So, what I have found in all these years when I'm talking to patients, I'm going over their urine collection, so they can understand what's going on and then have a better discussion with their doctor. Because lots of times when you're going into these doctor office visits, they just will say this: "Everything looks good." And it doesn't.
And they say that because sometimes the lab reference ranges are much too broad, and it's not related specifically for kidney stone formers. So, you know, I think that I think that it's very important that people understand that this diet has not just been made up. And there's when we're looking at urine collections, we are seeing how diet affects stone risk directly because everything you put in your mouth for 24 hours, food and fluids, will come out on that test.
And that's why all of you should have a 24-hour urine collection. Look, I don't make any money for telling you to do this. You I don't care if you consult with me or not.
That's your choice. My point is get that done because otherwise you don't know why you're forming kidney stones. That's a must.
I can't say it enough, and I try to put it in every single video. Because people come to me and they're like, "Jill, I finally got a urine collection." And then I take a history on them, and they've been making stones for 20, 30 years. They've lost a kidney because they have so much scarring, or they lost a ureter or had to have ureter reconstruction because there's so much scarring from these kidney stones.
"Well, you're just a stone maker. You're just a stone maker." Some of you will have You are making stones because of medical conditions, and there's and there's nothing you can do to 100% take them away, but you can always do stuff to lessen risk and make less. So, let me just get that before A lot of people don't stay to the end of the video.
I got to put that stuff at the beginning. Get a 24-hour urine collection. There's stuff on that urine collection that you would never know you had, which what we're going to talk about right now, unless you did a urine collection, is so important.
And, by the way, you're at risk for osteoporosis, too, if you don't know you have this thing. Now, let's talk about it. High urine calcium and the Kidney Stone Diet.
One day, Dr. Fred Coe—he is, he's the granddaddy of kidney stone prevention. His website, which Jeff will link in the in the comments here, in the description, excuse me, because that's where all the science lives, kidneystonediet.uchicago.edu, everything that I say in a very streetwise, down-home kind of way, is all found on that website.
That's where the science lives. Now, the reason So, one day, Dr. Coe and I were sitting We work on the website together.
I work with him. Lately, we've been working every Tuesday together, and we get together. But this was many years ago.
When we first wrote the article, "The Kidney Stone Diet"—Jeff, if you if you linked that specific one, Fred's web website, the science of the Kidney Stone Diet, there is an article for that, specifically. And we were sitting there, and we had written all these articles over the years. And then we were putting them all together.
I said, "Well," he said, "What do you want to call this, all these goals that we're always talking about?" I said, "Well, why don't we just call it the Kidney Stone Diet?" And basically this is pretty much This is kind of similar to the DASH diet, except we have the oxalate part. And that's why we got away with trademarking it.
It's a registered trademark. It's It's I've I trademarked the Kidney Stone Diet because there's the oxalate part. So, what the Kidney Stone Diet is, and so that's what we called it, we named that on his dining room table while we were working on everything.
And so, it was born there in Dr. Coe's apartment. And the Kidney Stone Diet is this.
You can find it at kidneystonediet.com. And it's drink enough fluids to produce 2.5 L of urine. We know that when we drink more, we pee more.
Why do we care about that? Because when we pee more, we are actually flushing all these crystals out of our body. All of us make some crystals.
It's a byproduct of what we eat. And if you don't pee enough, some of us more than others, by the way, if you don't pee enough, these crystals sit in the urine in your kidney, and they're like little magnets, they're looking for each other, and they form stones. If you have an existing stone and you're not drinking all the time and flushing those extra crystals out, that's how stones grow bigger.
Now, I put this in a very, like I said, street kind of way, practical, common sense. I'm not here to bore anybody, even me, with science. People want to know, "I see the science, Jill, but what the hell do I do?" So, that's my job.
Dr. Coe's job is to really delve into the science. So, if you really want all the science, in nitty-gritty research, numbers, charts, graphs, dots, kidney kidneystonediet.uchicago.edu.
