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Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women.

Abstract

BACKGROUND

Calcium intake is believed to play an important role in the formation of kidney stones, but data on the risk factors for stone formation in women are limited.

OBJECTIVE

To examine the association between intake of dietary and supplemental calcium and the risk for kidney stones in women.

DESIGN

Prospective cohort study with 12-year follow-up.

SETTING

Several U.S. states.

PARTICIPANTS

91,731 women participating in the Nurses' Health Study I who were 34 to 59 years of age in 1980 and had no history of kidney stones.

MEASUREMENTS

Self-administered food-frequency questionnaires were used to assess diet in 1980, 1984, 1986, and 1990. The main outcome measure was incident symptomatic kidney stones.

RESULTS

During 903,849 person-years of follow-up, 864 cases of kidney stones were documented. After adjustment for potential risk factors, intake of dietary calcium was inversely associated with risk for kidney stones and intake of supplemental calcium was positively associated with risk. The relative risk for stone formation in women in the highest quintile of dietary calcium intake compared with women in the lowest quintile was 0.65 (95% CI, 0.50 to 0.83). The relative risk in women who took supplemental calcium compared with women who did not was 1.20 (CI, 1.02 to 1.41). In 67% of women who took supplemental calcium, the calcium either was not consumed with a meal or was consumed with meals whose oxalate content was probably low. Other dietary factors showed the following relative risks among women in the highest quintile of intake compared with those in the lowest quintile: sucrose, 1.52 (CI, 1.18 to 1.96); sodium, 1.30 (CI, 1.05 to 1.62); fluid, 0.61 (CI, 0.48 to 0.78); and potassium, 0.65 (CI, 0.51 to 0.84).

CONCLUSIONS

High intake of dietary calcium appears to decrease risk for symptomatic kidney stones, whereas intake of supplemental calcium may increase risk. Because dietary calcium reduces the absorption of oxalate, the apparently different effects caused by the type of calcium may be associated with the timing of calcium ingestion relative to the amount of oxalate consumed. However, other factors present in dairy products (the major source of dietary calcium) could be responsible for the decreased risk seen with dietary calcium.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.

    , , ,

    Source

    Annals of internal medicine 126:7 1997 Apr 01 pg 497-504

    MeSH

    Absorption
    Adult
    Calcium, Dietary
    Dietary Sucrose
    Female
    Follow-Up Studies
    Food, Fortified
    Humans
    Incidence
    Kidney Calculi
    Middle Aged
    Multivariate Analysis
    Oxalates
    Prospective Studies
    Risk Factors
    Sodium, Dietary
    Surveys and Questionnaires

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9092314

    Citation

    Curhan, G C., et al. "Comparison of Dietary Calcium With Supplemental Calcium and Other Nutrients as Factors Affecting the Risk for Kidney Stones in Women." Annals of Internal Medicine, vol. 126, no. 7, 1997, pp. 497-504.
    Curhan GC, Willett WC, Speizer FE, et al. Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med. 1997;126(7):497-504.
    Curhan, G. C., Willett, W. C., Speizer, F. E., Spiegelman, D., & Stampfer, M. J. (1997). Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Annals of Internal Medicine, 126(7), pp. 497-504.
    Curhan GC, et al. Comparison of Dietary Calcium With Supplemental Calcium and Other Nutrients as Factors Affecting the Risk for Kidney Stones in Women. Ann Intern Med. 1997 Apr 1;126(7):497-504. PubMed PMID: 9092314.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. AU - Curhan,G C, AU - Willett,W C, AU - Speizer,F E, AU - Spiegelman,D, AU - Stampfer,M J, PY - 1997/4/1/pubmed PY - 1997/4/1/medline PY - 1997/4/1/entrez SP - 497 EP - 504 JF - Annals of internal medicine JO - Ann. Intern. Med. VL - 126 IS - 7 N2 - BACKGROUND: Calcium intake is believed to play an important role in the formation of kidney stones, but data on the risk factors for stone formation in women are limited. OBJECTIVE: To examine the association between intake of dietary and supplemental calcium and the risk for kidney stones in women. DESIGN: Prospective cohort study with 12-year follow-up. SETTING: Several U.S. states. PARTICIPANTS: 91,731 women participating in the Nurses' Health Study I who were 34 to 59 years of age in 1980 and had no history of kidney stones. MEASUREMENTS: Self-administered food-frequency questionnaires were used to assess diet in 1980, 1984, 1986, and 1990. The main outcome measure was incident symptomatic kidney stones. RESULTS: During 903,849 person-years of follow-up, 864 cases of kidney stones were documented. After adjustment for potential risk factors, intake of dietary calcium was inversely associated with risk for kidney stones and intake of supplemental calcium was positively associated with risk. The relative risk for stone formation in women in the highest quintile of dietary calcium intake compared with women in the lowest quintile was 0.65 (95% CI, 0.50 to 0.83). The relative risk in women who took supplemental calcium compared with women who did not was 1.20 (CI, 1.02 to 1.41). In 67% of women who took supplemental calcium, the calcium either was not consumed with a meal or was consumed with meals whose oxalate content was probably low. Other dietary factors showed the following relative risks among women in the highest quintile of intake compared with those in the lowest quintile: sucrose, 1.52 (CI, 1.18 to 1.96); sodium, 1.30 (CI, 1.05 to 1.62); fluid, 0.61 (CI, 0.48 to 0.78); and potassium, 0.65 (CI, 0.51 to 0.84). CONCLUSIONS: High intake of dietary calcium appears to decrease risk for symptomatic kidney stones, whereas intake of supplemental calcium may increase risk. Because dietary calcium reduces the absorption of oxalate, the apparently different effects caused by the type of calcium may be associated with the timing of calcium ingestion relative to the amount of oxalate consumed. However, other factors present in dairy products (the major source of dietary calcium) could be responsible for the decreased risk seen with dietary calcium. SN - 0003-4819 UR - https://www.unboundmedicine.com/medline/citation/9092314/full_citation L2 - https://www.annals.org/article.aspx?volume=126&issue=7&page=497 DB - PRIME DP - Unbound Medicine ER -