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.
Hello – Where can I find the updated lists mentioned below:
“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.”
Hello Peter, I guess I was not clear enough. Professor Holmes redacted the lists on this site and linked to this article, so this is the best of the lot. Fred
I am taking vitamin D every day – 1000IE/day. Will it cause kidney stone formation?
Ps: I have 9 small stones in both of my kidneys.
Thanks
Christina
Hi Christina, That dose of vitamin D should not cause stones. But since you have them you should get properly evaluated to find the cause and treat it. Here is my best effort on how to do that. Diet oxalate is rarely the most effective treatment, incidentally. Regards, Fred Coe
Hello Fredric, Thank you very much for sharing the article. I have been suffering kidney stone problem for over 20 years and had multiple surgeries. I did everything correct such as low oxalate, low protein, low sugar, high calcium diet, high intake of fluid, exercise etc.. I did 24 hours urine analysis, and other checks, all normal. But kidney stones keep coming back. I will visit States in end of April and I am wondering to visit you. I just want to know what happened to my body and what is the reason causing kidney stone. Are you able to help?
Hi Christine, I do all my consulting via telehealth, which can easily reach to Netherlands. Please let my secretary know when you want and we can arrange things – Banita Williams, 773 702 1475. Regards, Fred
Just learning and researching. Most informative. Thank you.
I have no issues, just interested.
It seems to me that many foods high in oxalates are also rich in potassium.
What foods are sources of potassium but low in oxalates?
Hi Aza, almost all fruits and veggies are high in potassium, and only the small fraction shown in the graphs in this article have serious amounts of oxalate. Stay away from those, eat lots of fruits and veggies, and check a 24 hour urine to see if urine oxalate is a problem. I bet it will not be. Regards, Fred Coe
Great info in here. Appreciate all the input. I’m trying to seriously reduce my oxalate intake overall. But I can’t find anything about if you cheat here or there, (weekends or holidays) and eat more foods that are higher in oxalate but eat much better during the week, (much lower oxalate foods) does this prevent the formation of the crystals that form stones? Another way to ask is how long does it take to form the crystallization in the kidneys where stones can start?
I’m not sure if oxalate is something that once in . .. it stays and builds OR if you drink plenty of water all the time and you “cheat” here and there, it will be washed away.
It’s just so hard to not be higher in oxalate intake at times.
Thank you
Hi Greg, oxalate from food is absorbed and that is that – only the kidneys can remove it in most cases. Good and bad days do not average out. On the other hand is oxalate your problem – just cause stones are calcium oxalate crystals does not mean food oxalate matters. So, once in and that is that but often it does not matter, depending on the particular person. Regards, Fred Coe
I have numerous calcium oxalate stones in both kidneys most are now too dense to dissolve and have four procedures in the next twelve months to clear them. I am being tested for genetic links as well as diet. Will the results make any difference to my lifestyle changes. Thanks
Hi Leslie, your 24 hour urine chemistries are the first issue. I Guess your urine oxalate is high and the testing is for primary hyperoxaluria. That makes sense as we have new treatments for that very worrisome condition. Regards, Fred Coe
Hi,
I sent a question and did see it but now it’s gone.
It was about how long does it take for the oxalate to start to build in your kidneys before they start to crystalize.
Again basically its very hard to not go higher on the oxalate mg numbers on weekends and holidays. Trying to do my best but it’s not realistic to be low all the time.
I totally get it if I were to get 500 to 600 mgs of oxalate every single day . . . that would not be good at all due to the average is always high. But if I go off the rails on vacations or holidays or weekends BUT keep drinking plenty of water and “most” of the time, I am doing well with keeping it at or around 100 mgs, does that seem to be doable OR is the oxalate a build up once in stays in type of thing?
How easy does the water drinking flush it?
Sorry, I’m not being overly clear but not sure how else to ask.
Appreciate any help.
Thanks
Hi Greg, I answered but have been slow – sorry. Lots of water dilutes crystal forming materials and is always a good idea for stone prevention. As for crystals, they nucleate at an atomic level, and can do this very rapidly but most pass out into the final urine. Even so, when many form, some will lodge by chance and can grow into stones. Crystals are like any other event – there is risk (high 24 hour urine oxalate losses, or sudden oxalate surges – and crystals or not or a lot. Consider where you park your car. Bad neighborhood, high risk, but the car is stolen or not. Every risk event is independent. Holidays are a hazard if oxalate is your problem and you use a lot of it then. Regards, Fred
Thank you for taking the time. Much appreciated!
