A 32-Year-Old Man Comes to the Office for Evaluation After

A 32-year-old man comes to the office for evaluation after a recent visit to the emergency department due to recurrent nephrolithiasis.  The patient passed the stone spontaneously with supportive care alone.  Analysis of the stone composition later revealed calcium oxalate crystals.  The patient drinks 1 or 2 beers daily but does not use tobacco or illicit drugs.  His diet consists of mostly processed foods and meats obtained at local stores, and he avoids fruits, vegetables, and dairy products.
Vital signs are within normal parameters.  BMI is 32 kg/m².  Physical examination is normal.  Serum chemistry is normal.  You provide affirmation of his desire to lose weight and recommend increasing his water intake.
In addition to weight loss and increased fluid intake, which of the following is the best dietary recommendation to reduce the risk of recurrent nephrolithiasis in this patient?

A) Add daily cranberry juice
B) Avoid coffee, tea, and alcohol
C) Decrease dietary purines
D) Increase dietary calcium
E) Increase dietary sodium

Correct Answer:

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