LISTS – AND LISTS
I know you are all looking for THE list. Here is one from a reliable source I have have downloaded on my site to a separate document so it opens with one click.
The reliable source, as it turns out, needed some updating. Dr Ross Holmes, professor, School of Medicine, University of Alabama, was kind enough to review the work of Dr. Michael Liebman who is a professor of Human Nutrition and Food Option at University of Wyoming and determine which food entries on the Harvard list needed changing. We cannot change the original but we have updated our lists accordingly and annotated updates with *** marks. So the lists here are the most recently edited available at present.Fred Coe and I have updates and annotated the list for those with a tendency to perfectionism: Updated table of oxalate foods. Set it at 50% for easier reading. Get yourself acquainted with the lists. They will tell you much of what you need to know. A lot of it will even surprise you. You are not as restricted as you think you are or as you have been told.
A more dramatic list is the 177 high oxalate foods we distilled out of the big list. Here are culprits! Not on this list? Probably not very high in oxalate so far as we know – with perhaps a few exceptions. Note that quantity is critical. For example black pepper is high in oxalate but the amounts used are small enough that total oxalate intake from it is negligible.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
LET’S DIVIDE AND CONQUER
FOODS TO WORRY ABOUT
A List of Concerning Foods
We have created two graphs for this article. Of the 177 foods on our master list, many are of concern but can be used in your diet if you control the portion size and how often you use them. There are 30 of them that are worrisome enough to deserve special attention.
Here are the 30. The graph shows mg of oxalate in a common portion. The details of the portions are in the complete list. The foods have in common that all contain at least 40 mg/serving. All other foods for which we have reliable data have less oxalate per serving.
Your budget is about 100 mg/day.
What does this graph mean? Does it mean you can never have chocolate, or a baked potato?
No.
It means if you want to use your whole budget on a treat, do it, but keep track and make sure you do not overspend in any meal or in any one day. Have your baked potato, but maybe share half with your partner. Or, have some hot chocolate but make it with milk because calcium helps reduce oxalate absorption. Eat your cashew nuts, but pay attention to how many. If one handful leads to ten, you cannot have them.
FOODS TO AVOID
The graph to the left is of the very few dangerously high oxalate foods.
There are only six foods, but spinach, being worst of all, has two entries. Be careful of this plot because of its range. It begins at 100 mg/portion and rises to 755 mg/portion in only 7 steps, so the distance from miso soup to spinach is about a 7 fold increase.
Rhubarb and spinach are so high you just cannot eat them. Rice bran is something few will miss, the same for buckwheat groats.
People like almonds but have a hard time controlling portion size. If you can keep it to 11 almonds a day – the portion size that gives 122 mg of oxalate, alright. Otherwise stay away from them.
If you have to eat any of these foods, caution is hardly a strong enough word.
Are you sure you need to eat them?
Why?
WHAT ARE WE SAYING?
We are saying that oxalate is common in foods, and that you have to be careful, but care is a scarce resource. How much care can you give every bite? The graphs say if you eat moderately high oxalate foods – the first graph – be careful.
Watch portions.
If you are eating one of the six dangerously high oxalate foods, stop eating it.
It is too hard to be careful with those six foods. They have too much oxalate for most of you to handle. So, just say no.
WHY BELIEVE OUR DATA?
These data arose from a major effort at the Harvard School of Public Health. A world class expert has curated it twice. Harvard can be wrong and so can Ross Holmes, but both will tend to be wrong less often than the average persons who attempt to put complex data into the public domain. We have always appreciated comments, and if anyone has a peer reviewed publication with different food oxalate levels than ours, we will read the paper and see if it warrants our making a change.
Medical research is endlessly argumentative, and food oxalate is no exception. A recent paper contrasts findings from 6 websites and 2 applications and finds some wide variations. Of the sites, the Harvard site – used here as our reference, and the Wake Forest site – which is a legacy of an outstanding investigative group have most standing with me. Leaf through the comparisons between them in the 4 charts and in the large table at the very end. On the whole differences are modest. The hyperoxaluria and oxalosis list from the paper has been withdrawn from their site.
DO YOU NEED A LIST?
Sure, a list is nice. But we helping you here. Lists can run on to hundreds of foods. The picture is meant for focus. Here are the ones to focus on.
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.
If you want to read some of the science about urine oxalate and risk of stones and about how we get to the diet oxalate goals, it is summarized at the end of this article.
Here we assume you do need to lower the oxalate in your diet.
CALCIUM FIRST
Low calcium diets can raise urine oxalate, and the solution may be as simple as a proper calcium intake. There is every reason for stone formers to eat 1000 mg of calcium daily to protect their bones. The common hypercalciuria of calcium stone formers puts bones at special risk when diet calcium is low.
Before changing your whole life around, ask yourself if you are avoiding calcium foods. If so, add them back and ask your doctor to check your urine oxalate again. It may fall enough that a low oxalate diet is not necessary.
If low calcium intake is not your problem, and you need a low oxalate diet, here is my take on how to do it.
WHAT IS THE DIET OXALATE GOAL?
Typical diets contain upward of 200 – 300 mg of oxalate. For stone prevention, a reasonable goal is below 100 mg of oxalate daily. An ideal would be about 50 mg daily if that can be accomplished.
To get there, consider the oxalate contents in common serving portions of all of the foods, and make up a plan for yourself.
FRUITS
FRESH
Everyone who comes to me is very unhappy thinking they can never have a berry again. This is Baloney. The only berry that is very high in oxalate is raspberries (look at the list). On the other hand, people do not realize avocado, oranges, dates, and even grapefruit and kiwi are very high and need caution.
This doesn’t mean you can never have these healthy treats. If you incorporate any of these high oxalate fruits into your morning yogurt you can reduce some of the effects of the oxalate content.
Also look at your portion sizes. You really cannot eat a lot at any one time. Dates are not a good bargain: One date is 24 mg!
CANNED OR DRIED
Canned pineapple is a problem.
Dried fruits have to be a worry because the water is taken out, so a ‘portion’ of dried fruit can be gigantic in oxalate content. Figs, pineapple and prunes are standouts. Just think: 1/2 cup of dried pineapple is 30 mg – not a lot of fruit for a lot of oxalate. If you want dried fruit, think about apples, apricots, and cranberry as lower oxalate options.
VEGETABLES
Spinach and rhubarb are standouts; stay away.
Other vegetables you need to be aware of are tomato sauce, turnips, okra, and yams (sweet potatoes) along with beans of different sorts.
I am not in the business of taking healthy foods away from people. But in the cases above you really must limit; there is just too much oxalate and these foods do not pair well with high calcium foods the way fruits can be mixed right into your yogurt or cereal and milk.
Many of you have been told to stay away from all green leafy vegetables. This is not true. Look at the list. There are plenty of salad options still available for you including kale. Even though tomato sauce is high in oxalate (see below) that is because of concentration. A whole medium tomato is only 7 mg and who eats more than one at a time?
Many of the salad vegetables are so low in oxalate they are freebies. Eat what you want.
POTATOES
These are Trouble! I put them into their own separate group even though they are vegetables.
From french fries to baked potatoes they are very high oxalate items. One ounce of potato chips has 21 mg of oxalate and who eats one ounce? Not I. Baked potatoes are terrible. One comes in at just under 100 mg of oxalate. Mixing sour cream into the potato will not help much; one tablespoon of sour cream contains only 14 mg of calcium. One ounce of cheddar cheese contains 200 mg of calcium, which could help, but it increases calories, salt and fat. But all in all, why struggle so hard? Potatoes are not ideal for stone formers.
DAIRY PRODUCTS
They have no oxalate. They are your main source of calcium. Use them. They can add a lot of salt – cheeses – and can be caloric. But they reduce oxalate absorption and preserve your bones.