Hi I am watching oxalate intake because I get migraines and strangely low oxalate diet helps me manage migraines so I do not have kidney issues. Anyway just diagnosed with high cholesterol and so attempting to get those numbers down I need some non animal protein ideas since beans and lentils seem to be an oxalate issue. Any suggestions? Thanks
Hi Joy,
You can def eat beans and lentils, just within portion size. People tend to overeat these foods along with not getting their calcium needs met and that is the reason for the higher oxalate levels in their urine. Eat beans and lentils within portion size and get your nondairy or dairy calcium while consuming those foods. Should be just fine, but a urine collection will def tell you. I have many vegans that continue to eat beans and lentils, they just consume with calcium foods or liquids and don’t overeat beans and lentils and their oxalate levels remain normal.
jill
Is hummus low oxalate? Also what is the best way to rid the body of oxalates that the body already has stored? I’ve been drinking a mixture of baking soda and lemon juice periodically through out the day…
Dear Bridget, the kidneys remove oxalate with dazzling precision so that blood levels are very low – so low it is hard indeed to measure. Alkali do not improve renal oxalate removal, nor will lemon juice – that I know of. Regards, Fred Coe
Very informative. Although I don’t think that I have problems with kidney stones, I do have major problems with histamines. Oxalates are “brilliant” histamine producers. Over the years, I have learned to stay away from them. I am on a very reduced diet because there are histamines in so many foods. Other things that increase histamines are folate (B9), caffeine and anything fermented. Do you know anything about it? I’m always interested in new information.
Hi Bridget, Alas I know nothing about histamine and oxalate. Sorry, Regards, Fred
Hi. I just had my first kidney stone and was fortunate to catch it before it began to pass. It was 9mm so I had Lithotripsy to break it apart. Post surgery, I had one day of discomfort, nausea, and bloating pain, but nothing close to giving birth/ER pain. Over the course of the month post surgery, I’ve passed about 8 decent sized fragments without pain or discomfort.
I have a question r/two of my current diet intakes. I take a multivitamin each morning (Nature’s Way Alive Ultra Potency Men’s 50+) which has Vitamin C 203 mg (226% daily), Vitamin D3 50 mg (250%) and Calcium 130mg (10%) among many other vitamins/minerals? I don’t eat a lot of vegetables, so I use this to supplement my vitamin intake. I also drink a protein shake each morning which is from Pea Protein – and I’m staying with vanilla and avoiding the chocolate flavors. Are either or both of these concerns? I feel like my stone formation likely was driven from years of being an avid runner with poor hydration habits. Thanks in advance.
Hi Brian, Did you have the stone analyzed?? If not, do. There is no sense guessing at the cause and prevention, just do the blood and 24 hour measurements you need and treat what is wrong. The shake is most likely a problem, but why guess? Be cause and do the testing before you begin changing things – so you can figure out what happened. Regards, Fred Coe
I have heard that hydroxy citrate or hydroxy citric acid could potentially benefit people with kidney stones. What is your opinion of this and would taking a low dose supplement of this be beneficial?
Hi Chris, Experiments suggest a value, no clinical trial, for a food additive with no apparent safety issues. So what can I say? No evidence of effect, no obvious evidence of harm. The link to a popular advice site points out it may lower blood glucose or prolong clotting. So my opinion is undecided. Regards, Fred Coe
Any further suggestions for a stone former who is gluten and diary free? Many of my substitutions involve almonds (almond milk, almond flour), and the only calcium I get is through a supplement. Finding alternatives to the almonds is proving challenging.
Hi Carolyn,
Many non dairy “milks” can be used to get calcium needs met. Here is an article that discusses just this:https://kidneystonediet.com/oxalate-content-of-plant-based-milk/
Jill
Hi Carolyn, Before undertaking more diet restrictions be sure you need to. Take a look here. Large numbers of stone formers do not need to worry overly about diet oxalate. If you do, Jill Harris is a useful online guide. Regards, Fred Coe
You suggest dried cranberries as a lower oxalate fruit, yet many articles and lists say cranberries are high in oxalate and cranberry juice as being high oxalate. Is there some magic in drying a cranberry? Any ideas about this discrepancy?
