Who doesn’t love dessert? I, for one, thoroughly enjoy cookies, cake, and ice cream, but I keep it for here and there and not everywhere.
I know that many of you love it, too, because you tell me everyday that this is the hardest thing for you to avoid. But I am here to tell you that it is possible to lessen your sugar and still want to wake up in the morning. Really.
I work with many clients who have a very tough time lessening their sugar intake. It is hard at first, but it gets better over time.
It’s Important To Reduce Sugar
Another recent article makes the case. Added, or refined sugar (sucrose) can raise your risk of kidney stones. It is also bad for your health.
Just one sugared drink raises your urine calcium within 30 minutes and keeps it up for at least 2 hours more. At the same time, it lowers your urine volume. If you have hypercalciuria – a majority of stone formers have it – the effect is larger because you start higher, and your urine volume will fall more. So with every sugary treat, risk of making stones increases for hours.
The drinks have no calcium in them, so where do you think the extra urine calcium comes from? It has to be from your bones. So sugar is bad for bone health, too.
I know we all see kidney stones as major, but think about diabetes and cardiovascular diseases – real killers. Also, obesity that is not just from calories, but of a special and very bad kind.
The fructose in added sugars is like a poison. It causes diabetes by making people resistant to their own insulin. It forces the liver to make lipids – triglycerides – that are a serious health threat. Fat from fructose does not accumulate around the hips but in the abdomen where it causes all these problems. So sugar is not just calories – it is a specific bad thing. Bad for your health in general.
Fruit has fructose; how can I say fruit is bad?
It is all the amount.
“Only The Dose Makes The Poison”
Paracelsus (1493 – 1541) was a physician, philosopher, professor, and chemist in the 15th – 16th century who is credited for the above adage. He was commenting on the basic principle of toxicology. In other words, too much of anything can be a problem, and portion is always key in staying healthy.
Make the Commitment
Commitment is key. You must make a conscious decision that lessening your sugar intake is something you want to do because you want to be a healthier person. You want to lessen your risk for kidney stones, heart disease, diabetes, and obesity.
Here is a staggering fact:
“Between 1980 and 2013, the proportion of overweight and obese adults rose from 28.8 to 36.9 % worldwide, with similar trends appearing in children and adolescents. The accompanying costs of health consequences and absenteeism associated with excess weight, estimated to range from 3.38 to 6.38 billion annually in the USA alone, make obesity a pressing public health problem”.
Sugar intake paralleled that increase in obesity. Here is one of many scientific studies. In Minnesota, from 1980 through 2009 sugar intake rose in men and women (black and white bars), plateauing in 2000-2002 and perhaps finally falling a bit. BMI in both sexes rose with sugar consumption. I could show many examples of this in the US and elsewhere. If you want deeper commentary, the CDC offers this about 2005 – 2010.
That is amazing to me. By simply choosing better foods we could lessen our obesity rate. We could lessen the odds of us becoming chronically ill and our children, too. Just sit with that for a minute.
The sugar problem is so severe the US recommendations have changed for all of the American people. They want added sugar reduced to less than 10% of total discretionary calories. For a woman that is 120 calories from added sugar, or 30 gm/day. The American Heart Association is even lower. They want around 25 gm/day for women. For men the number is around 36 gm/day.
Educate to Motivate
What to do? You educate yourself, like you are doing on this website. How much sugar are you eating a day? Remember, for a woman we want no more than 25 gm/day and for a man 36 gm/day. These are the goals for added sugar.
Most of you don’t even realize how much you are eating, but I will tell you that it is more than likely that you are eating too much. Everyone is too busy watching calories and fat. I would rather people focus on salt and sugar because if you do that you will be naturally cutting out all the junk foods and lose weight from these two things alone.
Look at what we are doing as Americans today compared to so many years ago.
I really like this graphic as it depicts nicely our sugar consumption epidemic. The article is very daring because they make it look like a Coke bottle.
In 1822 Americans consumed 45 gm of added sugar every five days – one soft drink. That comes to 9 grams of sugar a day.