For a stone former who has to watch salt intake, increase calcium intake, and lower oxalate intake, here is how to do that. You cannot have as much cheese as you want because of the salt. So portion sizes are very important. Yogurt, milk, even ice cream are good bargains – modest sodium and high calcium. These are a great place to add in a wee bit of chocolate – high oxalate foods – for those of you who cannot live without these high oxalate treats.
BREADS AND GRAINS
Some of the basic ingredients to make these foods are very high. White flour and brown rice flour are high in oxalate so everything you make from them will be high.
BREADS
Even so, as far as kidney stones go, breads are mainly alright because of portion size: not that much flour so one slice is 5-8 mg. French toast and New York style bagels top the list at 13 mg for two slices and 40 mg for one bagel – as much as anyone will eat of either food.
PASTA RICE AND GRAINS
Spaghetti, one cup cooked is 11 mg and most of us eat more than one cup.
Buckwheat groats, one cup cooked is 133 mg – I don’t see many of you saying ‘darn it’ or taking to your bed, but beware. Millet and bulger, wheat berries, rice bran, corn grits, and corn meal, these are widely used and are high. If you are using these, be thoughtful.
Here are some low oxalate options in this category: White rice, hummus, corn flour, corn bran, flax seed, and oat bran are popular and safe.
MEAT PRODUCTS
Since oxalate is only found in plant foods, all the meats are safe. Fish, too.
For our vegetarian friends, tofu and veggie burgers are very high.
NUTS AND SEEDS
These are just dangerous for two reasons.
Obviously they are very high in oxalate.
Secondly, I don’t know anybody who just has a few nuts at a time.
Just like chips no one eats one – the whole jar is more like it.
But, for one cup of pumpkin sunflower or flax seeds the highest is only 17 mg of oxalate and none for flax. For those of you who love foods in this category seeds are the better choice and they can be sprinkled on yogurt and ice cream.
SWEET STUFF
I have good news for my chocolate lovers. I know most of you have been sent home with a list and chocolate is high on it. But if you look at the numbers nuts are a lot worse than chocolate. Chocolate can be mixed in with dairy products, too, so as to reduce oxalate absorption.
Even so I do want to point out that half a brownie is on the high side, and who eats one half?
You can still satisfy your sugar craving but pay attention to your portion size.
Keep in mind, however, that sugar loads increase urine calcium loss which increases stone risk, so there are two reasons why this food group can be a problem.
But even without chocolate, you eat a lot of flour when you eat a piece of cake, so cake can be a problem – about 15 mg per piece, like french toast. Pies are half the risk because of their fillings – unless they are chocolate pies!
CRACKERS AND CHIPS
The big enemy here is potato chips. A one ounce serving contains a whopping 21 mg of oxalate. I repeat: A one ounce serving.
Your best bet in this category if you’re looking for something crunchy is corn chips – one ounce is 7 mg, popcorn – one cup is 5 mg, and pretzels, one ounce is 5 mg.
Crackers are OK mainly because they are small and the amount of flour is not that much.
BEVERAGES
PLANT SOURCES
Hot chocolate is the clear loser at 65 mg per cup; carrot juice is the runner up at 27 mg per one cup. Lemonade, tea, tomato juices, rice dream and the like are better but still high. The are 15 – 18 mg per serving. Lemonade – frozen concentrate – is 16 mg per 8 ounces so be careful about this as a source of citrate.
Soy milk, for those of you who prefer it, is not a good option. It is very high at 20 mg per cup. We have no data from standard sources for rice milk, cashew milk, and coconut milk; almonds are high in oxalate so the almond milk product will certainly be high.
Tea is so commonly used, here are the details. If you brew your own tea it is high in oxalate. The longer you steep your tea, the more oxalate it will have in it. If you use a sweetened instant iced tea one cup has 0 mg of oxalate.
Here are some juices that are low in oxalate and better substitutes: Apple juice, apricot juice, orange juice, grapefruit juice, grape juice. For all the lemonade drinkers, diet lemonade is low in oxalate.
Here is something very important: Coffee is oxalate free – almost, 1 mg for a cup (2 mg/cup for decaf). We already told you that coffee drinkers have a reduced stone risk, so lets debunk the coffee myth here: Drink it as you wish.
DAIRY SOURCES
Everything is good except chocolate milk. Even that is only 7 mg a cup for a sweet treat here and there.
ALCOHOL
What tops the list in this category is a can of beer: 4 mg of oxalate. All the rest are low and, frankly, the oxalate in a can of beer comes with a lot of fluid. This is not the problem area for stone formers.
WATER
If I didn’t say this to you I could not sleep well tonight. Water is the clear winner in this whole category. It is free of calories, sugar, and oxalate. Please use it as your main beverage and supplement with the items above.
SPREADS AND SAUCES
Chocolate, miso, peanut butter, and tahini are all high.
SOUPS
Miso soups is extremely high – 111 mg/cup. Lentil soup is high, and so is clam chowder – the potatoes.
BREAKFAST FOODS
This is a dangerous meal if you are a cereal lover. Many cereals are high in oxalate. I am afraid you need to look them up in the list by brand. Unfortunately the healthier cereals are highest in oxalate because they contain more plant based ingredients. Probably having milk in your cereal is wise, but we have no data to show.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life. I just released a course called The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
HOW DO WE MANAGE ALL THIS?
The first thing you need to do is to learn and remember what are the highest oxalate foods and beverages. Without this in mind it is impossible to shop and cook intelligently. Here is a short list of the highest oxalate foods all in one place.
BREAKFAST
For those of you who love cereal because it is quick and easy check out the list and see if the one you love is high in oxalate. If it is, choose the next best one with lower oxalate. Put milk in the cereal.
Alternatives to cereal that are also quick and easy: Yogurt or cottage cheese and fruit. The only fruits to worry about are raspberries because no one puts oranges on their yogurt. Bananas, peaches, blueberries and strawberries are perfect toppings.
More trouble, but no oxalate, eggs any way at all. Boil a batch on Sunday and have them for the week for breakfast, and snacks, too.
Your breakfast coffee is free and so is your water. For juices use orange, apple, pineapple, grapefruit – all great. If you want tea, don’t steep more than a minute and consider adding milk to it. Green tea is better than black.
LUNCH
Typically you are grabbing a salad or a sandwich for lunch, so what now? Many clients tell me they no longer eat salads because their physicians told them to stop all green leafy vegetables.
I’m bringing salads back to you.
Arugula, iceberg, romaine lettuces, and kale, are fine as your base. Stay away from spinach. Here are good toppings. Cauliflower, corn, cucumber, mushrooms, onions, peas, scallions, squash and zucchini are all fine. Tomatoes are fine, too; it is only the sauce that is high. Broccoli and green pepper are moderately high so watch the portion size.
Sandwiches will cost you between 12 and 16 mg of oxalate depending on the bread you are using – 2 slices. This doesn’t mean you can never have a sandwich, it just means you have to keep track of how much. You can have 50 to 100 mg daily. What goes inside between the two slices of bread is usually cheeses and meats which are oxalate free. So sandwiches are not something to be afraid of.
SUPPER
Beef, chicken and fish are all fine, and those the main courses for most of us. You will run into problems if you are a pasta or potato eater. If you are you need to limit the amount of times you have these foods each week and also the quantity each time you use them. Substitutes are a problem: White rice is a nice substitute for potatoes but there are few others. It is more veggies that have to fill in – very healthy but not as much fun.
Here is a recipe for cauliflower – ‘mashed potatoes’ you will like and even think, sometimes, is the real thing. There are many versions on the web, choose the one that makes you happy but be careful about the ingredients.
There is also quinoa which is not on our lists, but may well be high. A recent scientific article on this plant does not give oxalate contents which suggests they are not reliably known.
