Yes, Jeff. Here's the deal. Many people who have not done urine collections, and even people who have done urine collections, they will tell me, "You know, my doctor said that my oxalate is fine," obviously, they did a urine collection and that's how the doctor knows that, "and I'm just a stone former.
The doctor said it's just I'm just a stone maker." But the doctor never talked to the patient about salt. And so, we have a goal at the Kidney Stone Diet, one of the goals, there's six, one of them is to keep your sodium down to around 1500. By the way, the American Heart Association also calls for this number.
Now, many times, I will tell patients this, on the goal sheet at kidneystonediet.com, salt is listed as 1,500 milligrams a day. But I like to say 1500 to 2000. Why, Jill?
It's supposed to be 1500. Because when I say 1500, people go to 600, 400, because surely less must be better, and then people pass out. I say it all the time.
So, please don't do that. If a goal is what it is, stick around it, not way lower than that, okay? So, I'll tell patients 1500 to 2000, so they know if they're going anywhere, they go higher.
Okay. This is very difficult for most people. Everybody who does what I say as far as preventing kidney stone, and I look at their urine collection, and I say, "Lower the oxalate," they do the follow-up test and their oxalate's like a baby, it's under 30, which is where we want it.
On the urine collection results, you get 100 milligrams of oxalate a day to eat, but on your urine results, we want the oxalate value to be less than 30 in your urine. So, you know. Every lab result says different things, some are really, will say, "Oh, 45 is great." No, it ain't, we want it under 30, okay.
So, what doesn't get discussed a lot is sodium is a huge driver of kidney stones and it is really one of the hardest goals to achieve. I hear that every single day. "Jill, it's so hard." Listen, if you go out to eat, you're eating like 3,000 milligrams of sodium right there.
Couple pieces of pizza is 1000, 1500, 2,000 milligrams of sodium, so are you doomed? No, you just get right back on track, that's all. You're going to have salty meals sometimes.
Why is it that salt is such a pain in the tush for us? Well, number one, when we eat too much salt, people don't urinate as much. Common scenario, "Jill, I don't I don't even know what's going on here.
I drink like a fish, ain't nothing coming out of me." And that's because Paul has a 10,000 milligram a day salt habit. So, we all know this. When we eat too much salt, we can't button up our jeans, that's just, we get all bloated around the middle, our rings don't fit anymore, we have rings around our ankles from our socks, indentation.
We're bloated, because now that wherever salt is, water follows, so we get bloated. When you eat too much sodium, you bloat, so you will also decrease urine output. The other thing that sodium can do is increase your urine calcium.
A lot of doctors will look at your urine collection results and say, "Hey, Tommy, this urine, this calcium in your urine is way too high, you're going on a diuretic," which is a pill that will help lower your urine calcium. But why the hell is Tommy going to go on a pill when his sodium is high and all he has to do is lower it?
That's really important. None of you should be going on a pill unless you have already lowered your sodium. So, here is ideally how it should go: You do a urine collection, the doctor looks at the results, the doctor says, "Hey, Tommy, this salt in your collection, this sodium level is 6,000.
You got to lower that because it's pulling calcium out of your bone, dumping it into the urine, and when we have too much calcium in the urine, that is a huge stone increased risk. It will also leave your bones depleted, increasing your risk for osteoporosis." So, that's super important. Then what the doctor should do is this: "Okay, Tommy, let's lower your sodium to 1500 to 2000 milligrams a day.
We're going to do a follow-up test, and we're going to see if you still have high urine calcium. Or is lowering the sodium good enough for you?" For most of you, just lowering the sodium you're taking in every day, well, not only help your blood pressure, but it will also help you get the calcium out of your urine and keep it in the bone.
Also, you'll pee more without adding one more cup of fluid. Okay? So, when we lower sodium, we decrease the urine calcium.
That's a good thing, because when you have too much calcium in the urine in your kidney, oxalate, phosphate, all those crystals are looking for each other. That's how you form stones, especially if you don't pee a lot. The longer these crystals stay in your kidney, the more prone you are to forming kidney stones.
So, you got to flush those crystals out. So, if you're eating a lot of sodium, guess what else? You're not flushing those crystals out because now you're getting bloated and the kidneys are dealing with that excess fluids and nothing's leaving.
So, that's super important, too. So, before you get put on a diuretic, please say, "Hey, Doctor, it looks like I have room to lower my sodium. Can I do that first and then see if I need the diuretic?" Some of you will still need the diuretic.
"Well, what the hell, Jill, why do I got to worry about my sodium then?" Because if you don't, those pills don't work as well! So, you see, I still get my way for you eating healthier, because it's healthier to eat less salt, period. Because if your kidneys have to work harder to filter all that extra stuff, guess what else has to work harder?
Your heart. So, lowering sodium is not just great for your kidneys, it's also wonderful for your heart. And any cardiologist will tell you that as well.
So, sodium is really, really, really hard to lower. It hides out in things. People will say, "Jill, I don't use the salt shaker." I've heard it a million times.
I hear it every single day, multiple times a day. And then when I figure out how much salt they eat on that urine on that urine collection, they're flabbergasted, because you don't realize it. So, there's salt there's salt hidden in so many things: in your bread, in your oatmeal, in pizza, which you don't think.
You like a dry martini? That's because it's salty. Olive, olive, olives, olives juice, okay?
Very salty. And I know people that are eating half a jar of olives a day, and they don't realize that. It's silly things like that.
Look at your soy sauce. "Jill, I love stir-fries, I'm eating so healthy." There's a 1,000 milligrams of sodium in that soy sauce for one little tiny little bit. Canned goods, look for canned good labels, get the lowest salt one.
Soups are notorious for having high sodium. So, read your nutrition labels. Per portion, per portion is you want lower sodium per por- per portion.
So, people will say, "Jill, I'm eating low-sodium tortilla chips." Well, they're not low sodium when you eat a whole bag, Fran. "Oh, I guess so, Jill. I also hate you, Jill." Cheese!
People love cheese. "Jill, I love cheese, and you said to get calcium, so I'm going to eat so much cheese." Please don't. Please don't, Carol, because all that cheese has lots of salt.
Swiss cheese for calcium is the best, lowest salt one. Not as sexy as the others, but cheese is, again, cottage cheese, oh, my god, everybody's making cottage cheese recipes, it's so salt-laden. Half a cup of cottage cheese, 400 milligrams of sodium.
Now, you could say, "But I love it, Jill, and I watch my sodium everywhere else." God bless, go forth! If you can You can have whatever you want as long as you stay in the goals. Okay?
And if you have a day where you don't stay in the goals, just that's okay. You're not making a stone with that lunch. Just please get right back on track.
What I'm asking is that you never give up. So, when you have whatever it is, and you go you go over your Kidney Stone Diet goals that day, it's okay! Just get right back on track the next day.
It's when we give up that diets don't work. Everyone here has lost weight and you've gained it all back a million times in your lifetime, especially if you're my age in your 60s. I'm asking not for perfection, I'm asking for consistency.
So, when you enjoy, when you have your favorite cupcake, or whatever it is, you have your cottage cheese, you go over, you're going out to you're going out with the girls or the guys, and you're going to have beer and nachos and all that crap, I could care less! You got to have a good time in life, too! Get right back on track.
That's how we do it at kidneystonediet.com. You don't get obese, you don't get diabetes, you don't get kidney stones when you get right back on track, okay? That's it.
