Association between combined healthy lifestyle score and risk of kidney stones: a cross-sectional study in US adults

Lifestyle factors such as smoking, alcohol intake, physical activity, diet, and waist circumference are linked to kidney stone (KS) risk, but their combined effect is unclear. To examine the association between a composite lifestyle score and KS risk. We analyzed 2007–2016 NHANES data from 15,774 adults aged 20–80 years. A healthy lifestyle score (0–5) was derived from five factors: nonsmoking, moderate alcohol, adequate activity, healthy diet, and optimal waist circumference. KS was self-reported by questionnaire. Weighted multivariable logistic regression models were used to examine the association between the combined healthy lifestyle scores and KS risk. Restricted cubic spline models were employed to assess the dose-response relationship. The highest lifestyle score quartile had 51% lower KS risk (OR = 0.49; 95% CI: 0.41–0.63) versus the lowest quartile. Each 1-point increase reduced risk by 16% (OR = 0.84; 95% CI: 0.79–0.89). A linear dose-response relationship was observed (P-overall < 0.001; P-nonlinearity = 0.910). Sensitivity analyses supported robustness. Higher combined healthy lifestyle scores are associated with lower KS risk, highlighting the value of integrated lifestyle modification for prevention.