I have recently put together a private FB page called THE Kidney Stone Diet. It is a group that helps educate you on your physician prescribed treatment plans. As you can imagine, oxalate comes up in many posts. I moderate it to keep it clinically sound. Come on over and join the discussion!
URINE OXALATE AND RISK OF KIDNEY STONES
I promised you some science – here it is for those interested. It concerns only highlights from the food – urine oxalate research recently performed and seemingly germane to the problem of how stone formers should control oxalate intake.
The most useful data about urine oxalate we have so far is from three cohorts studied by Dr. Gary Curhan. Two are cohorts of nurses one a cohort of physicians. These people have kept track of many aspects of diet and health for decades, and among their records are onset of kidney stones.
As he did for urine calcium, Curhan measured urine oxalate in properly selected subgroups from each cohort, including people who did and did not begin forming stones. From these samples he could calculate the relative risk of new onset of stones in relation to 24 hour urine oxalate excretion.
The two nurse cohorts are red, the physicians – all men – are blue. The dotted line at 1 is the risk threshold: Above that line, risk is present.
The top of each crosshatched bar shows the mean relative risk for each of the five urine oxalate ranges. Clearly the mean goes up as urine oxalate goes up.
But the mean relative risk has a range of uncertainty around it. The bottom of the solid portion of each bar is the lower 95th percentile for that range of uncertainty. When that bottom lies above 1, risk is very likely to be present.
For both the women and men groups, that point is reached between 25 and 30 mg of urine oxalate a day. Therefore one wants to try to get urine oxalate below 30 mg daily and even lower, below 25 mg daily if possible. The average urine oxalate excretion among the women in this study was close – 26 and 28 mg/day for those who did not form stones and just a bit higher for those who did – 28 and 30 mg per day. The men are a problem: 39 and 41 mg/day for those who did not and those who did form stones.
This is not diet oxalate, it is urine oxalate. Urine oxalate is how much the body makes and how much is absorbed from foods. Mostly, we can control only the second part – how much is in the food.
HOW MUCH DIET OXALATE DAILY
All dietary advice depends on having a reasonable goal in mind for oxalate intake. My goal of 50 – 100 mg of oxalate from food daily is not unreasonable given the research that has been done in normal people and stone formers.
Holmes and colleagues found a urine excretion of oxalate of about 10 mg/gm urine creatinine in normal 
people eating a synthetic oxalate free high calcium diet (graph at left). As diet oxalate increased, urine oxalate rose from 0 to 10 mg/2500 kcal/d, urine oxalate rose steeply from 10 to 14 mg/gm urine creatinine. It rose more slowly, from 14 to barely 15 mg/gm urine creatinine as diet oxalate was increased to 50 mg/2500 kcal/d, and more or less at the same slope thereafter so that an increase from 50 mg/2500 kcal/d up to 250 mg/2500 kcal/d increased urine oxalate only from 14 to 18. The closed symbols are whole food the open symbols synthetic diets.
From this work the percent oxalate absorption could be calculated as around 10 – 15% and the contribution of diet oxalate to urine oxalate excretion as around 25 – 40% when intake of oxalate was between 50 and 350 mg/2500 kcal. Therefore one can consider a whole food 1000 mg calcium 50 mg oxalate as a usable low oxalate diet, and a 150 – 250 mg oxalate diet as relatively high.
The balance between diet calcium and diet oxalate does not matter greatly if diet calcium is high. Among normal men and women eating 1000 mg/day of calcium and 750 mg/day of food oxalate, 24 hour urine calcium was about 110 mg/day and oxalate about 44 mg/day.
If the calcium oxalate balance is altered so calcium intake is 400 mg and 20 mg of oxalate at breakfast and lunch, and 200 mg of calcium and 710 mg of oxalate at dinner, as compared with simply 333 mg of calcium and 250 mg of oxalate in all 3 daily meals, urine oxalate is lower after the high calcium low oxalate meals, but only slightly higher after the high oxalate low calcium evening meal than when calcium and oxalate intakes were balanced. This means that when diet calcium is at least 1000 mg daily the balance of calcium to oxalate within any one meal is not likely to affect stone risk.
Seiner and colleagues make clear that stone formers are different from normal people. They divided male and female stone formers into 2 groups of 93 people each, one with urine oxalate above 0.5 mmol (~50 mg) of urine oxalate daily and the other with urine oxalate below 0.4 mmol (~40 mg) daily. They found virtually identical calcium and oxalate intakes: 845 vs. 812 calcium and 101 vs. 130 mg daily of oxalate respectively in the lower and higher urine oxalate groups. But the below 0.4 mmol group excreted only 27 mg of oxalate daily on average, whereas the high oxalate group excreted 64 mg daily. In other words diet was not responsible for the higher urine oxalate excretion, suggesting a difference of oxalate absorption. Those prone to high oxalate excretion seem, therefore, to most need diet modification.
Knight and colleagues found a wide range of oxalate absorption among 38 calcium oxalate stone formers eating a self choice diet. Urine oxalate excretion (vertical axis) varied with percent of diet oxalate absorbed (horizontal axis). The mean absorption centered around 5%; a few outliers absorbed over 15% up to 25%. This supports what Seiner found – some stone formers will have urine oxalate levels very responsive to diet oxalate and sans a research protocol we will not know. This is another good reason to keep diet oxalate low – 50 to 100 mg if possible.
PROTEIN AND GELATIN
Diet protein intake does not affect urine oxalate excretion. In 11 normal people fed a 1000 mg calcium, 51 mg oxalate, 3000 mg sodium fixed diet, varying protein intake from 0.6 to 1.6 gm/kg/day – a very wide range – did not alter urine oxalate appreciably (mean values were 23, 23, and 25 mg daily for the three protein intakes) even though oxalate precursors like glycolate rose markedly (25, 22, and 46, mg daily).
Jello is a source of hydroxyproline which converts to glycolate and oxalate, and oral loading with gelatin can raise urine oxalate. Ten normal people eating a 1000 mg calcium, 150 mg oxalate diet (typical normal level) were fed supplemental gelatin as one quarter of daily protein intake. Urine oxalate was 24 mg daily vs. 17 mg daily when the same diet was supplemented with whey protein – containing little hydroxyproline – as a control. So lots of jello is not an ideal plan for stone formers.
Where does this leave us about how much oxalate is alright for a day. If diet calcium is high, as it should be, at about 1000 mg, then one should try to limit diet oxalate below 100 mg daily. Perhaps this is most important in those patients whose baseline oxalate excretions are higher – in the range of above 40 mg daily.
Eating a low oxalate diet can be overwhelming and difficult to incorporate into your daily life.
For those who need special help, I run an online course: The Kidney Stone Prevention Course to help you understand how to implement your physician’s prescribed treatment plans.
Hi Jill,
I just began a gluten-free, dairy-free, soy-free diet, following a 12 week protocol/elimination diet to improve my hypothyroidism/Hashimoto’s Disease. As a consequence, I increased my spinach, nut, and legume intake and soon realized the consequences of a high oxalate diet. (I have learned that I get interstitial cystitis symptoms as a result). I am eager to follow the guidelines to reduce my oxalate amount and thus hopefully reduce or stop my symptoms sooner than later. However, I realize that with my current Hashimoto’s guided diet, it may be hard to get calcium if I am also following the low oxalate diet. Do you have any advice? I am considering either eating dairy again to ensure I get enough calcium or continuing both diets and taking a good Calcium Citrate vitamin with my meals. I also wonder if you have an idea of the oxalate count for coconut milk and also winter squash and pumpkins as I am eating quite a bit of these. Thanks for your advice and insight!
