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
I am so confused. I am slowed to eat meat now or not. Can I eat eggs or not. One website says avoid neat and eggs and the other says I can eat beef and chicken and eggs.
Can you help please?
Thanks
Hi Anna, animal protein is not a stone risk, nor are eggs. Eat them in normal amounts. Here is the right way to eat for stone prevention. Regards, Fred Coe
Really great site . . . thanks for all the info and feedback!
What are your opinions on ketogenic diets for calcium oxalate stone formers? I had done a Targeted Ketogenic Diet years ago with great results, but stopped it after forming calcium oxalate stones. I knew nothing about oxalates at the time—but through the urologist and tests, I found that I was eating huge amounts daily of foods I should avoid . . . spinach, nuts (especially almonds), peanut butter, chocolate whey protein, roasted soybeans, and some others.
It’s been 10 years since that last stone . . . and I was toying with the idea of trying the keto route again since I felt great on it. If I continue to manage the oxalates and hydration knowing what I have known since that last episode, is that kind of diet ok or should it be avoided?
Hi Tom, Well, it is a bit of a gamble. If you can keep things in good order – 24 hour urines needed here! so supersaturations do not rise, OK. But risk is risk. Personally I would not advise doing again what got you into trouble once before, but maybe you can get away with it. Use your physician as a coach. Regards, Fred Coe
Do you have reference articles, guides and advice for a storn former who is trying to follow a low oxalate diet but also has to be Gluten free? Many of the low oxalate foods contain gluten. It is difficult to cross reference these different lists.
Have you this information available?
Thank you,
Gail Shorr
Hi Gail,
Actually, most low oxalate foods DO NOT contain gluten. Remember oxalate is found in plant foods which are low in gluten!
Jill
I am from a culture where herbs and – – especially – – spices are consumed frequently and in greater amounts than in the average Occidental diet. Where do spices and herbs fall in the safe/unsafe list?
I apologize for forgetting to ask this, also: we eat more black pepper than the average person in the U.S.A., both ground and whole types (peppercorns). Is white pepper better in this case?
Hi Blue,
There is research that suggests that turmeric and cinnamon are high. Pepper, as you know, is high. Please don’t use as much as perhaps you are used to. In small amounts, these spices can be used.
Hope this helps,
Jill
What about herbal teas? I’m thinking of Celestial Seasonings teas because I bought a whole bunch of those about a week before I had a stone.
Hi William,
Not every tea has been studied, but herbal teas are typically ok. Moderation. Have a cup or two a day and steep them less. Steeping time can raise oxalate levels. Black teas are the highest in oxalate.
Be Well,
Jill
In ref to teas, I like to drink Jamaica, or Hibiscus tea. I usually make a half gal at a time. I put 7 of the regular size hibiscus tea bags in pot of very hot, not boiling water. Its just under half gal amt. I let bags sit in for about 15 minutes, then remove and let liq cool off. I’ve not found any info on this particular tea as to how much oxalate. Thank You.
Hi Jan,
Seems like a lot of tea. Although these herbal teas might be on the lower side, I still would be very cautious in drinking that much. I would stick to a cup or two a day. Do you know if you need a low oxalate diet?
Jill
I make that much tea, but dilute and drink maybe 1-2 cups qday. Just like the taste of it. I had surgery last Sept 01, 17, to remove a 6-CM stone from L kidney. Have had occasional problems in past before that, but this was the worst. Fast fwd to March. Had KUB, now stones in both kidneys. Dr gave me a sheet mentioning Oxalate. Also had 24HR done. Results were: SS CaOx 8.35, Urine calcium, 107, Urine oxalate, 42, Urine citrate, 150,
SSCaP, 1.30, 24 HR PH, 6.246, SSUric acid, 0.68, Urine uric acid, 0.689. Dr didn’t explain any of the numbers. (plus more info). I know last time, maybe 6 yrs ago, was calcium. Anyway, in 2 wks, have to have lithotripsy. Have another KUB on May 01. Have been working on an Oxalate type diet, maybe next KUB will show something different. Like maybe smaller. Have 2 stones in each kidney now, no idea how large. Have had pain, enough to stop me from whatever I’m doing when working. Have tried getting back into seeing Dr, no luck yet.