But that's why we want more fluids. And research clearly shows when we drink more fluids, our urine is less saturated, it's called supersaturation, our urine is less saturated with these crystals, and when our urine is less saturated with these crystals, we make less kidney stones. Number two of the Kidney Stone Diet goals: eat less sodium.
The average person eats about 3,500 mg of sodium. I get patients who eat 8,000, 9,000, 10,000 mg of sodium a day. Meanwhile, before we look at their urine collection, they will tell me they don't use the salt shaker.
They are on a low-salt diet because they are not using the salt shaker. That does not make a low-salt diet. You have to turn it around, Buster Brown, and look at everything that you're eating and look at the sodium you're taking into your body per portion.
People say, "Well, Jill, my chips are low sodium." But when you eat the whole bag, Jeff, they're not no more. Okay? So, you got to look at your label, and based upon the portion you're eating, lower your sodium.
How low is the sodium? 1,500 to 2,000 mg of sodium a day. I always give the upper range.
The Kidney Stone Diet goals will say 1,500. American Heart Association says 1,500 for lowering heart disease, lowering blood pressure. But when I talk to patients, I say 1,500 to 2,000.
Why do I do that? Because when I say 1,500 or write about 1,500, people automatically go lower because lower must be better, and then they pass out. So, I'm very careful with that.
Why do we want a lower-sodium diet on the Kidney Stone Diet? What does the research show? When we lower sodium, we will lower urine calcium.
And this is why I want you to do a urine collection. Many of you are eating too much sodium, the urine collection will show that, and it correlates with the high urine calcium you're putting out. When we have too much calcium in our urine and we're not peeing a lot, that increases stone risk.
Also, it increases bone loss because that's where that calcium is coming from. Tons of research at Dr. Coe's—C-O-E—website.
Okay? So, also, what the research tells us about sodium: when we eat too much sodium, we retain the water we're drinking. Some people say, "Jill, what the hell?
I'm drinking a gallon of water a day. I ain't peeing it out." And that's because they're on such a high-sodium diet. So, they're not peeing out the water they're drinking because they're retaining it.
Everybody knows, especially the ladies out there, if you lower your sodium, you'll lose 2 lb overnight. If you eat at a restaurant, you can increase your you can increase your weight a couple pounds just because you ate too much salt at a restaurant, right? So, the weight goes up and down based upon sodium.
Also, urine calcium will go up and down based upon sodium. So, sodium is the number two thing you should lower. The goals are at kidneystonediet.com.
Number three: get enough calcium. What does the what does the science show about that? When we get enough calcium, we will lower our urine oxalate.
Because oxalate and calcium bind in the intestine and leave through the stool. If you're eating high-oxalate foods, but not getting any calcium, that will increase your stone risk. But the studies show on Dr.
Coe's site—and it's not just his studies, he rarely does his studies on there, by the way, he does all the research for kidney stone disease, he picks the best studies that are done, and those are the studies that are on his website. So, you need enough calcium, so you maintain bone and don't get bone disease when you're older, but that's what's going to lower urine oxalate.
Other goal of the Kidney Stone Diet: decrease or lower how much added sugar you're eating every single day. "Can I not eat fruit no more, old lady?" You can eat fruit. That's natural-occurring sugar, naturally occurring sugar.
I'm talking about candy, cookies, and cake where sugar is part of the ingredient list, it's not natural, it's junk you're eating, the processed foods. Why do I care about that? Research shows when we eat too much sugar in our diet, it can increase urine calcium.
It will also, just like salt, decrease the amount you pee. Lower your sugar, added sugar, lower your intake of processed foods, cakes, candies, and cookies, and you will pee more and lose a couple pounds just from doing that. "Well, Jill, I'm a sugar addict." Number one, I always say stop saying that to yourself.
What you say to yourself, you become. Pick up a pen and write a different character for yourself. How about somebody, and fake it till you make it.
