Association between Nonsugar Sweetener Intake and Kidney Stone Among US Adults: Cross-sectional Results from NHANES 2007- 2018

Backgroud: Kidney stones, a prevalent urological condition, impose a significant social burden. While some unhealthy dietary habits are known risk factors, the relationship between nonsugar sweetener (NSS) intake and kidney stone incidence remains unexplored. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2018 were analyzed. NSS intake was calculated from the first 24-hour dietary recall. Logistic regression, stratified analysis, and interaction analysis were used to explore associations between NSS intake and kidney stone incidence. Probability prediction plots visualized these relationships. Results In total, 6,891 U.S. residents aged 20 and above with complete data were included. The overall incidence of kidney stones was 11.62%, with rates of 12.17% (Q1), 11.04% (Q2), 11.35% (Q3), and 10.68% (Q4). After adjusting for covariates, high NSS intake showed a protective effect against kidney stone incidence (Q3 group, OR = 0.1101, 95% CI: 0.0129–0.9388, P = 0.0438). However, family income and extreme BMI levels modified this protective effect. For individuals with diabetes and coronary heart disease, high NSS intake increased the risk of kidney stones. Conclusions High NSS intake may protect against kidney stones in U.S. adults, but this effect varies with income and BMI levels. However, for those with diabetes or coronary heart disease, high NSS intake increases the risk. Validation through large-scale cohort studies is necessary.