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Activity, energy intake, obesity, and the risk of incident kidney stones in postmenopausal women: a report from the Women's Health Initiative.

Abstract

Obesity is a strong risk factor for nephrolithiasis, but the role of physical activity and caloric intake remains poorly understood. We evaluated this relationship in 84,225 women with no history of stones as part of the Women's Health Initiative Observational Study, a longitudinal, prospective cohort of postmenopausal women enrolled from 1993 to 1998 with 8 years' median follow-up. The independent association of physical activity (metabolic equivalents [METs]/wk), calibrated dietary energy intake, and body mass index (BMI) with incident kidney stone development was evaluated after adjustment for nephrolithiasis risk factors. Activity intensity was evaluated in stratified analyses. Compared with the risk in inactive women, the risk of incident stones decreased by 16% in women with the lowest physical activity level (adjusted hazard ratio [aHR], 0.84; 95% confidence interval [95% CI], 0.74 to 0.97). As activity increased, the risk of incident stones continued to decline until plateauing at a decrease of approximately 31% for activity levels ≥10 METs/wk (aHR, 0.69; 95% CI, 0.60 to 0.79). Intensity of activity was not associated with stone formation. As dietary energy intake increased, the risk of incident stones increased by up to 42% (aHR, 1.42; 95% CI, 1.02 to 1.98). However, intake <1800 kcal/d did not protect against stone formation. Higher BMI category was associated with increased risk of incident stones. In summary, physical activity may reduce the risk of incident kidney stones in postmenopausal women independent of caloric intake and BMI, primarily because of the amount of activity rather than exercise intensity. Higher caloric intake further increases the risk of incident stones.

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  • Authors+Show Affiliations

    ,

    Division of Urology, Department of Veterans Affairs Medical Center, and Department of Urology, Urological Research Outcomes Collaboration, University of Washington School of Medicine, Seattle, Washington;

    , , , , , , , , ,

    Source

    MeSH

    Aged
    Body Mass Index
    Comorbidity
    Diet
    Energy Intake
    Female
    Follow-Up Studies
    Humans
    Kidney Calculi
    Middle Aged
    Motor Activity
    Obesity
    Postmenopause
    Prevalence
    Proportional Hazards Models
    Prospective Studies
    Risk
    United States

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24335976

    Citation

    Sorensen, Mathew D., et al. "Activity, Energy Intake, Obesity, and the Risk of Incident Kidney Stones in Postmenopausal Women: a Report From the Women's Health Initiative." Journal of the American Society of Nephrology : JASN, vol. 25, no. 2, 2014, pp. 362-9.
    Sorensen MD, Chi T, Shara NM, et al. Activity, energy intake, obesity, and the risk of incident kidney stones in postmenopausal women: a report from the Women's Health Initiative. J Am Soc Nephrol. 2014;25(2):362-9.
    Sorensen, M. D., Chi, T., Shara, N. M., Wang, H., Hsi, R. S., Orchard, T., ... Stoller, M. L. (2014). Activity, energy intake, obesity, and the risk of incident kidney stones in postmenopausal women: a report from the Women's Health Initiative. Journal of the American Society of Nephrology : JASN, 25(2), pp. 362-9. doi:10.1681/ASN.2013050548.
    Sorensen MD, et al. Activity, Energy Intake, Obesity, and the Risk of Incident Kidney Stones in Postmenopausal Women: a Report From the Women's Health Initiative. J Am Soc Nephrol. 2014;25(2):362-9. PubMed PMID: 24335976.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Activity, energy intake, obesity, and the risk of incident kidney stones in postmenopausal women: a report from the Women's Health Initiative. AU - Sorensen,Mathew D, AU - Chi,Thomas, AU - Shara,Nawar M, AU - Wang,Hong, AU - Hsi,Ryan S, AU - Orchard,Tonya, AU - Kahn,Arnold J, AU - Jackson,Rebecca D, AU - Miller,Joe, AU - Reiner,Alex P, AU - Stoller,Marshall L, Y1 - 2013/12/12/ PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2014/4/15/medline SP - 362 EP - 9 JF - Journal of the American Society of Nephrology : JASN JO - J. Am. Soc. Nephrol. VL - 25 IS - 2 N2 - Obesity is a strong risk factor for nephrolithiasis, but the role of physical activity and caloric intake remains poorly understood. We evaluated this relationship in 84,225 women with no history of stones as part of the Women's Health Initiative Observational Study, a longitudinal, prospective cohort of postmenopausal women enrolled from 1993 to 1998 with 8 years' median follow-up. The independent association of physical activity (metabolic equivalents [METs]/wk), calibrated dietary energy intake, and body mass index (BMI) with incident kidney stone development was evaluated after adjustment for nephrolithiasis risk factors. Activity intensity was evaluated in stratified analyses. Compared with the risk in inactive women, the risk of incident stones decreased by 16% in women with the lowest physical activity level (adjusted hazard ratio [aHR], 0.84; 95% confidence interval [95% CI], 0.74 to 0.97). As activity increased, the risk of incident stones continued to decline until plateauing at a decrease of approximately 31% for activity levels ≥10 METs/wk (aHR, 0.69; 95% CI, 0.60 to 0.79). Intensity of activity was not associated with stone formation. As dietary energy intake increased, the risk of incident stones increased by up to 42% (aHR, 1.42; 95% CI, 1.02 to 1.98). However, intake <1800 kcal/d did not protect against stone formation. Higher BMI category was associated with increased risk of incident stones. In summary, physical activity may reduce the risk of incident kidney stones in postmenopausal women independent of caloric intake and BMI, primarily because of the amount of activity rather than exercise intensity. Higher caloric intake further increases the risk of incident stones. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/24335976/full_citation L2 - http://jasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=24335976 DB - PRIME DP - Unbound Medicine ER -