Dear Jan,
Be careful with drinking tea. As long as you are drinking truly 2 cups you should be ok. Perhaps adding a spot of milk like our friends in London do will help as well to bind the extra oxalate. Good that you are diluting it with water! Your citrate level is very low and it is worth talking to your doctor about. Keep trying to get a hold of him or speak to him about it before your surgery. Change your diet to reflect the one we speak of on this website, along with any other advice your doctor has for you and best of luck with your upcoming lithotripsy!
Be well,
Jill
Thank You Jill.
I would like to know if birch leaf tea if ok.
thank you
Hi Beata,
Not really sure as we don’t have conclusive numbers on it. When that happens I say have a cup per day and do NOT steep it long.
Jill
Thank you for answering my herbal tea question. I have one about oatmeal. Is it OK? Is one better than another, like rolled, quick, long-cooking? I eat about one cup for breakfast.
Thank you.
Hi William, I think all oatmeals are fine. Regards, Fred Coe
William,
Enjoy oatmeal as part of your healthy breakfast. It is a low oxalate food-
Jill
What wuld you recommend to a vegan, with gluten issues and high cholesterol. I do keep the oxalates down to about 25mg or less a day. i dont really have calcium unless it is a bit of broccoli or a bit of cheese occasionally. I also think i have candida. I eat bananas and pears (fresh). some veges from my garden. I have plenty of water (distilled) and plenty of energy. But there isnt much to eat and i still am slow to lose a few kilos. My BMI is 22.1 Can you help at all?
Hi Linzi,
You have many different things to tend to. It would take much more than a reply here. I suggest you speak with someone who can tend to all of your concerns.
Best wishes,
Jill
I’ve had 2 kidney stones in the past so I try and avoid the high oxalate foods. I’ve been recently diagnosed with prostate cancer (risk low enough to be on active surveillance) and I am trying to make additional diet modifications, a more plant friendly, fruit and vegetable based diet. A lot of prostate friendly foods (tomatoes/sauce, berries, avocados, spinach, nuts, sweet potatoes, brown rice, etc)). are on the high oxalate list. What’s a good approach to balance the two sides?
Hi Mark,
I am sorry to hear about your diagnosis. As a cancer patient myself, I know how scary it is to hear the word cancer in regards to yourself. When you have two conflicting dietary issues, it is important to seek advice from a professional that can deal with the complexities of incorporating the information into a lifestyle that you enjoy. You can ask your physician to help you find a nutritionist that can handle both.
Take good care,
Jill
Please can you tell me if a low oxalate diet could be beneficial if you have primary hyperoxaluria type 2? Should it be under 80mg per day?
If yes, where did you obtain your food analysis data from- were each individual food analysed in lab conditions?
Many thanks
Louise
Hi Louise, In this rare form of PH low oxalate diet and use of calcium with meals to reduce oxalate absorption has a role albeit limited as oxalate production is increased. As low as 80 mg/day would be hard to attain but possibly valuable – 24 hour urine testing is needed to be sure. Calcium intake with meals that contain oxalate will reduce oxalate absorption. Our oxalate lists originated in the Harvard School of Public Health and were then curated by Professor Ross Holmes – a world authority on diet oxalate. So they started our rather good and are as up to date as we can get them. All oxalate measurements arose from peer reviewed measurements made properly in laboratory settings. Regards, Fred Coe
What calcium-rich foods can be eaten to support a low-oxalate diet by a person who is both lactose and gluten intolerant?
