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How a Low Oxalate Diet Could Make Kidney Stones Worse

Whoa!? Say what!? A low oxalate diet could make kidney stones worse? Perhaps. Before you panic, make sure to read this entire article. I am NOT saying there is no place for limiting some high oxalate foods for some people. However, I do think that a low oxalate diet is massively over emphasized and prescribed for kidney stone prevention. Most importantly, low oxalate diets are often recommended without proper investigation into the cause of kidney stones... High urine calcium is the most common cause of calcium oxalate kidney stones. There are many things we can do to lower urine calcium that is completely different than treatment for high urine oxalate.

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Featured

 Fluids, Diet, and Meds for Kidney Stones

The most common kind of stone former has no systemic disease as a cause of stones – ‘idiopathic’ stone former means that. Being most common, their treatments rank highest for all physicians who treat stone formers.

 Is the Kidney Stone Diet a scam?

So all the aspects of the kidney stone diet, there’s six goals to it. There’s hydration, there’s salt, there’s calcium, there’s sugar, there’s meat protein, and there is oxalate. And all of those things. We have goals for all of those things based upon decades of research,... Is the kidney stone diet a scam? Absolutely not. And so the best thing about it, like I said before, is once you start paying attention to fluids, getting your calcium needs met, because that’s what lowers oxalate, lowering sodium, lowering sugar, lowering the amount of meat you’re having, you can still eat meat,

 What Harvard is telling us about preventing kidney stones

If when you take my kidney stone prevention course, the oxalate is the last thing I talk about because it just is not that important. You guys are eating too much sugar, you’re eating too much salt, many of you because of your job cannot drink enough water, many of you have illnesses that are contributing to your stones, and we may never get 100% decreased stone risk in you. Up to 80% of stones can be prevented.

Articles of Interest

The Kidney Stone Diet

High calcium intake is essential for stone formers. They have bones and many have idiopathic hypercalciuria that can cause bone disease unless there is a lot of diet calcium intake. Oxalate absorption is greatly hampered by high calcium intake, if the calcium is eaten when the oxalate is eaten. It is not only stone formers who need a lot of calcium. The new FDA diet recommendations include high calcium intake for all Americans.

Three Essentials to Reduce Calcium Stones and Preserve Bone

Diet sodium controls urine calcium. Diet calcium controls urine oxalate. Diet sodium and calcium control bone mineral... I have not been shy nor secretive. Article after article speak about the three, but always in context so other facts can distract one, as can superb but unmagical paintings from a few masterpieces hung on the same wall. I know some patients, some physicians, have fully grasped the crucial importance of the three, and put them to use. From the many comments I read weekly, I know many have not. So I am taken with a passion to redress matters.

Dietary oxalate and kidney stone formation

To limit calcium oxalate stone growth, we advocate that patients maintain appropriate hydration, avoid oxalate-rich foods, and consume an adequate amount of calcium.

Eating, Diet, & Nutrition for Kidney Stones

Drinking enough liquid, mainly water, is the most important thing you can do to prevent kidney stones. Unless you have kidney failure, many health care professionals recommend that you drink six to eight, 8-ounce glasses a day.

How To Eat A Low Oxalate Diet

Many of you leave the doctor’s office thinking you will never be able to eat a fruit or vegetable again. If that wasn’t bad enough chocolate and nuts are gone, too. Some of this sadly is true, most of it is not. I am here to bring you good news: Almost everything, high oxalate or not, can be incorporated into your diet safely. Do you need a low oxalate diet? You may if your stones contain calcium oxalate crystals and your urine oxalate is high enough to pose risk. If you do need a low oxalate diet, what is your goal? Less than 100 mg of diet oxalate is good; less than 50 mg is ideal.

Is There Really a “Diet” for Kidney Stones?

The majority (about 70%) of kidney stones are calcium oxalate stones. You might think that a low-oxalate, low-calcium diet is the best for oxalate stones. Not 100% true. While it’s important to avoid excessive oxalate (more than 50 grams a day), getting too little calcium from your diet can cause your oxalate level to rise and form kidney stones. If calcium is lacking, you will absorb more oxalate from food because calcium binds to oxalate in the gut before it reaches the kidneys. Include dairy products, sardines, canned salmon, beans and lentils in your diet.

