People’s Pharmacy | Can you drink enough water to prevent kidney stones?

Q. Several of my friends have experienced repeated kidney stones. You’ll probably say they should drink more water, but we need more explicit information on how much water they should drink.

A. Most urologists do indeed recommend increased fluid intake to reduce the risk of recurrent kidney stones. But a new study published in the Lancet suggests that is much more difficult than doctors generally realize (Lancet, March 21, 2026).

In this randomized trial, investigators assigned 1068 people who’d had more than one kidney stone to either usual care or intensive behavioral change. Both groups were able to increase the amount they drank, but they also developed new kidney stones. Intensive behavioral support aimed at increasing urine output to 2.5 liters per day did boost hydration somewhat but did not result in fewer kidney stones. Science has yet to come up with a good solution for your friends.

Q. When I was first diagnosed with type 2 diabetes, I heard you could control it with diet. I checked my blood glucose after eating and if it went over 140 I would figure out what I had eaten that caused the spike. Sushi rice, Triscuits and sweetened drinks were bad, so I quit eating them. The secret is to eat meals that you like that don’t set your metabolism off.

I learned to eat foods that don’t raise my blood sugar very much. My A1C was 5.2 a month ago. My regular meals have a lot of beans and greens, salads and veggies. I also eat fish, eggs and dairy products. That works for me. Meat would be fine for the A1C, but I don’t like it.

Research says you can overcome metabolic syndrome and get back to normal if you give your body a chance. Changes in diet did it for me. But you have to do this for yourself. The medical system doesn’t seem to believe you can change your diet very much.

A. We salute your success with this sensible approach. Knowing how your body reacts to foods and eating accordingly can be a good way to control blood sugar, as you have demonstrated.

Other people who would like to learn more about controlling blood glucose with diet may wish to read our eGuide to Preventing & Treating Diabetes. This online resource is located under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I like pickled beets (canned from the grocery store). Are they as helpful for blood pressure as the beets and beetroot juice that you have written about?

A. People with high blood pressure can lower their systolic pressure (the first, higher number) by approximately 5 points if they get 200 to 800 mg nitrate per day from beets (Nutrition, Metabolism, and Cardiovascular Diseases, Oct. 2024).

A study of beet juice products found significant variation in nitrate content among them, though (International Journal of Sport Nutrition and Exercise Metabolism, July 1, 2019). These investigators did not analyze pickled beets. Because pickles are salty, however, they would probably exceed the sodium recommendations for blood-pressure lowering diets (High Blood Pressure & Cardiovascular Prevention, Nov. 2021).

You might want to consider alternate vegetables as a source of nitrate. Cabbage, spinach, bok choy, lettuce and other leafy greens are considered good sources, although we have seen few if any studies on how much spinach it would take to help reduce blood pressure.

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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is Top Screwups Doctors Make and How to Avoid Them (Crown)

This story was originally published April 22, 2026 at 4:00 AM with the headline "People’s Pharmacy | Can you drink enough water to prevent kidney stones?."