In 2012, we consumed 765 gm of sugar in the same five days – 17 sugared soft drinks. That comes to 153 gm/day! Can you grasp that?
We should consume – a woman for example – less than 150 gm in five days or 25 gm/day. These amounts are shocking, are they not? We really eat too much sugar.
The Many Faces of Sugar
Sugar is has many different names and can be disguised in the ingredient list on the nutrition label.
Here is a sample list of the names added sugar may be called according to the U.S. Dept. of Health and Human Services:
Dextrose, brown sugar, cane crystals, cane sugar, corn sweetener, corn syrup, corn syrup solids, crystal dextrose, evaporated cane juice, fructose sweetener, fruit juice.
The New Label
All this confuses people, and, finally, big government has faced off with Big Sugar. The new labels that phase in during 2018 make an end to confusion.
The old label is at the left. Total carbohydrate is in grams – 37 in this case. But where is sugar? Only 1 gram. Where did the sugar go?
Here is where it went. Sugar is a carbohydrate. So is pasta that has glucose as its sugar – the one that causes only fat to accumulate on your hips not in your liver. But refined sugar seems to be absent here – very healthy.
The same food, the new label on the right. Total carbohydrate – the same, 37 grams. But sugar is back – 12 grams of it. Not only that, 10 grams are added sugar, and labeled that way. That 10 grams is 20% of what you should eat all day if you eat 2,000 calories a day. The added sugar is sucrose, the one with fructose in it. The one that causes diabetes and heart disease.
But remember a woman eats 1400 calories or so, so her sugar is much less – 25 gm added sugar a day. This 10 gm is nearly half of her day’s intake.
Serving Size and Calories
There is a lot more, too. The serving size is bolded and large so you do not have to guess, and it is harder for you to keep spooning out more into your bowl. The calories are very large, so you can tell what you are eating, and no longer need your readers.
Fats and Fiber
DId you notice about fats? The 8 grams are now 10% not 12% of your calories – same calories. The fat – heart disease link was fostered by Big Sugar to cast blame elsewhere. Ansel Keys, a famous scientist, did much to advance the low fat diet. But he was wrong, and the whole idea overblown. Links to news reports and science about the Big Lie are in another article.
FIber is the stuff that fruits and veggies give us. The amounts we need are increased so the 4 gram on the left goes from 16% of a day’s needs to only 14%. A prompt to eat more of it.
Special for Stone Formers
We love it so much, here is a pretty vision highlighting all the new treats just for us.
Vitamin D and Calcium
Vitamin D has been added in place of vitamin A. That is useful for us, because we want enough and not too much.
Calcium content is now given in mg so we can eat the amount needed for each person – 1000 to 1200 mg/day. The old label was not clear.
Potassium is easier to find. This is a big deal for stone formers. But it also matters for everyone.
We said this already elsewhere, but here it is again. Potassium lowers blood pressure. Potassium salts that convert to alkali – like potassium citrate – are not only good for stones but also for bones. So government interests are mainly about the big diseases – stroke and heart disease from high blood pressure, and osteoporosis.
Stone formers specially need high urine citrate levels and to get them use pills with potassium citrate in them. But one does not need citrate in the pills. Does that sound silly? No. It is not.
The liver turns citrate into bicarbonate, and the bicarbonate signals the kidneys to release citrate into the urine. The citrate in the urine binds calcium – old story for anyone who reads this site.
But the liver can make bicarbonate out of many other molecules from fruits and veggies like malate, for example. The potassium in fruits and veggies almost all comes with these kinds of molecules. So if you eat what the government recommends – high intakes of fruits and veggies – you may never need the pills in the first place. A long article about potassium citrate and its costs already made this clear. The articles on the kidney stone diet are filled with information about potassium from these foods. The new label will let you keep track.
What about Oxalate?
Oh, what about oxalate?
If you do what we say and eat your calcium – you have a skeleton to protect – the calcium so reduces oxalate intake that common fruits and veggies are quite safe. The main high oxalate foods are a problem but no one needs to eat a lot of them. There are so many other choices. Give up all the silliness about squeezing lemons, and drinking lemon juice. Just eat a proper amount of fruits and veggies as a part of your diet.