Hi Betsy,
That is a big diet change you are doing. A diet that is followed within moderation is always best as when you eliminate many food groups you overeat in other ones (spinach and nuts) and this can cause different issues. Getting your required calcium 1,000 mg for women who still get their periods and 1,200 mg for those that don’t, is very important for keeping oxalate levels low and bone density normal. If you are following a low oxalate diet that has NOTHING to do with calcium intake. Meaning, if you are following a low oxalate diet than you MUST get your calcium requirement. Getting it with food is always best, and if you cannot, then supplement with a calcium pill that will work best for you. Consult your doctor on which type that might be.
Hope this helps, Jill
I have to have a low oxalate diet that stays below 40-50 mg daily, so a lot of this food that some says is okay my doctor does not want me to eat. Iceberg lettuce is one such example, any suggestions?
Hi KGraves,
Iceberg lettuce can be used on a low oxalate diet. Perhaps your doc uses a different list than Harvard. Dr. Coe and I have our patients use the Harvard list as when followed, along with our other advice (getting your RDA of calcium), our patients do lower their urinary oxalate. Follow the list on this site and get your RDA of calcium and you should be able to eat most lettuces. Spinach, of course, will be a no-no. Jill
What about Herbal Teas – are they high in Oxalates? And since I can no longer use stevia – how about honey? Just found out I am a stone maker and trying to figure out what I can and can’t eat. I am also Diabetic so … this is like a mine field to me.
Hi Belinda,
You can use Stevia. The plant is high, once processed the sweetener is zero. Herbal teas drunk in a true cup per day is fine. Read this: .
Hope this helps, Jill
Hi Jill,
Great Great article and read, thank you for this.
One question about oat bran. You said that it is safe for people with stones, but on the list the Quaker Oat bran is listed as High at 1 1/4 cup at 10mg of oxalate.
I am really struggling to find foods to fill my day, can you help?\
Thanks,
Kevin
Hi Kevin,
I teach my patients to learn how to use the oxalate list. If you are given 100 mg/oxalate a day to eat then you can see that oat bran can easily be incorporated into your diet. Forget about “high, very high, and low”. Go by portion size and how much oxalate is in that portion size. You can see how many foods are still absolutely fine to eat!
Hope this helps, Jill
Thanks Jill!
I find myself not eating due to me being so confused and worried about all these factors (i currently have kidney stones). Oxalate levels, protein,etc.
Sorry, one more question. What is the deal with lentils? I thought that veggie sources of protein are better, but lentils seem to be on the higher side (i know you said not to worry)? Does it matter if it is dried?
Thank you so much for your quick reply and help!
Hi Kevin,
Eat within a small portions size and with calcium and you will be fine. Think about taking the Kidney Stone Prevention Course to get specific help for your situation. It really helps!
Jill
Well rounded, best I’ve researched on KS issues.
I prefer to avoid conventional medicine. In this article there is a point that I wish to have clarified – when you speak of calcium supplementation, which form? Chelated over ‘regular’ calcium? There are Cal Mag supplements that complement each other. Any suggestions that might not have the stearates (or other unnecessary additives) mixed in?
Have you come across calcium EDTA therapy that has been used for decades for stones? Your opinion?
Blessings
Hi Dman, The ideal way to control urine oxalate – if that is the cause of your stones – is a high calcium diet, from food, with low sodium to control the calcium in the urine. Take a look at the ideal kidney stone diet. As for chelation, it has no role in stone disease, nor do additives. I know the web has a lot about both, but no data support their use. Regards, Fred Coe
Thank you for this wonderfully accessible information. One question about reading the charts: You say in your article that because almonds are high in oxalates, Almond Milk must certainly also be high. Elsewhere it says that raw grapefruit is “very high” in oxalates but grapefruit juice contains “little or none”. Can you help me understand this apparent contradiction?
Hi Doug,
I would assume almond milk is on the higher side, but there is always debate on exactly how many almonds they use to make the milk. Still, since almonds are ridiculously high, I ask my patients to not drink it. Use flax milk if you are a vegan or lactose free milk if you can tolerate dairy. Grapefruit juice is more likely lower because the concentration of juice to that of the raw grapefruit. That being said, you could certainly have a grapefruit here and there. Remember to look at the actual mg of oxalate in the product in the serving size. Don’t go by the adjectives used to describe each food. Sunflower seeds are listed as “high” but that adjective is used to describe 1 cup of seeds and not many people are eating that much. And even with that portion the amount of oxalate is only 22 (I think- not looking at the list right now). If you are allowed to eat 100 mg/oxalate per day you can see that having most of these foods on the list is certainly doable. Remember to get your calcium as well! Best, Jill
How donI get insoluble amounts without a large amount of oxalates. I am a gastric patient from 2006 so balance is important to me. Please help point me in the right direction.b Thanks Kathy
Hi Kathy, Your note is not too clear. I gather you have had an obesity bypass surgery and have stones and perhaps high urine oxalate. If so, here is a good place to read about what can be done. Certainly you need 24 hour urine testing, as treatment depends on knowing those results. Regards, Fred Coe
I had two kidney stones 20 years ago and it ruined me for eating. But I haven’t had one since. My question is this. I eat pasta every night, and I know it’s not healthy for me. I would love to start incorporating things like Quinoa into my diet. But I know it’s high in oxalates. Do you feel Quinoa is something I could eat?
Thanks
Josh
Hi Josh, If you have had no stone symptoms for 20 years, you may no longer have a risk for stones. I would advise your physicians consider a low dose CT to be sure stones are not accumulating. If not, then diet is general and not stone directed. The ideal kidney stone diet matches the US ideal diet, so I would feel fine advising it for anyone, including yourself. If your diet calcium is high, as the US diet should be, Quinoa would not be an issue, as high diet calcium greatly reduced oxalate absorption. Regards, Fred Coe
How about eating fresh pomegranate? I see that it is high in oxalates but not on the list. Some sites claim it is a homeopathic remedy for kidney stones.
Hi Jane,
I have no problem with you having it as a treat here and there, but it will not prevent stones.
Best, Jill
So i was diagnosed with calcium oxylate stones when i was 20. I had a few of them till i was in my 40’s then havent had one for the last 15 years, till last month and took me over a month to pass a 6mm stone. Doctors decided not to analyze this one, and had no comments as to what i should do to avoid them. In the past, the doctors took me off all calcium, red meats, and a long list of other things. I am a vegetarian now, but dont eat a lot of calcoum because it messes up my stomach. I do eat nuts.. They did say the stone i had was in there quite a while and they dont see any others. What would be your suggestion for a vegetarian?
Hi Robin,
The only way to know what you need to do is by getting a 24-hour urine collection done. Ask your doc to order one for you!
Best, Jill
Hi Robin, It was an error to not analyse the stone. Low calcium diet is not a good treatment. Meats are not a significant stone risk. Here is a more useful approach to prevention by diet. You should get serum measurements and 24 hour urine studies to be sure you know what to treat and if treatment is doing anything. Regards, Fred Coe
I am looking for the oxalate value for Farro. I see it is high in calcium, has protein, and lots of carbs but I cannot find anything on its oxalate value. Do you know anything about it?
Hi Catherine,
I know you won’t like this answer, but I don’t have values for it. My suggestion would be to eat it within called for portion size and limit to once a week.
Best, Jill
I am a 59 y/o white male and have just had my first bout of calcium oxalate kidney stone. It was 9mm. I am also type 2 diabetic. Getting calcium is tough. I can do cheese, some yogart, but no cow’s milk. I use unsweetened almond milk as it is high in calcium and very low in carbs. I eat a bowl of oatmeal, made with unsweetened almond milk, a banana, and a tiny dash of salt. Does the calcium in the Almond milk neutralize the oxalate in the oatmeal? Can you suggest an alternative to oatmeal? If life were easy, monkeys could do it! 🙂
Hi Paul,
Get rid of the almond milk and use unsweetened flax milk as a low oxalate substitute. Continue to enjoy your oatmeal.
Best, Jill
Any lists for vegans? If pasta and beans are severely limited, then what?
