Ask The Doctor: Kidney Stones, Bed-Wetting, and Chocolate

Every month we ask top practitioners to address your health concerns. This month find solutions for kidney stones, bed-wetting, and questions about chocolate.

Question answered by BETH THAYER, MS, RD. THAYER is the spokesperson for the American Dietetic Association and specializes in behavior and lifestyle modifications, nutrition, and health coaching. 

Q. I have multiple kidney stones. I would like to know what kind of foods I should avoid. What kind of natural treatment, if any, do you recommend? My doctor told me to drink plenty of water and to avoid tea. I know there must be more food/ drink that I should avoid than just that.
 
A. If you have a history of kidney stones, then you are more likely to have them again.
Knowing the type of stones you make will help determine what type of dietary recommendations to make.
    
The most common type of kidney stones are calcium oxalate stones. With this type of stone you should limit foods high in oxalate like spinach, rhubarb, nuts, wheat bran, coffee, tea, chocolate, and berries, and increase your intake of calcium (which helps bind oxalate in the digestive tract so it doesn’t make it to the urine) with foods like milk and yogurt.
    
Limiting sodium is important, too. Sodium causes calcium to be released in the urine making it available to combine with either oxalate or phosphorus to form calcium oxalate stones or calcium phosphate stones. While sodium is high in the salt you add to your food, the majority of sodium consumed by Americans comes from processed foods such as hot dogs, lunchmeats, soups, condiments, and fast food. Avoid salt and read your food labels, aiming to keep your total sodium intake to less than 2,300 mg each day.
    
Supplements containing vitamins C and D also may contribute to stones. Vitamin C can be turned into oxalate by the body so avoid more than the recommended daily amount. In addition, if you are taking a calcium supplement, it should be taken with food
so it can bind the oxalate.
    
Uric acid stones are more likely with a diet high in animal protein and purines. Purines are found naturally in all foods but are especially high in organ meats, fish, and shellfish.
    
The most important thing, no matter what the stone, is to drink plenty of water. You
should be producing at least 2 quarts of urine every day. This helps flush out materials that might form stones. Water is the best choice and the most inexpensive. Tea, coffee and cranberry juice contain some oxalates so its best to avoid these, as well as grapefruit juice and dark colas which seem to increase calcium oxalate stone formation.

 

Question answered by ANTHONY L. ROSNER, PHD, LLD, LLC, who  is the director of research at the International College of Applied Kinesiology and specializes in chiropractics.
 
Q. My 7-year-old daughter still wets the bed. Her pediatrician has said there is no physical cause for it, and the advice of a psychologist hasn’t helped. Could chiropractic treatments provide relief?
 
A. Chiropractic care is one option to explore, since it seems as if you have already done what I would have suggested initially—have your daughter assessed by her doctor first. Most children outgrow bed-wetting on their own in time. Provided there’s no physical ailment causing it, any number of psychological issues could explain why a child of 7 still wets the bed—among them include changes in routine, starting school, or stress.
A disruption in the way her body responds (or doesn’t) to the sensations of a full bladder could also cause the bed-wetting.
    
Physically, bladder function involves voluntary control of the sphincter, but how that control happens is the net result of an array of physiological messages and responses. The
nerves that control the bladder can be traced back to the sacral joints in the spine. When the bladder is full, those nerves send impulses to the spinal cord, which then transmits a message back alerting the brain and body that sooner or later, the bladder needs relief. But other impulses get sent to the brain as well that mediate the when and where aspect of urinating—“Yes, I need to go, but I’ll hold it in until the appropriate time and place.” Any dysfunction in this complex system could contribute to bed-wetting. When it’s caused by impingement of the nerves connecting to the spine, a chiropractic manipulation can be effective.
    
But chiropractic care can also help if bed-wetting stems from anxiety or stress—which are common causes. Research has shown that chiropractic treatment reduces stress and the body’s level of cortisol—a hormone the body secretes when besieged by stress.
    
In studies, the incidence of bedwetting definitely decreases with chiropractic treatment. In one, the bed-wetting frequency dropped from 9.1 nights in two weeks to 7.6 nights in two weeks. Subjects who didn’t get chiropractic treatments showed no improvement. Furthermore, 25 percent of the treatment group displayed a 50 percent or greater reduction in wetbed nights, while the control group reported no change. In short, the improvement after chiropractic treatment was substantially greater than what could have simply been a natural development.
 

Question answered by DAN LUKACZER, ND, who has his own general practice clinic and specializes in diabetes, metabolic syndromes, cardiovascular disease, autoimmune diseases, digestive disorders, and thyroid and adrenal dysfunction.
 
Q. I keep hearing chocolate is good for you. I want to believe this, but is it really true?
 
A. My answer is an unequivocal yes and no. The cocoa found in chocolate has numerous
health benefits (the darker the chocolate, the better). But be warned—it’s only the cocoa, not all the sugar and fat that comes packaged with it, that has health advantages.
    
Cocoa comes from the cocoa bean, grown on the cocoa tree (Theobroma cacao). The beans have a variety of active phytochemicals that demonstrate healthy effects. Some of the more important are polyphenols, compounds best known for their antioxidant properties. In a recent study, a small group of healthy volunteers who ate 100 g of dark chocolate, containing approximately 500 mg polyphenols, were compared to those who ate 100 g of white chocolate, which contains no polyphenols. (White chocolate is simply the fat— cocoa butter—from cocoa beans mixed with milk and other ingredients.) The
researchers found that the dark, but not the white, chocolate decreased bloodpressure and improved insulin sensitivity (poor insulin sensitivity has been linked to diabetes and heart disease).
   
You’ve also probably heard people say that chocolate makes them feel better. There may be something to that as well. Cocoa also contains other compounds called methylxanthines that seem to improve mood. Another study showed that subjects eating
dark or milk chocolate versus those eating white chocolate (which contains no methylxanthines) showed a positive mood-altering effect. These phytochemicals may even go through breast milk. Mothers who reported eating chocolate daily rated the temperament of their 6-month-old infants more positively in terms of crying and fussing. The bottom line is that your chocolate indulgence does come with some health benefits. However, because chocolate also comes with lots of fat and sugar, you should limit intake.