Thank you.
Hi Herb,
Most foods can be eaten if one eats in a normal portion size and gets their daily calcium needs met. My patients enjoy dried cranberries in oatmeal here and there, and continue to lower oxalate. Go to my website for more free resources on oxalate: kidneystonediet.com/start
Does potassium citrate help reduce some formation or alkali drinks from Moonstone?
Hi Stam, Alkaline salts have a role, but that role depends on what is causing stones. Take a look here and see if you have been fully evaluated and what was found. Some people have low urine citrate and will benefit from potassium citrate or its OTC equivalents – like moon stone. Many do not. Regards, Fred Coe
I had some questions about potatoes. An oxalate amount is listed for a potato *with skin*. I’ve read elsewhere that most of the oxalates are in the skin. Is that true? Is an oxalate amount known for a potato without skin? I’d also read boiling potatoes and microwaving them helped reduce oxalates. Is that accurate? Thank you!
Hi Amy,
You can certainly still eat potatoes and don’t have to boil the heck out of them. The reason people get high oxalate is more about not getting their daily calcium needs met once they stop eating spinach and almonds all the time. Taking away spinach and almonds and eating all other foods within portion size and getting daily calcium needs met is truly what most people need to lower urine oxalate. Go here for many free resources: kidneystonediet.com/start
Jill
Hi Amy, The bulk of a potato is starch, so the skin is a main source of oxalate. But be sure oxalate matters to you – it is very overhyped for stone formers. Here is a good review to check. Is your urine oxalate high? Are there other abnormalities in the 24 hour urine that are causing your stones? Regards, Fred Coe
Could you please send me a printable copy of the article? I had gastric bypass 10 years ago and am having problems with my kidneys. The surgeon and internist each sent me a 1 page sheet with very little foods listed and options.
Thank you for any help you can give me.
Hi Cherol,
For complete printable list go to kidneystonediet.com/start
jill
Very informative article, thank you for your knowledge.
Hello Jill,
I don’t see any mention of parsley on your list but I’ve seen elsewhere that it’s very high in oxalates. I have some recipes that call for a cup of fresh chopped parsley for a serving of four. Is this something to stay away from?
Hi Bill,
Use it. I do. Although parsley was not studied by Harvard, I have all my patients continue using herbs. Great flavor when going low sodium and also, it is all about portion. No one gets a stone while using parsley in a serving of food.
j
Thank you Jill! How about black pepper? I read where white pepper is actually lower in oxalates and preferred.
Hi Bill.
White pepper can be used, but not needed. This is a portion game, black pepper didn’t cause the stone, it was all the other high oxalate foods one was over eating and the sodium, sugar, and fluids. Along with not getting your calcium needs met.
j
Why is white rice low oxalate, but rice flour high oxalate?
Hi Nathan,
The concentration usually matters and whether the rice flour has any brown rice in it.
j
What about chia seeds? I did not see them listed but think they are high in oxalate. I usually add a spoonful to yogurt. Should I be avoiding them or are they ok paired with the yogurt?
Hi Susan,
Havard didn’t study them but all other sources say they are high. I would switch to flax or ground flax for your yogurt.
j
Flax gives me stomach aches — I guess this is not uncommon. Just to be aware of this! I’ve heard others say same. It was interesting when I took flax because I am not prone to them.
How about tumeric? Is is high with oxalates?
Hi Rick, Turmeric indeed contains oxalate and can raise urine oxalate. Regards, Fred Coe
I’m very disappointed that swisschard is not on either list but especially the high oxalate foods. And it’s not 177: Potato chips are listed twice as is all-purpose flour, french toast, white rice flour, fudge sauce, wheat flour, candies with nuts, chocolate syrup and miso, french fries, brown rice flour, corn grits,–all listed twice! It makes me wonder how carefully this list was put together.
Hi Pat, Curiously enough, so am I. As the article notes, this material was curated by outside experts and certainly me, and I think chard should be featured. I will look into its omission. I also found the duplicates and removed them. Regards, Fred
The oxalate list does not include Almond Milk and a few types of Beans such as Black, Great Northern, Pinto, Red and Light Red. Where do these items reside on the oxalate list?