Kidney Stone Diet

NPR's Patricia Neighmond reports on a study in today's New England Journal of Medicine that claims the traditional treatment for kidney stones — reducing the patient's calcium intake — may do more harm than good.

Medications & Dietary Changes for Kidney Stones

Your doctor may recommend that you drink more fluids to help prevent new kidney stones from forming. He or she may also recommend dietary changes, such as decreasing the amount of animal protein in your diet, including beef, chicken, fish, and pork; eating more fruits and vegetables; and increasing your intake of calcium-rich foods. Depending on the type of kidney stone you have, you may be asked to limit your intake of foods that are high in oxalate, such as beets, black pepper, black teas, chocolate, nuts, rhubarb, soy products, and spinach.

Preventing kidney stones

Drink water and cut back on sodium and animal protein to avoid kidney stones or to keep them from coming back.

The Low Oxalate Diet

The low oxalate diet is simply eating healthy, non-toxic foods and reducing your daily oxalate intake to less than 100 mg per day. For those at high risk for kidney stones or who are battling debilitating symptoms gradually lowering oxalate intake to 50 mg per day is recommended. When your urologist hands you a guide to a low oxalate diet it often seems overwhelming. You may feel hopeless and wonder how you’re going to follow it. Many people believe it to be an elimination diet and wonder what’s left to eat.

This Too Shall Pass: Avoid Kidney Stones Through Diet

The evidence on diet is just beginning to accumulate. The most recent study published in Clinical Journal of the American Society of Nephrology suggests that calcium-rich foods -- such as low-fat milk and yogurt -- can be protective. This may seems a bit odd -- given that kidney stones are partially formed by calcium. "It is a little bit counterintuitive, maybe, that actually higher intakes of dietary calcium are associated with a reduction in kidney stone risk," says Dr. Eric Taylor, a kidney specialist at Brigham and Women's Hospital in Boston. The theory is that dietary calcium binds with a waste product in the gut called oxalate. The two substances stick together, crystallize and exit the body long before there's a chance to form kidney stones.

What Foods Should I Avoid to Prevent Kidney Stones?

Drink more fluids, consume less sodium and eat a diet that includes calcium-rich foods.

Whole Diet Approach to Calcium Oxalate Kidney Stone Prevention

Poor diet has been identified as a primary cause of kidney stones.1 Dietary patterns consistent with the typical diet in the United States, characterized by high animal protein, salt, and sugar and low fruits and vegetables, cause undesirable changes to urine chemistry that predispose people to kidney stones.7 Urine chemistry changes that may occur include low urine pH, high urine calcium, high urine uric acid, and high urine oxalate. Urine oxalate may be elevated due to a variety of reasons including, but not limited to, excess oxalate intake, inadequate calcium intake, or endogenous production of oxalate from excess protein and fructose intake.7

Resources

Kidney Stone Program, University of Chicago

The Kidney Stone website has resources for all audiences seeking to understand the truly complex nature of stone disease and its prevention. We include detailed materials, including videos, the kidney stone guide book, case examples, and more. If you have personal experience with the disease or want to ask questions or our team, you can also pose questions through the contact feature.

The Kidney Dietitian

No matter who you are, or why you had kidney stones, there ARE things you can do to reduce your risk of kidney stones. You just need some help from an expert. The Kidney Dietitian is on a mission to change the status quo of kidney stone care. Rather than generic or useless advice, we believe every person with kidney stones deserves a personalized kidney stone prevention plan that actually works!

Kidney Stone Diet

Drawing from my work with world-renowned University of Chicago nephrologist, Dr. Fred Coe, and the thousands of patients I’ve taught over the past 26 years, I’ve created a simple, self-guided online video course, meal plans, cookbooks, and group coaching to help you prevent kidney stones for good.

The Science of the Kidney Stone Diet

Oxalate is important only for kidney stones but the healthy diet helps because high calcium intake lowers oxalate absorption. Rather than begin with cumbersome food oxalate lists I suggest patients raise their calcium intakes and then get a new 24 hour urine collection. Often urine oxalate will no longer pose stone risk. If it does despite high calcium intake and timing of high calcium foods or calcium supplements with meals, then is time enough for the lists.