Hi Maureen,
Flaxmilk is good, some people use coconut milk that is fortified with calcium. There are many lactose-free versions of yogurts too. I love Fairlife milk. It is lactose-free and has a nice amount of calcium. It is particularly delicious too.
Thanks for writing,
Jill
Is quick/rolled/long-cooking oatmeal all right?
Hi William,
Yes, it is.
Enjoy,
Jill
Avocados are high in oxalate? The lack of consensus across multiple information sources on this important subject is remarkable
Hi Murray, I have asked Jill Harris to respond to this – too technical for me. Fred Coe
Hi Murray,
Avocados can easily be eaten on a low oxalate diet. You see different amounts on different lists because the growing conditions have much to do with the oxalate content. You can eat them though. Eat half at a time and pair them with a higher calcium food to absorb extra oxalate and you will be fine.
Jill
What about protein drinks(17g of protein) that I use as a quick run out of the door breakfast. It is made with soy protein and pea protein.
Hi Patricia,
Soy is high in oxalate. And do you really need that much protein? In my practice, I find that people are really overdoing it on protein and many of these drinks are filled with junk. Check the label, please. If you really need the extra protein, check out egg white protein powders. They are low in oxalate.
Best,
Jill
Hi Murray,
Avocados can easily be eaten on a low oxalate diet. You see different amounts on different lists because the growing conditions have much to do with the oxalate content. You can eat them though. Eat half at a time and pair them with a higher calcium food to absorb extra oxalate and you will be fine.
Jill
I have found flaxseed on the medium high oxalate foods list and made me wonder about the use of flaxseed milk. You recommend it as a lactose-free source of milk so I am wondering how you reach that recommendation.
Hi Gloria,
We use the Harvard list for oxalate content and it says little to none. Also, I know it is low as all my vegan patients use it as a source for calcium and they do indeed lower their oxalate.
Hope that helps,
Jill
Can you please confirm that blueberries are low in oxalate as there are many websites stating they are high in oxalate
Hi Shivani,
Harvard’s lists them as low and our patients do have them and maintain a lower urinary oxalate. BUT. This does not give you reason to eat them all day. Many patients tend to overeat the low oxalate foods and even the low ones will add up, so be conscious of this fact.
Best,
Jill
My mother has recently been put on a low oxalate diet after being diagnosed with oxalate nephropathy secondary to gastric bypass. Can you tell me the difference between kidney stones and the “crystals” that were found in her kidneys due to the oxalate nephropathy? Also, is the idea that the “more calcium, the better” idea the correct mind set for this diet? Can you off set the amount of oxalate taken in by increasing the amount of calcium taken in? Thank you in advance, this page has been very help.
Hi Pamela, Your mother has a very serious condition and low diet oxalate and high diet calcium may not be close to a sufficient answer. The crystals in her kidneys are not stones, but rather damaging the kidney tissue itself and there is danger of kidney failure and dialysis. I presume her physicians are expert in this problem – usually one needs a university medical center. If desired I can try to help find additional help for her. Let me know. This is a very serious problem. Regards, Fred Coe
After scouring the internet I found your site a few days ago. I appreciate the information that I’ve found here. I’m looking for a ‘recipe’ that I thought I saw on your site but can’t seem to find it now. It consisted on lemon juice, olive oil, and apple cider vinegar. Was that on your site?
Thank you~
Hi Rebecca,
Thanks for asking your question. No, we did not post the recipe in question on our site and would not be inclined to suggest this as it is not something that would work on current stones, nor prevent new ones.