Hi Teresa,
I have worked with many vegans. We discuss how to incorporate beans and pasta in a way that works with their low oxalate diet. The rule of thumb is making these foods in normal portion sizes and not the main bulk of your meals.
Hope this helps, Jill
Thank you
Hi,
It would be nice to know the values of pomegranate , pomegranate juice, coconut water, coconut flour & coconut milk
Thanks,
Amir
Hi Amir,
Harvard does not list these foods so I am not sure. However, my patients do sub out coconut flour and use coconut water. They still have low oxalate values on their urine collections as those that do get their RDA of calcium from foods.
Best, Jill
Hello Again,
Sorry, I have two questions.
1)Is par broiled rice ok?
2) If I ate something like pineapple everyday, less than a cup, does that add up during the week or is it the daily consumption the issue? Another is Kale, if I had Kale everyday would that be a problem?\
Thank you in advance.
Kevin
Hello
I have two questions if that is okay.
1) I see that things like pineapple and kale are low in oxalates, but if I had those everyday, is that a problem? Is it daily consumption that we need to worry about, or throughout a week for example?
2)Are animal protein sources an issue?
Sorry, one more…3) Is par broiled rice okay? I know that brown rice is a no no.
Thank you in advance.
This is the best source of this kind of information on the web!
Hi Kevin,
The food you eat matters each day. It doesn’t “add up”. That being said, I always talk to my patients about adding variety to their diets and try not to eat the same foods every day. Animal proteins are a problem, again, if you overeat them.
Best, Jill
Hi Jill,
Thank you for your reply.
What is considered as “overeating animal proteins? I find it extremely difficult to eat enough protein in a day without eating animal proteins, especially when most vegan protein sources are high in oxalates. Also, I am lactose intolerant, so that makes it even more difficult.
Par broiled rice ok or not ok?
Thanks
Kevin
Hi Kevin,
I don’t quite know what “par broiled” rice is but having a normal portion of rice is fine. Make sure you are getting your calcium each day. There are excellent articles on this site talking about protein and how much. Typically we say 0.8gm-1.0gms/kg/day. If you are trying to get your calcium try Fairlife milk or unsweetened flax milk. They both are lactose-free.
Jill
Thank you Jill, I really appreciate your help.
I cannot find flax milk or Fairlife anywhere in stores. I found only rice milk, almond and coconut, soy, and hemp milk. I will try lactose free cows milk I guess. Health foods are very hard o locate.
Thanks again!!
Kevin
Hi Jill, (last post I promise)
This reply may appear twice as my laptop lost wifi as I was writing my last reply. I apologize.
Thank you for all your help and efforts in helping us.
I could not find Flax milk or Fairlife milk. Would regular lactose free cows milk be okay?
I only found hemp, almond, soy and rice milk.
Thanks Jill.
Kevin
Kevin, Yes, of course. Jill
Jill, this site is fantastic. Thank you. Just double checking, I weigh 170 which is 77 kg, so if I calculate correctly, I can have 7 grams of animal protein a day? (I have to be very careful, I just lost a kidney due to complications from Oxalate stones. I can keep my Oxalates below 50, but I do enjoy chicken, fish and eggs. ) Thanks so much David
Hi Jill,
I guess i am only allowed so many comments.
One last question.
What is the deal with avocados? I am finding conflicting answers on the web.
Thanks.
Kevin
Hi Kevin,
Although avocados are listed as “high” the amount per serving is well within your daily allotment. You can safely have them if you eat half of one, that is only about 9mg. I give my patients a bank of 100mg/day to eat as long as they are getting their RDA of calcium. Don’t go by the adjective describing the food on the oxalate list, go by serving size and amount of oxalate in serving size. That will be better for you. You have many questions, you should think about taking The Kidney Stone Prevention Course. It will help sort everything out for you. You get to work with me for 5 weeks.
Take Care, Jill
Hi Jill,
I am sorry for all my questions. I would love to take your course but I cannot afford it at this time. The web is often very confusing. Kale is another, although in your article above you said kale is fine, other sources list it as high oxalate.
I really appreciate your patience with me.
Kevin
kevin,
Kale is fine to eat.
j
I follow a Paleo diet for help with the symptoms of late stage Lyme disease – no processed foods, no dairy, grains, legumes, white potatoes, or sugar. I was just told by my urologist that I need to follow a low oxalate diet, decrease vitamin C (I don’t take a supplement), increase calcium (800-1000mg daily), limit red meat, nuts, fruit, and vegetables. I’m trying to stay with the Paleo diet because it really helps to decrease pain. Can I take a calcium supplement with meals instead of adding dairy to my diet? I think I can manage to work with the rest, based on your information. The high oxalate food list is not nearly as extensive as my doctor made it sound.
Thanks!
Hi Kathi,
The docs tend to make a really big deal out of the oxalate foods. It is a big deal, but the list of foods that are an actual no-no is not that bad at all. You not getting enough calcium IS a big deal. For your bones and stone disease. Notice that foods do contain some calcium and see how much you are getting from foods per day (an average) and supplement from there. I must say this so I can sleep tonight, you know by food is best. BUT. If you just can’t get it from food you can supplement. Take with meals (NOT SNACKS) and spread throughout the day.
Best, Jill
Hi Kathi,
You can take a supplement, but take it with foods and don’t go over what you need. Also, spread it throughout the day.
Best, Jill
Hi Jill,
I am very new to this, and finding it to be the most confusing diet I’ve ever come across. Other than meat and dairy, there are no real “groups” that are okay/not okay. Everything is so individual, and the many lists that I have come across seem to have wide variations. I am wading in slowly.
I just recently had some stones removed, at nearly 46 years old, for the first time. I am scheduled for the 24 hour test in the next few weeks. Should I eat normally until after the test? Will eating low oxalate now skew the results?
Also, I have been extremely low on calcium for nearly 15 years. Milk tends not to sit well, so I quit drinking it. I don’t think to eat cottage cheese or yogurt very often. Cheese and coffee cream have been my main sources, and not a whole lot of those, either. I don’t really feel that I have been a huge consumer of high oxalate foods (potatoes are probably going to be the hardest to give up, but even those are only eaten a couple of times per week, at most), so could my low calcium intake (and often, lack of adequate water intake) have been enough to cause the formation of stones? I’m not looking for a diagnosis, obviously. I’m just trying to wrap my head around this, and wondering about the general possibility.
Also, assuming that I do need to begin eating low oxalate, how does it work in terms of (and I hate to use the term, but can’t think of another way to ask) “cheating”? What I mean is, say, with Thanksgiving coming up, if I were to have a serving of stuffing and a serving of mashed potatoes along with the turkey, (and probably again later) does that screw up all my progress if I have been staying below 50 mg oxalate and above 1000 mg of calcium for a month before and after? With most diets, I can say, “Okay, back at it tomorrow,” but in this case, if screwing up one day can cause a stone to start to form, the stakes are higher. Or is there some room for the very occasional indulgence in a potato? I honestly don’t know the answer and, like I said, am just trying to wrap my head around what I am most likely going to be living out soon. Any guidance is appreciated. And thanks for the information that you’ve shared here. It is, by far, the most helpful and clear collection of information that I have found.
Hi Katy,
Please know that you don’t even know what to do yet as you have not done a urine collection. When you do the urine collection (I wrote an article on doing them, read it here:
When you do the test eat and drink as you did when you were making the stone. Docs tend to give out generic advice before the urine collection is done and this can be confusing for you and you may not even need to do the things they say. The collection results will help your doctor give you a treatment plan to lower your risk.
What you do that day is what matters. So in your example of Thanksgiving, it doesn’t undo your low oxalate eating that one day. You are not going to form a stone with one meal. It is what you over time that matters. I do offer a course that helps and we have written about it here on this website. It is called The Kidney Stone Prevention Course. You have many good questions and I am glad you are taking this seriously. You should. Your health is important.