While We’re Waiting, Look at Labels We Have Now
As illustrations, we use what we most love. You can think about your own desires and find the labels for them.
Ben and Jerry’s ice cream contains 26 gm of sugar in 1/2 cup, and I have never eaten less than 1.5 – 2 cups for dessert.
You know sugar has been added (3 different times) by looking at the ingredient list. For example, sugar is the third item, meaning more important, and also the fifth and later as cane sugar. So of the 20 gm, much is added. I have nothing against Ben or Jerry, many ice creams are high in sugar, I picked it as Dr. Coe loves it, and I too when around him, have it on occasion.
Your Everyday Foods Might Be A Problem
I know sometimes when you read my articles you must be thinking, “she sure knows how to ruin my fun”. I understand that uncovering the truth about what you might be eating is a bummer at times, but so is being sick. Being sick is so much worse than being mindful of the foods we are eating. So let’s take a look at some very common foods you are eating that could be really high in sugar.
Yoplait Original has 27 grams of sugar—more than five teaspoons! And at 170 calories, 108 of which come from sugar, it is hardly a health food. When you look for yogurt, always check the label and pick the one with lowest sugar.
By contrast, Fage yogurt – same quantity – has 190 calories but only 8 grams of sugar, none of which is added. You may not love it, but it is the better choice. You could add fresh fruit to get the sweetness factor back if you like. Some of you will be daring enough to just rough it and do without. I for one, need the bit of sweetness and it is also a good way to get some fiber into my diet.
Blueberries, even a few raspberries, can be added here because the calcium in the yoghurt will soak up the extra oxalate they contain. And we all need our calcium as it is an important part of your kidney stone prevention plan and good bone health.
Meaning no special criticism of any one brand, here is an example of a healthy looking cereal. If you were picking this cereal based
upon what the front of the box shows you, you would think you were choosing wisely. If you take a closer look and read the nutrition label, you will see that health is not the prime virtue.
Look first at sodium – 180 mg for one cup. Who actually eats a cup of cereal? A whole day’s ideal sodium intake is 1500 mg.
Now, sugar. See the 17 grams in the one cup?
Sugar is listed three times in the ingredient list: Sugar, corn syrup filled with fructose, and brown sugar (and its syrup) all are added. This is a sugar festival in only one cup. If you eat two cups you are already past the daily allowance!
Sugar is used in this product to help preserve shelf life. This can contains over two servings, but how many of you will fail to eat all it as one serving – the whole can?
Look at the nutrition label. If you eat the whole can, which most of us do, than you will be getting 30 grams of ADDED sugar! Would you ever think that? That is over your whole daily limit if you are a woman. Many canned soups will have high fructose corn syrup added. Please read labels and pick another with less added sugar. They are also high in sodium, as I have said many times before, so look for low sodium ones too. The 450 mg of sodium is almost 1/3 of a whole day’s intake with one serving, and almost the whole 1500 mg (1,125 mg) if you eat the whole can.
Many of my patients use this as a go to snack when on the run. They choose it because they assume it is healthy. Please read the label as many of them are NOT healthy at all and it is a very easy way to accumulate your added sugar for the day.
Make sure they do not have added sugar in the ingredient list. Also remember that since the water is taken out of the fruit the sugar content is higher per serving than if you were to eat whole fruit.
All of what follows about fructose content comes from the USDA database. You can look things up, too.
Even the best fruit snacks are not a good idea. For example Kind Fruit Bites Cherry Apple has no added sugar but 11 gm of ‘natural ‘ sugar from the fruit. All of that will be fructose. We have already figured out that a woman can have less than 25 gm of added sugar (36 for a man) which is 1/2 fructose. So that means 12.5 and 17 gm of fructose are the whole day’s allowance. A pouch of these bites has 11 gm of fructose in just that one snack. That is just too high for one snack. You could have a lot of apples for that much fructose and you get the fiber.