I love crunchy things, but I don't go around saying that all the time because then I'm going to just feed my addiction, right? So, I just refrain from it. And also, when we say, "I'm a sugar addict," it kind of gives us an escape, "Well, what can I do?" You're not a prisoner to it.
Do your best to stop eating it, and you're going to be shocked. And if you're one of these people, I hear this every day, "Jill, I stopped eating it. I don't crave it no more." In the comments, please tell other people so they can remain hopeful that I'm not making this up.
Okay? So, you want to decrease your sugar. The next thing: meat.
Overeating meat. We don't want you to do that. Why?
Because that can increase urine calcium. It can decrease citrate. Citrate is important, it's a molecule in our body, and we know what it does for kidney stone risk.
It can decrease risk. You can get enough citrate by eating fruits and vegetables. Some people will need to be put on a supplement, your doctor will talk to you about that.
How do you know? You get a urine collection done. But when we eat too much meat, it can lower our citrate level, and citrate is needed to protect calcium so oxalate can't bind to it in the urine.
The other thing too much meat does is it can decrease your pH and make your pH very acidic, and that's a very kidney stones love an acidic urine. So, that's the reason those goals are there. So much research on Dr.
Coe's site. My job is to take his lofty research and the things that are on his site and bring it all so we mere mortals can understand it. You got to realize he was in he was in he went to college at 15.
He was at University of Chicago at 15 years old. So, he is a common, you know, he's a Doogie Howser kind of guy. So, he doesn't understand he doesn't understand that people don't understand what he's writing.
'Cause that's the world he lives in, and that's why I'm by his side to say, "Are you crazy? What does that mean?" And then he's a great teacher, he sits, he explains it to me, and that's how I learned, so I could teach you. I don't understand half the?
It really is. And also, you know, on his website, if you guys If you have a If you go to one of his articles and you ask a question, he answers them all day long. And they're very meaty, you know, medical questions, he will give you answers.
So, you might want to go to any one of his articles, if you write in and ask a question, he does answer them. So, please do that if you have any questions or you don't understand what he's writing about or you want more than I'm giving here. The things I've been helping people He sends his patients to me, you know, as far as the diet goes.
So, he'll look at urine collections, too, but he'll say, you know, "Go talk to Jill, because she'll tell you exactly how to do what I'm telling you to do." So, he may say, "Go lower salt," but he's not going to sit there and tell somebody how to do that or how to read a nutrition label, 'cause quite frankly, I that's what I bring to him.
He doesn't he doesn't do that, okay? So, you know, he didn't even know there was such a thing as a plant milk. He doesn't know that.
That's the latest article we're writing, plant milks and kidney stone risk. So, I'm just saying, we are a wonderful pair, and he has taught me everything I know. And I've just learned how to say it in a different way so patients can understand it and make it more do- doable.
But we wanted to do this video because I do bring a certain way of discussing everything, and I do want, and Jeff wanted, we both wanted to make sure you understand that this is deeply rooted in science, very deeply rooted in science, and his website, and soon on my website, I'm going to link to all the places, the things that I'm talking about and also link it to his website, so you can see where the science is coming from.
So, you don't have to say, I mean, people come to me 'cause they trust me, but there's always a person that says, "Well, who are you?" You know, and I say, "I'm I'm the Kidney Stone Diet girl, but also, here's all the science to back it up." Most people don't want to be bored by the crazy science, so we keep it off my site, but there's certainly all of it on his and just well-researched stuff.
And, listen, I couldn't be doing this for almost 30 years if the Kidney Stone Diet didn't work. Now, does it work 100% of the time for every single person? Can I guarantee you'll never make a stone again?
No, because there's some medical conditions. And I think the next batch of videos we do will delve into the medical conditions that some of you are experiencing that can increase stone risk. That will be coming very soon, so look for that, too.
That this I Do you think that's okay, Jeff? We got everything we need?