Best, Jill
This is incredibly helpful, thank you. Are you able to provide any resources for increased calcium on a vegan diet? Many of the sources (some greens, sesame seeds, etc) would fall into the high ox. category. Trying to work out a vegan, kidney stone friendly diet. Will be cutting back on spinach, berries and potatoes for sure. Curious as to your take on tofu/edamame. Thank you.
Hi Lisa,
My vegans still enjoy a good variety of foods. The ones that are highest on the list I say to do without. This obviously includes spinach and soy and almonds. Any food over 50 per serving I say get rid of. But there are not too many of those. Look at the list and see what you are taking away but don’t have to. Pistachios are a good example, the list says high but you can easily incorporate those into your diet as a snack or on top of salads. PORTION is always key. People come work with me bc they were eating handfuls of almonds a day. Keep to the portion size and you can eat tons of things. As far as calcium, google foods high in calcium and compare them to your oxalate list to see which will work for your situation.
Jill
Thanks very much.
Hi Lisa,
Just google calcium rich foods and don’t eat the ones that are high in oxalate but work with your diet.
Best, Jill
Hello again,
Is decaf green tea ok?
Thanks,
Kevin
Hi Kevin,
Please read the article A Thirst For Variety on this website. Yes, it is ok.
Jill
Thanks Jill,
I cannot find the article, but I will continue to look.
“But, for one cup of pumpkin sunflower or flax seeds the highest is only 17 mg of oxalate and none for flax”. I have been eating flaxseed for gut health. Does flaxseed have oxalate or no? Kind of confusing how you worded it.
Thanks ( absolutely my last post, very sorry).
Kevin
Hi Kevin,
Flax seeds are fine.
Jill
Hi, new to this site, but is sunflower butter high in oxalate?
Hi Keith,
Remember to look at your oxalate list. Sunflower seeds are listed as high on the Harvard list, but for a whole cup there is about 20 mg/oxalate. You can fit them into your low oxalate diet for sure. Have a glass of milk with your sunbutter sandwich and don’t overuse the portion.
Best, Jill
Does potassium citrate tajen as a supplement help keep oxalates down?
Hi Todd, No it does not. High diet calcium will lower urine oxalate. Take a look. Regards, Fred Coe
The bit about meat is COMPLETELY incorrect. Incidence of kidney stones statistically rises with consumption of red meat especially, white meat somewhat. Pescetarian is usually pretty safe. Meats do not CONTAIN oxalates, but when your body breaks them down, in combination, they RELEASE tons of oxalates through the digestive process.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754098/
Hi Molly, I know the article you quote, but take a look at this one. Recent work by Taylor and Curhan found no special effect of red vs non red meat, and no real effect of meat altogether on stone risk. I was surprised enough I asked the authors to read my summary of their new work, and that is what they found. Protein metabolism does provide glycine that can convert to oxalate, but so much of urine oxalate reflects diet oxalate as opposed to metabolic oxalate production there is not a robust correlation between diet protein and oxalate. Best, Fred Coe
Thank you for the informative article. I have easily replaced potatoes with white rice in my diet, but many Asian dishes are noodle based. Should I avoid these in the same way I am avoiding spaghetti?
Hi David,
Yes, I would. Unless they are rice dishes. Please do be aware of the sodium content of Asian Cuisine. It is typically quite high. A stone former should keep his/her sodium to around 1,500 mg/day.
Best, Jill
Thanks for this article, but I’m confused about your avocado comment because the consensus of opinion is that avocado is actually very low in oxalates. On almost all charts it is listed as being very low. Are you perhaps confusing it with having high potassium which it does. I eat avocado almost everyday so I am very interested in knowing the truth.
Hi Jeanne,
Remember if you can have 100mg/oxalate per day then you can easily eat avocados. Harvard lists them as high but always look at the portion size and not the adjective. You can have them. My patients do and maintain a low oxalate diet. Don’t forget to get your calcium each day!
Best, Jill
I recently added avocado to my low oxalate diet because of my dry skin. What cooking oils should I use to saute mushrooms and fry eggs. Using a bit of avocado now. Is coconut oil good?
Hi Sylvia,
I use olive oil, mostly. But you could surely use coconut oil if you prefer.
Best, Jill
Reading about oxalates and its effects on inflammation – i feel I’m left with a list of 10 total items i can consume 🙁 – – I’d love to see perhaps an article with results on research done about combining certain high oxalate foods with others to reduce its absortion. Or how to flush oxalates with certain juices/types of water, etc. In the meantime, my philosophy is – we’ve bound to die of something – so – exercise caution and just eat healthy best way you know – no sacrifices or abstinences
Hi Martha,
If you combine your high oxalate foods with foods containing calcium it will reduce your urinary oxalate. We talk about this extensively on the site!
Best, Jill
When was this list compiled?
Hi Elaine,
I believe Harvard obtained this list in the 1980’s.
Best, Jill
I guess I had two questions. When was the last time you updated your list? I’m finding that avoiding stones is a dietary minefield!
Hi Elaine, I am answering for Jill. The list was curated several years ago by a recognized oxalate expert, Dr Holmes. Diet to avoid stones, however, makes only modest use of oxalate lists, because it has in it much more than diet oxalate. Take a look at a more developed diet for stone prevention, and see for yourself. Regards, Fred Coe
Thanks, and happy Thanksgiving!
For vegans n Asians not normally eating dairy as their source of calcium n protein, what are they left with to consume?
For vegans n Asians whose diet do not use dairy products to obtain calcium n protein, what are they left with to eat?
Hi Semzang,
You can get your calcium from nondairy sources like flax milk or supplements if that helps (of course we suggest you try by foods for better absorption). Google non dairy sources of calcium and limit the highest oxalate foods. As far as protein you can eat beans if you learn how to do it without going over your oxalate limit (if you do indeed need to limit your oxalate). It will take some education and planning, but I work with many vegans and teach them how to get enough protein and calcium whilst sticking with their vegan diet.
Best, Jill
This is an excellent article and contains a lot of very good information. However, there is at least one major error that must be addresses. That error is the statement that dairy increases your calcium intake and “protects bones”. This is a statement that is so erroneous as to cast a shadow of doubt over other aspects of the entire article.
Animal proteins are high in sulfur-containing amino acids, especially cystine and methionine. Sulfur is converted to sulfate, which tends to acidify the blood. During the process of neutralizing this acid, bone dissolves into the bloodstream and filters through the kidneys into the urine.
It is well documented in multiple studies that consumption of dairy creates inflammation. As a result, eating or drinking dairy leaches calcium from bones to counter the rising ph in body chemistry. Cheese, being 70% saturated fat, is by far the worst culprit of all and should be completely eliminated from one’s diet. Read The Cheese Trap by Neal Barnard MD, FACC.
Sonneville KR, Gordon CM, Kocher MS, Pierce LM, Ramappa A, Field AE. Vitamin D, Calcium, and Dairy Intakes and Stress Fractures Among Female Adolescents. Arch Pediatr Adolesc Med. Published ahead of print March 5, 2012.
Holick MF, Garabedian M: Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In Primer on the metabolic bone diseases and disorders of mineral metabolism. 6th edition. Edited by Favus MJ. Washington, DC: American Society for Bone and Mineral Research; 2006::129-137.