Healthy, right? One cup of raisins contains 49 gm of fructose. There is a reason you love them on your oatmeal. That is the fructose in 100 gm of table sugar – 20 tsp filled with it. Remember table sugar is 1/2 fructose, 1/2 glucose and it is the fructose that causes disease.
A great ‘natural’ sweetener, right? A cup of dates, chopped, is 29 gm of fructose.
One cup of dried apricot halves contains 16 gm of fructose.
Dried cranberries contain 11 gm but in 1/4 cup, so a cup would contain 44gm. Remember they are always sweetened. How else could you eat them?
All of these are bathed in syrup and syrup is made of sugar in water. The sugar is all added and mostly dextrose – 1/2 fructose. So these are bad choices altogether.
This is an easy win.
Bananas are relatively high, so one cup of mashed banana – about one whole one – has 11 gm of fructose. Whole pears range from 8 to 10 gm of fructose each. An apple or a cup of blueberries is about 5-7 gm of fructose depending on the variety. Strawberries are even lower at 4 gm per cup. And watermelon, honeydew melon, plums are about 4 – 5 gm per cup.
In other words, the fresh fruits have fructose in them but they have a lot of fruit, bulk, water, fiber. No one eats that much of any one of these on a regular basis to worry about fructose or, frankly, anything else at all. There is the oxalate problem, and you have your lists. But if you are eating the proper amounts of calcium, and portions are in the cup range, it is not a major issue.
The Afternoon Meal, Luis Egidio Melendez Spain, ca. 1772 belongs to the Met.
Dressings and condiments
Notice the sugar levels in each portion size. Fat free dressings are notorious for having more sugar added to make up for lack of flavor in fat free versions. Also, there is much sodium in these products too. The best thing is to watch your portion size. I am not saying you cannot have ketchup on your burger, but do you need as much as you are using? Cut down on the condiment and dressing portions and you will lessen your added sugars and sodium.
Many are high in sugar and again, remember the portion size. More of it, more sugar in it. When dining out you can always ask for your sauces on the side this way you can control the portion size. Also, why not skip the sauce altogether and have your chicken grilled and sautéed in olive oil instead?
This product makes me want to cry many times. Please look at the label of your favorite granola bar and notice how much sugar is in it. You will be shocked. Sometimes these products are just as bad as a candy bar. Here is a popular and reasonably representative granola bar for you to think about.
Two bars is a serving size. They contain 190 calories and 12 gm of sugar. All of it is added, obviously. The second item is sugar. Later on, honey is mentioned – pure sugar. This is another ‘100% Natural’ product, but added sugar is not natural. Don’t let the labels on the front of the box fool you. Read the nutrition label.
Oats have no added sugar, but have starch which is pure glucose. If you subtract the 12 gm of added sugar from the 28 total carbohydrates you get 16 gm of glucose from starch. Remember, glucose can make you fat but not insulin resistant.
By now I must sound like a scold and also a critic of everything. But no. The people who make these products tell you what is in them. They are not dishonest. It is up to you to read what they say. They make what people want and buy. If you do not want the sugar, buy something else – like fresh fruit, or yogurt.
Gluten free products
Everyone is gluten free these days and I certainly don’t understand how this has become such a thing. Many of you will be tested and find out that you are indeed gluten sensitive, even worse may have celiac disease and you must be gluten free. Most of you have fallen prey to the hype of gluten free and think it is healthy so you are doing it. For the record, most of these items have extra sodium and sugar in them to make up for the taste of gluten free foods. They also tend to be overpriced. Look at your label and if you don’t need gluten free, don’t buy it.
A recent report raises questions about the health drawbacks of a low gluten diet. Remember, it is a low grain diet. People in the highest gluten intake groups, after adjustments for confounding factors, had a definite reduction in cardiovascular disease. This was observation, not a trial, but even so these diets are not ideal unless medically necessary.