Be well,
Jill
Hi. Great article and I am learning so much. I have a questions on avoiding high oxalate food. Is that totally taking them out from diet forever? Or could I do a rotation, e.g. take one to two meals with Med-High once a week. And rest with Low oxalate food? Thanks
Hi Stephanie, It is not so much taking these foods out of your life as it is eating a proper diet altogether for stone prevention. Here is the correct – complete – story. The kidney stone diet is identical to the ideal US diet except for moderation of diet oxalate. Please read it and see if it helps you. Regards, Fred Coe
I am really confused. it seems like one website lets you eat oranges (as an example) but next sight says no. Are there different diets for different stones/
Hi Christine, It is all about quantity; an orange has very little total oxalate; many oranges – like juice – can add a lot more. In fact low oxalate diet is just one – small – part of the proper kidney stone diet. Here is the real diet, and not at all difficult to manage. Regards, Fred Coe
I have calcium oxolate stone and uric acid stones. How do I find out abt foods with high uric acid. So I can take care of both types with my diet. Please help, my stones are out of control. Thank you
Hi Dyan, For the calcium oxalate stones, this is the correct diet. For uric acid stones there is no diet; treatment is potassium citrate to raise urine pH above 6 on a 24 hour average. Here is an article for you. So you need two treatments. Regards, Fred Coe
I have calcium oxalate stones and i learnt a lot from this website about diet. Can you please tell me which treatment should i do for excretion of stones? I am currently taking potassium citrate tablets-Urocit-K. Is it alright to treat calcium oxalate stones?
Hi Manal, Prevention is a process with evaluation and treatment. Here is my favorite article for your type – most common type – of stone former. Regards, Fred Coe
I’ve had to follow a low oxalate diet for yrs. Could you please send me an updated list so I have it first had. I have one working kidney because of calcification damage etc/surg./ca yrs ago I find today the Dr has taken me off all dairy and ?? some other foods. Please I need a print out sent to me. The Dr’s here where I moved are not that educated on these problems. My income is very limited and can’s afford to pay for books etc. Thank you L Kuhn
Hi Leonora, you can print out the diet sheets anytime you wish. But be sure that diet oxalate is really your problem. Read this. The very worst approach is low calcium diet; it is bad for bones, not very effective for stone prevention, and indeed makes for very high urine oxalate levels. The ideal diet is here – take a look. Regards, Fred Coe
I’m curious if calcium supplements would be as effective as food to get up to your recommended 1000mg daily calcium? Except for cheese and ice cream I’m not fond of most other dairy products and as you noted these are higher in sodium. I’ve kept a detailed diet diary for the last month and I’ve managed to avg 102mg/day oxalate, 1774 Cal/day and 2387mg/day sodium. I haven’t kept a detail on the calcium, but a spot check indicates 500mg for a given day is maximum.
Thank you for this website!
Hi Dave,
Good job on your tracking methods. I find that most patients really do have to track at the beginning as they have no idea how to approach the dietary changes necessary to lessen stone risk. Calcium supplements are NOT as effective as the body does absorb calcium best from food sources. Can you drink milk? Have a cup with each meal will really boost your numbers. Yogurt too helps.
Your sodium level needs to be dropped to about 1,500 mg/day. So more work must be done there. You will not be perfect, but more days than not try your best.
Hope this helps,
Jill
I understand that Tomato Sauce is bad and pizza should be avoided, but what about a White Pizza which only has cheese and seasonings but no tomato sauce? Also, I love Hummus but I’m confused, doesn’t Hummus contain Tahini, which is Very High in oxalate?
Hi Christine,
You really can eat a little bit of everything (except the foods that are super high in oxalates like spinach and almonds and a few others). Pizza can be eaten and so can hummus if you can control your portions. I worry more about the sodium in pizza than I do the oxalate. They are not putting tons of sauce on a pizza nor is the tahini is crazy amounts. Portion not perfection and you can eat way more than you think.
Be well!
Jill
I have a very high oxalate count. I only have one kidney. I also need to lose weight and would like to be able to use a protein bar. Have you found any protein bars on the market that would be okay for low oxalate. I take 6 potassium citrate pills a day.
Hi Paula,
I am so not a fan of protein bars as they typically contain too much sugar and additives. I like it best when people learn how to eat real food. Everyone thinks they do not have time in the am, but fruit and yogurt are just as easy as grabbing a bar. The bars will leave you hungry soon after eating them as the alternative will provide you with calcium, protein, and fiber (blueberries are great for fiber).
