Soft drink consumption and urinary stone recurrence: A randomized prevention trial

The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode o...

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Published inJournal of clinical epidemiology Vol. 45; no. 8; pp. 911 - 916
Main Authors Shuster, J., Jenkins, A., Logan, C., Barnett, T., Riehle, R., Zackson, D., Wolfe, H., Dale, R., Daley, M., Malik, I., Schnarch, S.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.08.1992
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Abstract The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode of urinary stone disease, who were aged 18–75 at that time, and who reported consuming at least 160 ml per day of soft drinks. Half of the subjects were randomized to refrain from consuming soft drinks, while the remaining subjects served as controls. The intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from recurrence ( p = 0.023 one-sided) over the control group. One important secondary finding was that for those who reported at the time of the index stone that their most consumed drink was acidified by phosphoric acid but not citric acid, the experimental group had a 15% higher 3 yr recurrence-free rate than the controls, p = 0.002, while for those who reported at the time of the index stone that their most consumed drink was acidified by citric acid with or without phosphoric acid, the experimental group had a similar 3 yr recurrence-free rate to the controls, p = 0.55. This interaction was significant, p = 0.019.
AbstractList The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode of urinary stone disease, who were aged 18-75 at that time, and who reported consuming at least 160 ml per day of soft drinks. Half of the subjects were randomized to refrain from consuming soft drinks, while the remaining subjects served as controls. The intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from recurrence (p = 0.023 one-sided) over the control group. One important secondary finding was that for those who reported at the time of the index stone that their most consumed drink was acidified by phosphoric acid but not citric acid, the experimental group had a 15% higher 3 yr recurrence-free rate than the controls, p = 0.002, while for those who reported at the time of the index stone that their most consumed drink was acidified by citric acid with or without phosphoric acid, the experimental group had a similar 3 yr recurrence-free rate to the controls, p = 0.55. This interaction was significant, p = 0.019.
The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode of urinary stone disease, who were aged 18-75 at that time, and who reported consuming at least 160 ml per day of soft drinks. Half of the subjects were randomized to refrain from consuming soft drinks, while the remaining subjects served as controls. The intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from recurrence (p = 0.023 one-sided) over the control group. One important secondary finding was that for those who reported at the time of the index stone that their most consumed drink was acidified by phosphoric acid but not citric acid, the experimental group had a 15% higher 3 yr recurrence-free rate than the controls, p = 0.002, while for those who reported at the time of the index stone that their most consumed drink was acidified by citric acid with or without phosphoric acid, the experimental group had a similar 3 yr recurrence-free rate to the controls, p = 0.55. This interaction was significant, p = 0.019.The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode of urinary stone disease, who were aged 18-75 at that time, and who reported consuming at least 160 ml per day of soft drinks. Half of the subjects were randomized to refrain from consuming soft drinks, while the remaining subjects served as controls. The intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from recurrence (p = 0.023 one-sided) over the control group. One important secondary finding was that for those who reported at the time of the index stone that their most consumed drink was acidified by phosphoric acid but not citric acid, the experimental group had a 15% higher 3 yr recurrence-free rate than the controls, p = 0.002, while for those who reported at the time of the index stone that their most consumed drink was acidified by citric acid with or without phosphoric acid, the experimental group had a similar 3 yr recurrence-free rate to the controls, p = 0.55. This interaction was significant, p = 0.019.
The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an earlier case-control study of adult males, had a causal component. The study sample consisted of 1009 male subjects, who completed an episode of urinary stone disease, who were aged 18–75 at that time, and who reported consuming at least 160 ml per day of soft drinks. Half of the subjects were randomized to refrain from consuming soft drinks, while the remaining subjects served as controls. The intervention group had an observed 6.4% advantage in actuarial 3 yr freedom from recurrence ( p = 0.023 one-sided) over the control group. One important secondary finding was that for those who reported at the time of the index stone that their most consumed drink was acidified by phosphoric acid but not citric acid, the experimental group had a 15% higher 3 yr recurrence-free rate than the controls, p = 0.002, while for those who reported at the time of the index stone that their most consumed drink was acidified by citric acid with or without phosphoric acid, the experimental group had a similar 3 yr recurrence-free rate to the controls, p = 0.55. This interaction was significant, p = 0.019.
Author Jenkins, A.
Riehle, R.
Schnarch, S.
Shuster, J.
Zackson, D.