Hi Todd, Food oxalate data are as available. The Harvard list has what was available. IN general almond milk must have considerable oxalate. The other beans, if not on the list were not measured or the quality was not considered high enough for inclusion. Government does not mandate food oxalate, NIH rarely funds doing the measurements. Regards, Fred Coe
First of all, thank you so so much for your help navigating us through the Oxalates. Your site is extremely helpful. Quick question: what’s the verdict on grapefruit juice? I’m seeing a lot of conflicting research on line. Thank you!
Hi William, Grapefruit juice does not have enough oxalate to matter if you use a glass a day. Fred
Quick question: Cornmeal, grits, polenta…etc.; the oxalate levels are based on 1-cup portions. I’m assuming you mean cooked? This would seem like an awfully high level just for a cup, no?
I’m starting to bargain with myself again….I’m craving dried corn and tortilla products lately.
Hi Jason, yes. Be careful about making your life too difficult. Here is an article about diet oxalate, check if it you who has to go to the ultimate outer edge. Jill Harris has wonderful resources about diet, check her out. Maybe life can be easier and more fun. Best, Fred Coe
Hi Jill,
Is there a relationship between kidney stones and diverticulitis? I had both suddenly last Aug. and have been on a low acidic forming diet and now want to add the calcium and avoid high oxalate items.
Hi Colleen,
If the diverticulitis causes bowel malabsorption issues it could def heighten your stone risk.
j
Could you please tell us your sources for oxalate numbers on tofu? Many sites reference a 2001 paper from Massey et al that shows tofu having 43 to 235 mg per serving, depending on the type. But a follow-up 2005 paper on which Massey was an author found that eighteen of nineteen brands had less than 10 mg oxalate per serving, and many brands had less than 5 mg. But the follow-up paper didn’t mention why the numbers were so different from the earlier 2001 paper, and I’m confused. You can view the 2005 paper here: https://core.ac.uk/reader/38935472?utm_source=linkout
Hi Steve,
Watch my YouTube channel for answers to your questions. Here is a video that will talk about why oxalate discussions vary from source to source.https://youtu.be/RfMnRhiiKx4
Jill
“Soy milk, for those of you who prefer it, is not a good option. ”
Well, it’s not that I “prefer” it. I have a dairy allergy.
Do you have any suggestions for people who have dairy allergies to get their calcium? Finding adequate calcium sources that are low in oxalates with this restriction has proved to be very difficult.
Hi Barry,
Go to kidneystonediet.com/blog for latest articles on non dairy calcium sources.
Jill
Could you please say more about the oxalate content of tofu? Your list puts it at 10g per serving, but many other lists give much higher numbers like 235g. There’s a 2001 paper from Linda K. Massey et al that documents the 235g number. There’s also a 2005 paper from Ismail A Al-Wahsh et al, in which Massey was also one of the authors, which found dramatically lower numbers for tofu, mostly in the 2g to 10g range depending on the brand. But there was no explanation for why the numbers were like 1/100th of the numbers from the 2001 study, so I’m not sure what to think.
How do you combine diets for:
Type 2 Diabetes
Low sodium
Low carbs
Oxylate
Low protein
I want to get help figuring this out. I feel overwhelmed!
Hi Sandi, Here is our main article on the kidney stone diet. Here is some of the science behind it. I think this may help sort out the problem of what to do. Regards, Fred Coe
Hello, I see on the oxalate list there are several mentions of oat bran, some noted as being high oxalate and others as low oxalate. I’m wondering about Bob’s Red Mill brand which is just oat bran, nothing more, mixed with water or milk for cereal. Would this be considered a low oxalate meal option? Thanks.
Hi Bill,
I eat the Bob Red Mill High Fiber oat bran cereal. It is low in oxalate and super good. You can have it.
Jill
As a vegetarian who is usually trying to lose weight (and thus avoid full-fat dairy products), I find very few ways forward after reading this well-supported article. What am I supposed to eat if I need to stay away from soy, many beans, many whole grains, many nuts, many vegetables and fruits? It seems like the main staples of my diet are all listed here. Help!