With all this being said, if you must, how about something like this:
Can’t find eggplant or butternut squash on your very helpful list. Is there any information on these vegetables?
Hi Katherine,
If you cannot find it on the list I tell my patients to eat it only here and there and within normal portion size amounts. My patients do incorporate both of these items and maintain lower urine oxalate values. But don’t forget to make sure you are getting your RDA of calcium!
Best, Jill
Thank you!
Katherine,
You’ve listed “Blueberries” as having very low oxalates. However, most other sites list “Blueberries” as being high in oxalates. I find that when it comes to certain foods nutritionist cannot agree. It drives me crazy! I’m a kidney stone sufferer and I’m trying hard to prevent another one. I love blueberries and I want to be able to eat them without fear. Your thoughts?
Carlos
Hi Carlos,
My patients eat blueberries and have maintained lowered urinary oxalate. Stop looking at all the lists and follow the one we support on this page. It along with our other advice will help lower your urinary oxalate. Too many lists will make you a bit nuts!
Jill
The doctor didn’t offer to do any of these tests beyond a basic diagnosis so I am trying to figure it out for myself. There is so much variation in dietary advice. Some say oranges will help dissolve stones; others say not to eat oranges. Some say to limit meat; others that meat is okay. How am I supposed to figure this out? thanks, Joy
Hi Joy,
Please read Dr. Coe’s articles on the kidney stone diet here on the website.
Hi Jill,
I am slightly confused as I read through this. It says oranges are high in oxalate and require caution. But orange juice is a OK? For a preventive measure I am thing about some lemon juice and water or an orange juice in the morning due to the citric acid and water for the rest of the day. Is there any issues with this?
Many thanks
Brett
Hi Brett,
It is always the concentration of the food. Oranges also include the pith so it could be higher as well. One orange is not going to make a stone. It is how much oxalate you eat each day. No more than 100mg/day is recommended along with your RDA of calcium. Whether you use orange or lemon they both contain citrus. Remember, not all people benefit from added citrus and you need to do a urine collection to see if you do indeed need to do this.
Jill
Hi–the PDF link to oxalates in foods isn’t working.
Hi, I just checked the links and did not find one broken. Perhaps you might specify the text of the link so I can look again. Regards, Fred
Couldn’t see this information on the your site> Are chickpeas high in oxalates because tahini is but hummus is ok? Has kombucha been tested for oxalates yet?
Thanks for your time
Dear Lesley,
Please eat chickpeas in small amounts (which is typically the portion size) and you will be fine. My patients do eat them within normal portions and they maintain a low oxalate urine. Must make sure you are getting enough calcium into your diet to help with oxalate absorption. I have no reliable source regarding kombucha and oxalate. Since it is made with tea I would drink it here and there and not have many bottles per day.
Hope this helps-
Jill
Hi Jill. I was wondering if ALL nuts are high in oxalate. I’ve read that almonds are high in oxalate. But what about pecans, walnuts, and cashews? Also, I see that white rice is ok. What about brown rice? Thank you kindly!
Hi Denise,
Please look at the list that we have in the article How to eat a low oxalate diet. You will find the values we have in it. All nuts should be eaten in very low quantities. Pistachios and sunflower seeds can be eaten if you use the portion size given on the list.
Jill
Thanks Jill. Noted about the nuts. I did not see this list the first time. This list is extremely helpful. How would you suggest going about finding out how much oxalate is in other specific foods consumed? For example, I’m wondering what the oxalate is in Dandelion Root Tea.
Hi Denise,
My advice is always the same when we don’t have reputable values on a food or beverage. Eat within normal portion and in this case, don’t steep too long. If it is a food item, normal portions, NORMAL portions, and only a couple of times a week. My patients have followed that advice and do fine. Also remember to get your calcium requirements.
