title: Changing trends in the American diet and the rising prevalence of kidney stones.
abstract: OBJECTIVE
  To evaluate the trends in the American diet over the last 40 years (1974-2010), during which time the National Health and Nutrition Examination Survey data set has documented an increase in stone prevalence from 3.8% to 8.8%.
  
  
  METHODS
  We used the National Health and Nutrition Examination Survey reported rates for stone disease (1974-2010) to compare the United States Department of Agriculture's food distribution data during the same period. Three data points for prevalence were used from the literature. We correlated these to changing lithogenic food distributions using linear models to interpolate annual changes in prevalence. Spearman correlations were performed (P ≤.05) using SAS 9.2 (SAS Institute, Cary, NC).
  
  
  RESULTS
  Increased total daily calories (rho, 0.96; P <.001), fat (rho, 0.79; P <.001), protein (rho, 0.85; P <.001), fruit (rho, 0.6; P = .01), and vegetables (rho, 0.73; P <.001) correlated strongly with increasing stone prevalence. Dark green vegetables, flour or cereal products, fish or shellfish, corn products (including high fructose corn syrup), and added sugars also showed strong correlations with stone prevalence. Citrus fruits were negatively correlated to stone disease (rho, -0.18; P = .31). Protein, fruits and vegetables, and added sugars actually decreased in proportion to daily caloric per capita increases.
  
  
  CONCLUSIONS
  Increases in caloric intake and several lithogenic foods correlate temporally with increasing stone prevalence. The nature of this relationship is difficult to determine from this data; although, clearly, American diets have changed over the last 4 decades.
authors.affiliation: Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Shubha K
authors.initials: SK
authors.lastname: De
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH. Electronic address: endourol@yahoo.com.
authors.forename: Manoj
authors.initials: M
authors.lastname: Monga
mesh_terms: D003611:Dairy Products; D004032:Diet; D004044:Dietary Proteins / Q000737:chemistry; D002149:Energy Intake; D005247:Feeding Behavior; D005396:Fish Products; D005638:Fruit; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology* / Q000209:etiology*; D009749:Nutrition Surveys; D010070:Oxalates / Q000737:chemistry; D015995:Prevalence; D011687:Purines / Q000737:chemistry; D014481:United States; D014675:Vegetables
chemical_list: D004044:Dietary Proteins; D010070:Oxalates; D011687:Purines