Hi Christine,
You can eat plenty. It is just the amount of these higher oxalate foods that people were eating along with no calcium sources that got them into trouble. Also the other elements of the kidney stone diet are just as if not more important than the oxalate part. Go to my website or YouTube channel to learn more. Lots of free practical resources. kidneystonediet.com/start
Many of you think that you can not have any of the foods you listed above. You certainly can. You just need to eat all foods within portion size. Nobody gets a stone when that happens. It is when we eat the same highest oxalate foods in any portion we want, day in and day out, without meeting our calcium needs. And there are plenty of non dairy calcium sources. My website will list tons!
Best, Jill
I’m confused about some of the diet items. If tuna and mayo are both zero oxylate, how does tuna salad rate moderate? Or hummus be low if tahinni is high? And some lists say meat protein is bad, and yet if all beans appear to be bad how do i get protein? And these are discrepencies from university hospitals. I’m struggling with finding a sane path
Any advice for a Parkinson’s patient who recently had oxalate crystals in her urine? No discernible stones at the moment, but trying to adapt to a low oxalate diet. Protein during the day is a problem as it blocks the effectiveness of levodopa medication and dairy products are generally discouraged for PD so getting the calcium up is a concern. Also, high calcium intake is also discouraged.
Hi Julie, I suppose the most prudent possible advice is to measure 24 hour urine stone risk factors and see if you have abnormal levels of calcium or oxalate. Another prudent measure is a stone protocol CT (almost all CT scanners are now ultra low radiation dose) and be sure no stone are present. Regards, Fred Coe
Hello,
On the oxalate content list coffee is noted as having “little or none”while decaf coffee is noted as being “low”. Is there really any oxalate difference between reg and decaf coffee?
Hi Bill, Low and little or none are the same, and coffee is not a stone risk. Fred
Is there a vegetarian friendly low oxalate diet plan?
Hi Bill,
Of course. Many of my patients were overeating the highest oxalate foods without getting enough calcium. Go read many of the articles and free resources I have on a veggie safe, low oxalate, lifestyle. kidneystonediet.com/start
Jill
Hello,
I’m wondering if there are any citrus fruits safe to eat on a low oxalate diet? Oranges are rated “very high”, and tangerines as “high”. What about mandarins? They are quite small, is it safe to eat 2 a day in order to have a serving of citrus fruit? Thanks for answering these questions, it’s much appreciated.
Cheers,
Hi Bill,
You can eat all citrus on the kidney stone diet. Remember, even though something says “high” you still get 100 mg/day unless your doc has told you otherwise. Go to my kidneystonediet.com website to learn HOW to use the oxalate list. My days are spent bringing healthy foods back on my patient’s plates. Go to the start page on my website to learn about all the foods you can bring back: kidneystonediet.com/start
Best, Jill
I’ve read that lemon or lime in water helps with kidney stones, so is it the sugar in lemonade thae makes it high in Oxalates? I also have read that citrus was excellent at helping to break down existing stones, is this not true?
Hi Mark,
The only stone that can be broken up is uric acid stone. No other will can be.The kidney stone diet is so much more than oxalates. Lemonade is not high in oxalate (I know it has a value of 15 and that is due to the pulp or rind that may be in the concentrate). Knowing HOW to use the Harvard list is very important. I find my patients limit themselves to much in regards to oxalate when they needn’t. Go to my website to learn how to use the Harvard list: kidneystonediet.com/start
You will find it very helpful:
jill
Hi, Just found your site, very helpful. Thank you. I did not see pumpkin (canned) or almond milk?
Hi Lisa.
There was no research prior on almond milk. We have it now. Go to this link from my website:https://kidneystonediet.com/oxalate-content-of-plant-based-milk/
Pumpkin is part of the squash family. My patients eat it and get their calcium each day. Their oxalate remains low.
Jill
Hi.
Thanks for this comprehensive and informative article.
I noticed that tahini is listed as high, however it is also high in calcium. Would the high calcium cancel out the effects of the oxalate?
Best regards,
David
Hi David.
Get your calcium from other sources. Let’s just say all the calcium in spinach didn’t cancel out the oxalate. Watch this from my YouTube channel that talks about the calcium/oxalate ratio:https://youtu.be/hMFYYEs_ggQ
jill
I believe the comment was on tahini.
