intake!

    It’s worth noting that most vitamins and minerals have what’s called an upper tolerable intake — a number that helps distinguish when too much can become dangerous. For Vitamin C, this is set at 2,000 milligrams.

    Downing 8 grams of Vitamin C to, in essence, make your cold last one day less is not recommended. Super dosages of Vitamin C often result in gastrointestinal distress, particularly diarrhea and nausea.

    Additionally, continuous high intakes have been linked to an increased risk of developing kidney stones, since the breakdown of Vitamin C results in a waste product known as oxalate (which, when attached to calcium, forms kidney stones).

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