Hi Roger, Use of dairy products to provide calcium for bones is rather a well established matter. I think the best source is the 2015 US diet guidelines that contains the full reviews of the food recommendations for the country. Acid load from protein and effects on bone is very contested. I have reviewed the matter. In fact, I did one of the better experiments in this field when a much younger person – in the linked article. One school of thought is that acid loads from protein reduce bone mineral balance. A contrasting school holds that bone mineral balance increases with diet protein because of increased GI calcium absorption. A single experiment from the Dallas group – in the linked article – showed that protein load + enough alkali to neutralize the acid from the protein raised urine calcium independently of acid – no doubt a direct effect on the kidney. The Hollich review does not say that dairy products injure bones – The senior editor of the Primer, Dr Favus, was my long term research partner and I know the work very directly. I looked up the Sonneville article on PubMed and copy here the summary sentence of the abstract: ‘CONCLUSIONS Vitamin D intake is associated with lower stress fracture risk among adolescent girls who engage in high levels of high-impact activity. Neither calcium intake nor dairy intake was prospectively associated with stress fracture risk.’. There is no mention of dairy products causing inflammation or bone disease. As for cheese and doctor Barnard, I do not know his publications. I found nutritional papers by ND Barnard, on plant based diets, but nothing about inflammation. In this large meta analysis, inflammation was inverse to fairy product use apart from those with allergies to dairy products. Regards, Fred Coe
I would like to bring something that I feel is very important to your attention. Calcium Oxalate stone formers need not restrict calcium intake. Calcium is an essential mineral in human metabolism and for stone formers, calcium binds with available excess oxalates in the blood, thereby preventing the oxalates from contributing to stone formation. Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Publ Health. 1997;87:992-997.
Hi Roger, You are correct. IN fact, .in another related article I point out that given an ample diet calcium intake management of urine oxalate is greatly simplified. There is no mention of low diet calcium in the article you have commented on. In this linked article you will find my graph of all of the trials to date using diet calcium to lower urine oxalate. The Stampfer group is epidemiologically based, the graph presents actual experiments. Regards, Fred Coe
all Calcium supplements and synthetic vitamin d supplements damage the kidneys .
Hi Michael, I allowed this post despite that it does not state the facts correctly. ‘all Calcium supplements…’ do not damage kidneys. Misuse of calcium supplements can raise urine calcium and promote stones and possibly kidney tissue mineralization, but used correctly supplements may be the only way for many people to get adequate diet calcium. Vitamin D supplements taken in normal doses have no known role in causing kidney disease or kidney stones. Abnormally high vitamin D intakes are dangerous. Regards, Fred Coe
What kind of sweetener can you use…
Hi Carla,
You can have sweetener, I like Stevia best. The plant itself is high in oxalate, but once processed has 0 mg of oxalate.
Best, Jill
Thank you…
Your list says that 1/2 cup of navy beans has 76mg of oxalates. Is that 1/2 cup of dry beans or 1/2 cup of cooked beans?
Hi Michael,
Cooked.
Best, Jill
Thank you.
Hi Jill. What are your suggestions for those of us that like to bake, especially cakes. What can we do to replace baking soda and its high level of sodium? I know of a reliably acceptable baking powder substitute by Hain (Featherweight Baking Powder). But the only low sodium baking soda substitute I am aware of by Ener-G is not very good at all.
Any ideas?
Thanks.
Hi Roberta,
I have found and used low sodium baking soda. Not good to say the least. Best advice? When baking only eat small portions of your finished product. It is always portion, not perfection. Also, watch sodium for the rest of the day!
Best, Jill
I’m confused on the Stevia. Above you say each tsp has 42 mg. oxalate.
Hi Kathy,
The plant has oxalate. Once processed no oxalate.
Best, Jill
I wonder what nutritious food is left to eat since besides kidney stones i also have high histamine problems and elevated cholesterol, all this while following more of a mediterranean diet and not a typical American food diet. What should I prioritize: low oxalate, low histamine or low cholesterol?
Hi Mary,
Your priorities should be based upon your 24-hour urine collection. Have you done one? If not get one ordered. I can help put all your dietary issues after that.
Jill
I am on potassium citrate er 15mg (twice per day) and chlorthalidone 25 mg. (1 per day). I’m afraid this is good for preventing kidney stones, but harmful to kidney function? Thoughts please?
Hi Cheryl, POtassium citrate nor chlorthalidone affect kidney function adversely. The former is merely an alkaline potassium salt. The latter has millions of uses for high blood pressure and as a diuretic. Apart from uncommon allergic reactions, it has saved lives in high blood pressure trials and no reports of falling kidney function have been published. Low diet sodium potentiates the effects of thiazide on urine calcium, blood pressure, and bone balance, so the dose might be lowered. Regards, Fred Coe
Thank you
Just wanted to point out that the charts you provide do not include swiss chard, which is very high in oxalate.
Hi Marilyn, Thanks for the comment. It is very high and I had thought it was prominent on the list. I will ask Jill Harris to check and fix if needed. Regards, Fred
Dr. Coe/ Jill,
My PCP just prescribed Vit D- a megadose- which I don’t want to take after reading the 2012 article from Endocrine Science. My Vit D level was insufficient but not too far from normal. I think I will try a 1,000 iu tablet every other day.. She didn’t order any 24 hr urine or even follow up blood work for a year 🙁 Thoughts on Vit D supplement for a one time stoner- guessing it was Ca oxalate- not tested in surgery ?
Hi Lisa,
It is recommended that you do a higher dose (not mega) to get your levels where they need to be and then get your blood tested to make sure you are there. Once in the happy range, go on a maintenance dose to keep your levels within normal range. Get tested each year to ensure you are where you need to be.
You need a 24 hour urine collection (as you know). It is your health, push back on this with your health care provider.
Best, Jill
First and foremost, thank you all for this invaluable resource. It’s difficult to find an informative and helpful resource online, so thank you for all that you do and have done!
I have had a rough history with kidney stones and recently had to have surgery for a blockage caused by a large stone. During that time, I was diagnosed with stage 2 kidney disease.
At the time, I was eating a healthy, high protein low carb (not no carb) diet, but I was incorporating a lot of spinach, sweet potatoes, beans, etc, (the higher oxalate foods but still very healthy) without any knowledge or regard to how often I was eating them. Upon receiving the results of my 24-hour test, I learned what types of stone I’m creating (calcium oxalate) and that I need to be eating differently.
I have since removed most very high oxalate foods and reincorporated more dairy (mostly milk as I was already eating cheese and greek yogurt) back into my diet, and I’ve managed to lower my creatinine levels to a healthy range. Hopefully, at least for now, slowed the progression of kidney disease—My doctors are a lot less concerned about it now!
I do have a couple of questions related to exercise and protein. I’m not training for a competition like I have in the past, those days are over, but I need to lose weight, get in better shape and stay healthy.
— Is lifting moderate weight advisable? For example, not ever lifting at my maximum single rep, but rather, somewhere in the middle of allowable weight at 10-12 reps.
— Are protein shakes advisable at all?
— What about protein shakes to meet daily protein requirements when animal proteins aren’t available? (I.e. I have to work through lunch but need something to hold me over or a shake for breakfast running out the door.)
— With the recommended 0.8 – 1 gram/pound/day body weight in mind, is that ideal weight based on BMI, and not overweight, weight that I am trying to lose?
Hi Riley,
First, I love your name. Now down to business. I am an avid weight lifter and recommend it for all women to ward off bone disease and to feel empowered and strong. My routine consists of using a weight that I can do for 4-6 reps and tire. More than that and it is too light, less than that and it is too heavy. I do three sets of each exercise and wait 1-2 minutes in between reps to give my muscles time to recover so I can properly do the rest of what I need to do.
Protein and the amounts you need. I do about 1 gm per pound. What I would recommend is that you do this but do at the weight you that is ideal for you. You say you want to lose weight, so you might want to calculate at that weight.
I am not a fan of bars and shakes as they tend to be unhealthy. I suggest hard boiled eggs, higher fiber fruits and veggies, and cheese sticks, to name a few ideas, to get you through. Most Americans are getting too much protein and once you adjust what the RDA states you will see that you will have no problem achieving your goal.