Jill
Would drinking milk when eating prunes counteract the oxalate content? After reading studies showing 6-10 prunes per day increased bone density in post-menopausal women I added 6 prunes per day to my diet to help with osteoporosis. I had also unwisely lowered my water consumption to only about 20 oz. per day and 2 months ago suffered my 2nd kidney stone 7 years after my first. Now I have adjusted my diet, including minimum 2 liters of water per day, and would like to reintroduce the prunes. Please advise and thank you for this wonderful site.
Hi Ann,
Drinking milk or having any food containing calcium will help you absorb a high oxalate food as long as you eat the products together. Please make sure you are drinking enough fluids to produce at least 2.5 liters per day or urine! Good job on getting your water to at 2 liters!
Best,
Jill
How should I get enough calcium if I’m allergic to dairy? Would coconut yogurt work the same?
Dear Kay,
You can get it many ways. Unsweetened flax milk (Sweet Karma is a good one) that is fortified with calcium. Coconut yogurt, oj, salmon, etc. Google nondairy sources of calcium and exclude the high oxalate foods and you can manage.
Hope this helps,
Jill
Do you know the oxalate content in quinoa? Also, I love breakfast cereals, particularly shredded wheat (thought I was eating healthy) do you have any good substitutions for these. I’ll do anything to avoid another kidney stone attack. Never been in more pain in my life. Thanks.
Dear Brian,
We are not sure of the values of quinoa so my advice is always the same. Eat within normal portion size and only a couple times a week. I tell this to my patients and their urinary oxalate remains low. Make sure you follow the recommendations of the Kidney Stone Diet here on this website. Lower sodium, RDA of calcium, fluids, and a lower oxalate IF YOU NEED IT. Getting your 5 servings of fruits and veggies is a requirement as well. Not just from us but from all health officials!
Best,
Jill
I can’t take NSAIDS for joint pain and wanted to take a product containing Curcumin C3 Reduct and Boswellin and Maca are any of those high in oxalates and would it be ok to use it.
Hi Larry,
Tumeric has been cited as high in oxalates. I have no data on the other two.
Best,
Jill
I am looking into writing an app to calculate oxalate content in recipes/dishes based off the Harvard list information. Is there a way for me to contact them for permission?
Hi Heather, It is public, so far as I know. There are some errors we had to correct for this site. Regards, Fred Coe
In that case may I use the list on this site?
Hi Heather, I gather from Jill you are doing an app. The site materials have been curated and not only by me. Perhaps we should discuss this in a more private forum. Regards, Fred
Is there a non public way to give you my email or can you look it up in the comments related information? If you can look it up you have my permission to eon so and to contact me if it is needed.
Hi Heather, Of course. Here is my secretary’s phone number – she can arrange whatever you wish; Kathleen Dineen 773 702 1475. Regards, Fred Coe
Thank you.
Any idea of oxalate content on Vegan sports protein?
I specifically take Vega Chocolate protein.
1 scoop a day.
https://myvega.com/products/vega-sport-protein
Thanks!
Hi Tony,
Not sure, but if it contains chocolate it will have some. The sodium in one scoop is rather high. Perhaps find another protein drink that has less sodium and vanilla?
Be Well,
Jill
Is Ezekiel bread and brown rice high in calcium oxalates?
Hi Sil,
We don’t have numbers on them, but my patients do eat both and maintain low urinary oxalate. Please make sure you eat within normal portions and get your calcium!
Best,
Jill
Hi,
I see you list avocados as “high” in oxalates. However, from everything I have researched, I cannot find that avocados are high in oxalates, in fact on the contrary – avocados are actually low in oxalates, (0 – 5mg’s per serving). Is this an error on your part? Can you clarify please. Thanks. Cheers.
