Quinn on Nutrition: Managing multiple nutrition conditions

kidney stones
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Q: My husband was recently diagnosed with kidney stones (lots of them!) and has been advised to limit high oxalate foods. He was also treated for prostate cancer a while back and also has been diagnosed with osteoporosis. Trying to come up with a mostly vegetarian diet that manages these three conditions seems to be impossible. Is this something you can address?"

A: It's true that nutrition recommendations get messy when we're dealing with more than one medical condition. On top of that, we each have individual food preferences and needs. Which is why I would advise you to seek out a registered dietitian nutritionist (RDN) who can understand all the nuances of your husband's conditions and design an eating plan that works best for him. To find a nutrition expert in your area, talk to your doctor or go to the Academy of Nutrition and Dietetics www.eatright.org/find-an-expert.

In the meantime, here are some general guidelines to help you maneuver your husband's nutritional needs:

Drink plenty of water. It's probably the most important thing one can do to prevent kidney stones, say experts. Six to eight cups of water a day is a good place to start unless you have been advised to limit your intake of fluids for any reason.

Not all kidney stones are the same although those formed from and are the most common. If your husband has oxalate stones, he will need to put a limit on high oxalate foods such as nuts and nut butters, peanuts, rhubarb, spinach, and beets.

Don't eliminate calcium. It helps fortify bones and believe it or not, helps protect against the formation of calcium oxalate stones. How can that be? Calcium binds to oxalates in the intestine so they can be eliminated from the body instead of being absorbed and formed into kidney stones. For example, cheese (a high calcium food) eaten at the same time with spinach (a high oxalate food) can help keep the oxalate from being absorbed into the body. If you use soy foods (which are high in oxalates) choose calcium-fortified varieties.

Don't overdo calcium, however, especially calcium supplements. Excessive intakes of calcium can increase one's risk for stones and may be linked to a higher risk for . For men and women 51 years and older, excessive means more than 2000 milligrams of calcium a day from and supplements combined.

Cut back on sodium. Too much salt and other sodium-rich foods causes the body to lose valuable calcium. When calcium is excreted out of the body in urine, it increases the risk for some people to form .

Embrace a diet that provides a balance of nutrients to fight off cancer and rebuild healthy cells. One eating pattern that has shown promise in treating and preventing prostate cancer—plus provides bone-building nutrients and can be adjusted to avoid high oxalate foods—is the Mediterranean diet. This eating style features a wide variety of fruits and vegetables, fish and olive oil. It includes moderate amounts of cheese, yogurt and red wine. Meats and sweets are eaten less often in much smaller amounts than our traditional American diet.

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