Just tell me what works!” And these 10 things apply specially to, even though some of them may be good for general health, these are particularly designed for people who are at high risk of kidney stones.
If you’ve had a kidney stone before or if you get a urinalysis or other markers that your doctor discusses with you that suggests you’re at high risk for kidney stones, that’s where these things really come in.
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Number 1: you want to stay well hydrated.
By default eight 8-ounce glasses of water per day is a good target, or drink according to thirst, but err on the side of drinking at the first sign of thirst (water that is, not alcohol) drinking water on the first sign of thirst and not waiting until you feel really thirsty and highly motivated to drink the water.
Number 2: you want to eat a high-potassium diet; the bulk of your diet should be vegetables, I would include potatoes in that, which are a very good source of potassium, and you want this to be balanced with a low salt intake.
The low salt intake is especially important that it only applies to people at high risk of kidney stones because if you do not have a high risk of kidney stones and you don’t have high blood pressure, more salt tends to be good for you because it supports your cognitive function and your metabolism and your adrenal function and all kinds of things like that.
So for most people I would say salt to taste, but if you’re at high risk of kidney stones I would say try to err on the side of very lightly salting your food: pour the salt into your hand, take a little tiny pinch and put it on, and avoid processed foods that are rich in added salt.
Number 3 is for your minerals you want to take them in the citrate form.
The most beneficial examples would be potassium nitrate and magnesium nitrate because the potassium and magnesium are beneficial, but the nitrate itself is helpful and a good natural source of nitrate would be to take four ounces of lemon juice and distribute it through the water that you drink for the day.
Number 4: You want to measure your urine pH and you want to make sure that after you’ve eaten the first meal of the day it stays between 6.
4 and 6.
8 or so.
The 2nd and 3rd bullet points with the sodium and potassium balance and the nitrate salts should help keep your urine pH in the ideal range, but if it’s not in the ideal range even after following those principles, then consider taking a quarter teaspoon of potassium bicarbonate on an empty stomach and seeing what that does to your urine pH.
Experiment a little bit to find the right dose that will help keep your urine pH in the optimal range.
Number 5: You want to avoid processed foods because processed foods often contain phosphate additives that are hidden and not listed on the label and that can aggravate the risk of kidney stones.
Number 6: You want to get 800 to 1200 milligrams of calcium a day.
Many people believe that, because calcium is found in kidney stones, eating calcium causes kidney stones.
That might be true at very high intakes of calcium such as 1.
8 grams per day or higher, but 800 to 1200 milligrams of calcium is an essential target and is highly protective against kidney stones.
In your intestines, calcium prevents you from absorbing too much phosphorus; in your blood, calcium helps push the phosphorus into bone instead of the kidney; and finally, calcium reduces your need to take calcium out of your bones.
Taking calcium out of your bones can leave little crystals of calcium phosphate that are very good at causing kidney stones.
So at least 800 milligrams preferably 1200 milligrams of calcium per day.
Number 7: You want to get your fat-soluble vitamins.
If you don’t have liver diseases, kidney diseases apart from the high risk of kidney stone, if you’re not about to become pregnant and you’re not in the first eight weeks of pregnancy and you’re not very high risk of osteoporosis, the ideal target for vitamin A on average is probably 15,000 IU of vitamin A as retinal per day, but if you have any of those existing conditions that I just listed then you probably want to limit your vitamin A at 10,000 IU and consume between 5 and 10 thousand IU per day for the beneficial impact on kidney stones.
For vitamin D, it’s controversial, but I believe the sweet spot is 30 to 40 nano grams per milliliter for most people and you want to keep your parathyroid hormone or PTH in the bottom half of the range.
You don’t want to go higher than that on vitamin D because if you do you can actually increase your risk of kidney stones, so you want to stay in the sweet spot.
For vitamin K you want to get vitamin K2.
There are two forms of supplements, MK-4 and MK-7,i t’s best to get a mix of both, and it’s best to get at least 200 micro grams per day.
But if you’re at very high risk of kidney stones you may need up to 2 milligrams and it’s a lot easier to get two milligrams from MK-4 supplements because they come in higher doses.
Number 8: You want to avoid excess fructose, but this does not mean that you want to avoid fruit because fruit, although it provides fructose, provides many beneficial compounds that protect you from kidney stones.
So consume 2 to 3 servings of fruit per day, but be very strict with moderating your intake of honey and completely avoid refined sugar.
Number 9: You want to consume the lower end of what is a healthy amount of protein.
This only applies to people with a high risk of kidney stones and if you don’t have a high risk of kidney stones you definitely don’t want to follow this recommendation if you have body composition specific goals.
The ideal intake of protein to stay on the bottom part of the normal range or the health-promoting range is if you measure your weight in pounds, a half gram of protein for every pound of body weight.
If you measure your body in kilograms, 1.
2 grams of protein for every kilogram of body weight.
Again if you have body composition-related goals and not high risk of kidney stones, two to three times this amount is probably what you want.
This is only for high risk of kidney stones.
Number 10: Finally, you want to limit exogenous and endogenous sources of oxalate.
Exogenous means what you eat that’s not generated in your body.
If you google high-oxalate foods you’ll find a list, you want to keep those minimal, but also as I discussed in a previous video, gelatin or collagen can generate oxalate.
You might do best to use glycine instead of collagen if you’re at high risk of kidney stones.
Vitamin C can generate oxlalate.
You might do well to limit your vitamin C supplementation to 500 milligrams a day to avoid that risk.
With all that said the last two points are points that could hurt you if you don’t need to practice them.
In other words, vitamin C and collagen can be very beneficial for your health, even some foods that are high in oxalate like spinach have a lot of good things about them.
And so ideally you want to focus on the protective factors so that you can increase your ability to tolerate the potentially harmful factors.
I believe if you follow the first eight of these then you may well put yourself in a position where you’re fine consuming more protein in order to benefit your body composition or where you’re fine getting the benefits of vitamin C and collagen supplementation, but it’s really important to try to implement all of the protective factors and when you don’t know that you have everything right just yet to moderate the possible harmful factors even when they seem to have benefits in other contexts.
Narrated by: Chris Masterjohn