Dear Troy,
Please note that depending on where a plant was grown, soil conditions, and type of product, oxalate levels will vary. That being said, my patients all enjoy avocados as a part of a low oxalate diet. Although Harvard lists avocados as high (19 mg) they can easily remain in your diet. I do not consider them high at all. Don’t go by the adjective given to each food. Go by the numeric values to determine if you can safely eat the food. You can eat 100mg/day of oxalate. The foods you choose to get to the limit is up to you. Also, remember to get your daily amount of calcium. This is just as if not more important! Best, Jill
Sounds good Jill… thanks for your reply. Cheers.
I have been just diagnosed with a calcium oxalate kidney stone. I have been told it is very small and should be able to pass it. This is the eighth kidney stone I have had ( over a period of 20 years). I am drinking 48-80 oz of water a day trying to pass it. I would like to know if I can have any calcium in my diet now as I am trying to pass the stone?. Your article is the best I have ever read regarding stones. Thank you!
Hi Perri, I am sorry about all the stones. Yes indeed, calcium is important in your diet. Here is the kidney stone diet – it mimics the US ideal diet, as a matter of fact. Here is a good introduction to prevention. Regards, Fred Coe
Jill,
Has there been any study about hydroponically grown vegetables and whether their oxalate content is any less than soil grown? Thank you,
Barbra
Hi Barbara,
None that I can find (yet)!
Jill
I usually have porridge oats for breakfast but have recently given up dairy to avoid another health issue. What are the best alternative providers of calcium? And are the breakfast iats ok to continue with? Thanks.
Hi Roy,
You may continue the oats for breakfast. Making sure you get your 1000mg/day of calcium for men is key to lessen stone risk. If you cannot tolerate dairy, then you can have these alternatives that have been fortified: flax milk, coconut milk, non-dairy yogurts (not nut based) that have calcium too. You can also find there are veggies and salmon that have calcium too. Google non-dairy calcium sources and make sure they are low in oxalate and you will be able to get your RDA of calcium!
Be well,
Jill
I find there are conflicting reports of the oxalate content of foods. For instance, on this list, Avacados are rated as high. On other lists they are rated as low and even encouraged as the alkalinize the body.
There are other examples. Any insight in this?
Hi Chas,
You CAN eat avocados. Although they are described as “high”, one of the fruit only has 19mg/oxalate. You are allowed (unless otherwise advised by your physician) to have up to 100mg/day. Don’t forget the importance dietary calcium plays in keeping your oxalate levels low. I tell my patients to not go by the adjectives on the food list. Go by how much oxalate is in the portion size of food listed.
Hope this helps-
Jill
Hi – I am on a permanent low carb diet, and eat broccoli every day, and a fair bit of spinach too. If we eat a lot of cheese with those vegetables would that counteract the oxalate content that ultimately is in our kidneys/urine? Is there anywhere we can find i) charts that list the calcium content of various cheeses (or all foods); and ii) charts to match calcium consumption requirements to counteract oxolate related food consumption? Thx!
Hi Sandy,
Spinach is just too high to counterbalance with cheese. It really needs to be one of the very few foods I tell people to stay away from. Stay away of the highest oxalate foods and get the RDA of calcium that is right for you. Menstruating? 1,000mg/day. Postmenopause? 1,200mg/day.
Hope that helps,
Jill
People without gallbladder’s are they prone to kidney stones? Also would taking a digestive enzyme with ox bile help?
Hi Cors, Indeed yes. Some develop fat malabsorption that raises their urine oxalate. That would require 24 hour urine testing to certify and base treatment on. Regards, Fred Coe
I know that turnip roots are high in oxalate but is it okay to eat turnip greens? I haven’t been able to find anything definitive on that and I understand that mustard greens are low in oxalate so was hoping turnip greens without roots in them would be okay.
Hi Yanya,
I would assume if the roots are high the leaves will be in the higher range as well. Have this product in limited amounts and with a source of calcium when and if you do.
Thanks for writing-Jill