DEAR DR. ROACH: I am 57 years old and love Pepsi, Coke, and unsweetened iced tea for the caffeine, which greatly improves my mood and gives me more energy. Unfortunately, I am borderline diabetic and get horrible kidney stones. I need a caffeine replacement source.
Are there any natural supplements or foods that might help me? The difference of being with and without caffeine is very noticeable for me.
— M.D.
ANSWER: I’m guessing you have calcium oxalate stones (the most common type) and that you have been warned because tea has oxalate in it. However, there are two competing factors in tea: One is the fluid, which is very good for people who want to avoid stones, while the other is oxalate, which you don’t want.
It turns out that drinking tea reduces the overall risk of kidney stones. However, the stronger the tea, the more oxalate, so you do want to drink tea that hasn’t been steeped for too long.
Furthermore, green tea has less oxalate than oolong or black, so this would be a preferred choice for you. Of course, I recommend unsweetened tea for everyone but especially for a person who is diabetic or prediabetic.
There are other options. It’s not hard to find caffeinated water now, and there are also caffeine tablets for people who really need it.
The amount of caffeine in tea is much less than in coffee, on the order of 30-50 mg per cup of green tea and 40-70 mg in black tea, compared to 100 mg in coffee on average.
DEAR DR. ROACH: My dad is in excellent health and shape, and at age 100.Recently, he said that he had a doctor “read him the riot act” after a visit concerning his high blood sugar level. He said that I shouldn’t give him candy goodies anymore.
I think that at age 100, he’s earned the right to eat whatever he wants! But Dad is from the generation that never questions a doctor, and he says that he can’t have sugar now. I say that Dad is fine and should eat my treats. Who is right?
—C.D.
ANSWER: I suspect that there is a compromise between never having sugar again and having lots of candy goodies. Even people with diabetes can have occasional treats, especially when it’s given with a meal that contains protein and healthy fat, which slows absorption and helps keep the blood sugar from spiking after a sugary snack. There are also very good alternatives available, which use different sweeteners instead of sugar.
ToYourGoodHealth@med.cornell.edu.
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