There is an excellent Seinfeld episode called Ed’s Non-Fat Frozen Yoghurt where Elaine joins millions who start eating non fat FroYo. There is so much added sugar in those items that if you eat it, you will definitely be adding a lot of sugar to your day. This particular episode speaks about non-fat FroYo and during that time in NYC there was a chain that said they had no fat in their yoghurts but they actually did. Elaine and pals do indeed gain weight and soon after put their plastic spoons down. Have this item as a treat here and there. And watch the toppings. As far as I am concerned, they defeat the purpose of you trying to choose healthier.
Some of them are WORSE than soda. I hate them, you don’t need them. Get more sleep, eat well, exercise, and save your money. I just got really mad writing about them and may need a FroYo to get over myself. Enough said. If you read the labels you will find massive sugar loads.
Here is one of many. Monster. Once again, I am not singling out any one product. This one is popular so it depicts what people buy and drink.
The serving size is 1/2 can, but do we think most people drink 1/2 can and put the rest in the fridge for tomorrow? Really? So, a serving is a can, 54 gm of sugar. All of it is added. Now, all is glucose, not fructose. Glucose can make you fat, but it does not have the creepy fructose toxicity with insulin resistance and all.
So, strangely enough, although these drinks are silly from a nutrition point of view, they can be better than, for example, binging on raisins.
Red Bull – sounds bad. And, it may be. It has 39 gm of sugar in a 12 ounce can – larger can than Monster.
But sugars are listed as sucrose, then glucose, meaning that it must contain a lot of fructose as part of the sugars. Not good. Of course the labels still do not tell us exactly what we are drinking. Even so, this is not a good choice for any reason.
Sugar and sodium reign supreme in many frozen dinners. These items are to be used when you simply have no other options. Most people may say, “But Jill, I have lost much weight eating them”. The reason is the serving size. They are made for baby dolls. There is nothing miraculous about these products, and much of the time, nothing healthy in them either.
Let’s Talk About Starbucks
I have been known to go to Starbucks here and there to work and sip coffee. I have also been known to glance up from my computer and look at the people in line ordering what might as well be an ice cream sundae for breakfast and muffle the scream that is about to come from deep inside me. You may not realize how much sugar is in your favorite coffee drink from this popular place. Look at the sugar in these common Starbucks drinks and see if what you order is a total sugar bomb? Remember, this is all added sugar which means 1/2 fructose.
OK Party Pooper, What The Heck Am I Supposed To Do About Dessert?
I know you expect me to say just eat fruit. This is one way that I take care of my sugar tooth (that is what I call it). But what else? Sometimes an apple is not going to cut it.
Kettle Corn Pipcorn. This product has four versions. The one I suggest is the sweetest of the four: ‘Kettle’. It has 4 gm of sugar added in 2 cups, and only 95 mg of sodium. The other three versions have almost no sugar, and are high fiber. Their problem is high sodium 190 mg, and they will not be sweet. I eat the White Truffle. There is no oxalate – corn lacks it.
Annie’s Cinnamon Bunny Grahams. Two full sheets are 9 gm of added sugar. Total carbohydrate is high – 25 gm because it is made out of wheat flour. But this sugar is glucose not fructose. Safe but fattening.
Fruit based smoothie (made with milk or coconut milk base or water). These are a great nutritious way to get your sweets with calcium and fiber. But you need to be very careful of the amounts. My smoothie is one cup of frozen fruit with enough milk to make it drinkable. That’s it. You will get about 4 – 7 gm of fructose. You cannot make it much bigger because 2 cups will give 8 – 14 gm of fructose, a day’s worth. Watch your portion size. Remember, fructose is not just about stones. It is about serious diseases.
Low sugar cereal and milk. Cheerios plain has only 1 gm per cup of added sugar. It has 20 gm of total carbohydrate because it is oats, but that will all be glucose. One cup with milk is a nice sweet treat.
Decaf or reg coffee and milk with cinnamon stick and dusted cinnamon on top. I know you’re thinking ‘she’s lost her mind’ on this one. But I do drink it after dinner and it really satisfies my sugar tooth. And, its pretty, festive, looks like a treat.