Hope this helps, Jill
I seen cram of wheat is a big no no and I was wondering if Oatmeal is off limits too.
Hi Debbie,
My patients enjoy oatmeal for breakfast and keep their urinary oxalate low by following all of the advice on this website.
Best, Jill
thank you
The list says oatmeal cereal is ok. Is oatmeal cereal the same as instant oatmeal? I’ve googled this and Quaker oatmeal is all that comes up.
Hi Brian,
My patients eat oatmeal and they all do maintain lower urinary oxalate levels.
Jill
Reading this through tears. Terrible year, hospitalized with a large stone Stu k in the ureta, followed by a stent to save the kidney (I had kidney failure). Not the first time with stones (now I recognize what that pain was throughout my life). Now feeling overwhelmed. Stones again last week, passed quickly. Kidney aching again today. Just discovered your site, which is already vastly more helpful than my urologist who said to avoid spinach and animal protein, get you calories from fruit and vegetables. That’s it! Feeling frustrated and scared. I have too much calcium in the urine, but oxcilate was ok. Asked urologist why, he said ‘it just happens’. Not helpful 🙁
Dear Janine,
It saddens me to have so many patients come to me in this state. You are right to feel overwhelmed by the lack of information you were given. Make sure to read these two articles on this site: The Kidney Stone Diet and How to be a successful kidney stone patient. They will give you the info you need, at the very least a solid starting point for your journey. Also, I have a closed group Facebook page discussing how to do the diet and it is called The Kidney Stone Prevention Diet and Course
Best, Jill
Check your parathyroid. That’s a typical scenario if you have enlarged parathyroid or parathyroid adenoma.
Hi Janine, The high urine calcium is probably idiopathic hypercalciuria and treated with low sodium high calcium diet. It is genetic. Diagnosis requires your serum calcium be normal, and that your physicians exclude other causes of high urine calcium from systemic disease. Oxalate may not be your problem, and even if it is a high calcium diet will lower oxalate a lot and make a special oxalate diet of minimal importance. Animal protein has almost no role in causing stones unless the portions are remarkably high. Here is a good place to begin reading in the site to organize yourself for prevention. Regards, Fred Coe
I am having difficulty eating enough fiber without adding oxalates. I also suffer with vulvadyonia and the oxalates cause the condition to flair up. I am also lactose intolerant. Is there a meal plan I can follow that would give me 21 grams of fiber with a needed balance of both soluble and insoluble? I have added frozen wild caught salmon but worry about the sodium content. Need some help. Also wanted to ask what type of Doctor checks for oxalates in my urine. Thanks for you assistance. Kathy H in Virginia
Hi Kathy,
Any doctor can order you a 24-hour urine collection. See that you do get one ordered. Think about taking the online kidney stone prevention course that I put on. It will help you deal with all the dietary issues including adding more fiber while keeping oxalates low. Fiber is such an important part of one’s diet and it is not discussed enough! Read the articles on “Online Course Lessens Stone Risk” on this website. Or “The Kidney Stone Prevention Course” also found on this site.
Best, Jill
Is fair life milk ok to drink for calcium? I saw the small amount of sodium so just checking on your thoughts. Thanks for replying
Hi Kathy,
Yes, Fairlife is fine to drink. I actually drink it as well. Cashews will be higher in oxalate. Stick with fortified coconut or unsweetened flax milk if you don’t want dairy.
Best, Jill
I meant to ask about sodium free cashew butter? Thanks
Most informative and amazing oxalate article – ever! Thank you, Jill, for your tireless research and succinct presentation. Over the past six years, I’ve had about 10 shockwave treatments and 3 laser-zaps sessions. At one point, ten stones in each kidney. The rudimentary information my urologist provided and the “lists” on various websites helped… a little, I guess 🙂 or maybe not! Your analysis has both layman and scientific aspects which greatly appealed to me. I walk away with a better understanding of how to modify my diet further to avoid a painful future. Thank you. –Stephen
I am a human pez dispenser and have passed so many stones I’ve lost count. I’ve had 7 surgeries to remove stones that were stuck and was told by my urologist i will most likely always form them. He also told me to have calcium with every meal (I drink skin milk) and to avoid foods high in oxalate. I’ve given up nuts (which I love), peanut butter, most of any type of potatoes and have increased the amount of water i drink, but still not as much as my urologist wants me to consume. I’ve dealt with this my whole life and am concerned if this is damaging my kidneys. What other suggestions would you give me to help cut down on the amount of new stones i form? And for all you suffering with this I feel for you!
Hi Terrie,
It is very possible for you to lessen your stone risk. Drinking more fluids is absolutely necessary to do that. Please read the article The Kidney Stone Diet on this website. It is a great beginning step. Also on this site, you can find How To Be A Successful Patient. Another great place to start!
Best, Jill
Hi Terrie, I agree with Jill and add to look at this chapter for an overall view. It is essential you find out what is causing so many stones. They can go from nuisance to menace, and you need to stop them. Regards, Fred Coe
I just read that celery juice is good for flushing out toxins and is very good for keeping stones from forming. On your list you have raw celery as very high. Please explain. Thank you.
Hi Ray,
Celery juice IS high. Not sure of the source that you read that celery juice is good from keeping stones from forming but it is NOT true.
Thanks for writing, Jill
Thank you for the response. Did some more research and your right. Be well.
Hello,
How can i find out what kind if stones I have? My family doctor said the only way is if I pass one to obtain it and bring it in for analysis. Isn’t there another way?
Thanks
Kevin
Hi Kevin, I answered this to your other post which was identical. Fred Coe
Hello,
My Urologist told me not to drink coffee as it is high in oxalate, but you stated that it is “free” from oxalate?
Hi Tisha, In epidemiological studies, coffee is not a stone risk, and oxalate levels in coffee are not high. Regards, Fred Coe
Hi Jill
Would you recommend drinking almond milk daily as I take it with a protein shake ?
Hi Jan,
I would NOT use almond milk as almonds are just so high in oxalate. Use unsweetened flax milk as a substitute.
Best, Jill
Thank you what about coconut milk ?
Hi Jan,
Coconut milk tends to be higher in added sugar and not all have calcium. Check your labels over there and tell me what you find!
Jill
Thank you
Since you say oxalate are only found in plant foods, therefore meat is okay, yet collagen, an animal derived product, is high. How is this possible?
Hi Audrey,
You are correct in writing that this makes no sense? What resource did you use that says it is?
Jill
Hydrolized collagen derived from animal hides raises oxalate levels in urine per studies published.
Hi Audrey, Hydroxyproline from collagen will indeed convert to oxalate, and I would not use it in any amount if a stone former. Regards, Fred Coe
Hi Audrey, Hydroxyproline from collagen will indeed convert to oxalate, and I would not use it in any amount if a stone former. Regards, Fred Coe
If my 24-hour urine test was done after I had been on a low-oxalate diet for some time, are the results helpful in deciding whether I need the diet?
Hi Pat,
We ask when doing your first collection that you revert back to your stone making diet so it can be seen what treatment plan is best for you.
Jill
Thanks! I had a second round of stones after being on the diet for over a year. My urologist ordered the test but did not tell me to change my diet. So I guess the results are not that helpful.
Hi Pat,
Happy to take a peek at them if you like. Email them to jharris1019@gmail.com
Best, Jill
Hi Patricia, If you are still forming stones, take a closer look at your serum and 24 hour urine data and see if perhaps some abnormalities are still untreated. Regards, Fred Coe
Jill, This is a great site thank you. With regard to animal protein intake, I weigh 170 lbs/77 kg., so if my calculations are correct, I could eat 7 grams of animal protein a day? Thanks David
Hi David,
Find what range is best for you using the equation in this article:https://kidneystones.uchicago.edu/does-too-much-protein-increase-stones-or-damage-bones/
Best, Jill