Hi Ann,
Tahini is thought to be higher in oxalate. Doesn’t mean you can’t have it here and there though! Portion not perfection is the name of this game. Getting your daily calcium needs met just as if not more important!
Jill
Thanks all of the list are great, but obviously not complete. I appreciate the simplicity of avoiding the heavy hitters and seeking an appropriate amount of calcium. Thank you for all of the information!
Very informative article. Time to try these great recipes from your site https://kidneystonediet.com/recipes/ Thanks
I don’t understand why you chose spinach for the main picture here when it is uniformly identified as one of the WORST foods for oxalate. It made me immediately doubt what’s happening here.
Hi Marlene,
We chose spinach bc it is the one food that best represents oxalate in general and one every stone former relates to. If you look through the site you will be able to see that it is quite reputable. I am very sorry the image portrayed in this article led you to doubt our intentions.
jill
Please send updates
Hi Leona, I am not sure what you are asking for. The entire list is linked to the article. Regards, Fred Coe
Thank u for this very helpful info. Sometimes we think we r eating healthy. But we r not. What’s healthy for 1 person may be detrimental to another person’s health. In the last three years I have had lithotripsy with stent placement three times. The left was 3 years ago. The right 6 mths ago n both kidneys last Friday. It’s really scaring me. I plan on following this diet completely. They r calcium stones n get super big n cause hydronephrosis. I m 76 yrs old, but it’s never too late to start getting a little healthier! Thank u!!😊
Hi Rosalie, You must not assume stones are from diet, especially as we grow older. Here is an article about stones in middle age. Here is how to get properly evaluated as to cause of stones.The surest road to failure is some kind of random diet change, especially worrying about oxalate. Regards, Fred Coe
Hello Jill and Fred,
Are there any low oxalate hot tea options?
Thanks,
Hi Bill,
Any tea can be had if you have it in a normal cup or two per day. Get your calcium needs met each day.
Jill
Aloha Jill,
I haven’t seen too much data on Açai. Look like youy take on the Oxalate Count. Mahalo Mike
Michael,
When a product doesn’t appear on the list we say to eat it in normal portion size and get your RDA of calcium.
j
Would like to follow for list of oxalates
Hi Claudette,
Go to my website at kidneystonediet.com/start for your oxalate list.
Jill
Hi,
Not sure about Chokeberry/Aronia juice oxalate level? .. some says this berries contains too much oxalate, but not juice? .. what’s the difference?
Hi fango,
Juice will be less concentrated than the whole fruit.
Jill
do you know if einkorn is low in oxylate, i cannot find any info anywhere? !!
Hi Bill, Lots on the web. Here is a bread maker using flour from einkorn who reports just under 5 mg of oxalate in a slice. He credits this site for his oxalate information. Here is a fine science article about ancient wheats (of which einkorn is among the elders). So bread from einkorn is not unsafe. Regards, Fred Coe
I read this article. What do people who have lactose intolerance do? I have lactose and gluten intolerance as well as hypothyroid. I cannot consume dairy and gluten-containing grains.
I do drink plenty of water and eat fruits and vegetables. I eat apples, bananas, and blueberries and some citrus as well as lettuce (no spinach or kale due to being goitrogenic), carrots, and other vegetables. I do eat cucumbers. I do not eat many grains, only gluten-free on occasion. I do eat fish, but I do not eat much meat. I do like my nuts and seeds, so this is a problem. They are my main source of protein and heart-friendly fats. I do eat legumes. I eat just a little dark chocolate. It is high in anti-oxidants.
Most forms of the ‘good for kidney’ foods listed here are NOT optimal for hypothyroid. Taking calcium carbonate is definitely a NO NO for me. I am aware of algae-based calcium supplements. I do like Nori seaweed.
What are your suggestions for those of us with lactose and gluten intolerance?
I would appreciate your time. Have a good day.
Hi Gina, To me the first issue is what do you need. Do you form calcium oxalate stones? Is your urine oxalate high enough to pose a clear risk of such stones. Do you avoid chicken and other meats because of heart concerns thus forcing yourself to find calories in veggies? If so, is there a sound reason for you – as an individual – to do this. Hypothyroidism is easily corrected with thyroid hormone, so is that not possible for you? Put another way, to what extent and why do you need to avoid oxalate? Regards, Fred Coe