Wolfe, H.
Barnett, T.
Logan, C.
Dale, R.
Malik, I.
Daley, M.
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  surname: Shuster
  fullname: Shuster, J.
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  surname: Jenkins
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  organization: Department of Urology, University of Virginia Health Sciences Center, Charlottesville, VA 22908, USA
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  surname: Logan
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  organization: St Vincent Infirmary Medical Center, Little Rock, AR 72205, USA
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  surname: Barnett
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  organization: St Vincent Infirmary Medical Center, Little Rock, AR 72205, USA
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  organization: Department of Surgery/Urology, Lithotripsy Unit, New York Hospital-Cornell Medical Center, NY, USA
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  organization: Department of Urology, Carle Clinic, Urbana, IL 61801, USA
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  surname: Dale
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  organization: Northern California Kidney Stone Center, Los Gatos, CA 95032, USA
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  organization: Lancaster Urological Group, Inc, Lancaster, PA, USA
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  surname: Malik
  fullname: Malik, I.
  organization: Urology Center for Stone Disease, Cincinnati, OH 45206 USA
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Issue 8
Keywords Citrate
Phosphoric acid
Urinary stone disease
Urolithiasis
Citric acid
Soft drinks
Language English
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References Boyce, Garvey, Strawcutter (BIB2) 1956; 161
Cochran, Cox (BIB8) 1957
Shuster, Scheaffer (BIB1) 1984; 24
Shuster, Finlayson, Scheaffer, Sierakowski, Zoltek, Dzegede (BIB3) 1985; 38
Peto, Peto (BIB6) 1972; 135
Archilles, Schulze, Schalk, Rodeck (BIB9) 1990; 18
Kaplan, Meier (BIB4) 1958; 53
Tsiatis (BIB7) 1990; 3
Berg, Larsson, Tiselius (BIB10) 1990; 18
Greenwood (BIB5) 1926; 33
References_xml – volume: 53
  start-page: 457
  year: 1958
  end-page: 481
  ident: BIB4
  article-title: Nonparametric estimation from incomplete observations
  publication-title: J Am Stat Assoc
– volume: 24
  start-page: 327
  year: 1984
  end-page: 331
  ident: BIB1
  article-title: Economic impact of kidney stones in white male adults
  publication-title: Urology
– volume: 38
  start-page: 907
  year: 1985
  end-page: 914
  ident: BIB3
  article-title: Primary liquid intake and urinary stone disease
  publication-title: J Chron Dis
– volume: 33
  start-page: 1
  year: 1926
  end-page: 26
  ident: BIB5
  article-title: The natural duration of cancer
  publication-title: Rep Public Health Med Subjects
– volume: 18
  start-page: 13
  year: 1990
  end-page: 16
  ident: BIB10
  article-title: Effects of different doses of alkaline citrate on urine composition and crystallization of calcium oxalate
  publication-title: Urol Res
– volume: 18
  start-page: 1
  year: 1990
  end-page: 6
  ident: BIB9
  article-title: The
  publication-title: Urol Res
– volume: 161
  start-page: 1437
  year: 1956
  end-page: 1442
  ident: BIB2
  article-title: Incidence of urinary calculi among patients in general hospitals, 1948–1952
  publication-title: JAMA
– volume: 3
  start-page: S120
  year: 1990
  end-page: S123
  ident: BIB7
  article-title: Methodologic issues in AIDS clinical trials: Intent-to-treat analysis
  publication-title: J A.I.D.S.
– year: 1957
  ident: BIB8
  article-title: Experimental Designs
– volume: 135
  start-page: 185
  year: 1972
  end-page: 198
  ident: BIB6
  article-title: Asymptotically efficient rank invariant test procedures
  publication-title: J R Stat Soc [A]
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Snippet The object of this study was to determine if a strong association between soft drink (soda) consumption and recurrence of urinary stone disease, found in an...
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SubjectTerms Actuarial Analysis
Adolescent
Adult
Aged
Beverages - adverse effects
Citrate
Citrates - adverse effects
Citric Acid
Humans
Male
Middle Aged
Patient Compliance
Phosphoric acid
Phosphoric Acids - adverse effects
Recurrence
Soft drinks
Urinary Calculi - etiology
Urinary stone disease
Urolithiasis
Title Soft drink consumption and urinary stone recurrence: A randomized prevention trial
URI https://dx.doi.org/10.1016/0895-4356(92)90074-W
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