Frozen greek yoghurt drops. This is a darling site and worth a visit for you and your kids. Here is a picture of her frozen yogurt covered blueberries. Aren’t they pretty? Use low sugar Greek yogurt and you will have yourself a fine treat.
Frozen banana. (push a popsicle stick into the bottom of a peeled banana and put it in the freezer)
Halotop Icecream is one of a group of low sugar products. I eat it. The vanilla is my favorite and contains 60 calories for 1/2 cup, 5 gm of added sweetener in the form of erythritol and five grams of added sugar. It also contains stevia as a minor additive. Chemical stevia has no oxalate. This ice cream tastes best when you let it sit on the counter for 15 minutes. It is made with real milk and cream and eggs.
This little gem came from my Facebook page.
Dark Chocolate. Also, eat a square or two of dark chocolate, if you can limit yourself. I know it has oxalate, but have it here and there and you will be ok. If you can drink it with milk that will help too. You can even have a glass of chocolate milk if you just put a tiny bit of chocolate in there- just to satisfy your sugar tooth.
Jill, You Know Not What You Say. I AM AN ADDICT!
You may recall in Dr. Coe’s article he confided in you that he was a sugar addict- that he was not the type that could have a little bit as that would open the flood gates to SA (sugarholic anonymous). I told him what I am going to tell you. You cannot deprive yourself of never having sugar again. You will only want it more. We humans are not made that way. Those of you who have taken The Kidney Stone Prevention Course are aware that I always say, “deprivation leads to temptation”. Almost always!
There will be a couple of you (Dr Coe is one) who will really go cold turkey and never eat added sugar again. To you I say “God bless- you are better than I”. Most of you will not be able to do that and to you I say; live, love, laugh, but limit.
Try your best to stay under 25 grams of added sugar for women and less than 38 grams of added sugar for men. Here is how I do it. When I find myself going overboard on sugar, I say this to myself: ‘Rein it in sister. Get it together’. The more I have, the more I want. So in reverse, the less I have, the less I want. It is true.
Start weaning yourself off of added sugars. Use the above substitutes to help you through the withdrawal period. Use healthier snacks as your staples and the brownies and chocolate as rare sweet treats.
Will a frozen banana ever be as good as a Snicker’s bar? I’m not going to lie, it won’t. But you get used to the substitutes. The reward to all of this is less kidney stones, less obesity, less heart disease, less diabetes, and more health.
How sweet is that?
129 Responses to “How To Wean Off Sugar”
For convenience, I eat dried fruit on occasion as part of a meal. I use the following criteria when purchasing and consuming. No additives including sugar. And I use the same swerving sizes as I would for fresh: 2 prunes, 3 apricots, 20 raisins, 1 date or fig. I use the old weight watchers exchanges for serving sizes for fruit. I ignore the serving sizes on the packages, as I consider them excessive.
Fredric L Coe, MD
Hi Kim, If you eat dried fruit just like real fruit I cannot see a problem. Fred
What are the oxalate level in monk fruit sweetener? Is it okay to use?
Fredric L Coe, MD
Hi Renee, I am so sorry to answer so late – your comment was overlooked. I cannot find the oxalate level in monk fruit despite some effort. Fred
I’ve read that cinnamon is very high in oxalates. Is this a spice to stay away from on a low oxalate diet? Say a Snickerdoodle cookie recipe that calls for a tablespoon of cinnamon?
One can certainly still consume cinnamon. Not enough cinnamon in one or two cookies to matter much. Make sure to get your calcium needs met each day as that is super important.
Thank you so much for this informative article. I’ve been drinking ‘mushroom coffee’s where they add adaptogen mushrooms like reishi and Chaga onto the coffee, are those a cause for concern for kidney stones?
Fredric L Coe, MD
Mushrooms are not a problem. Fred
Are sugar alcohols okay to have? My sugar free cookies say they have no added sugars but sugar alcohol. Do they cause any problems for stone formers?
They are ok for stone formers as long as they do not cause you to have stomach upset and they don’t increase your actual sugar cravings.
Hello! I’m trying find oxalate info for monk fruit, particularly sweeteners made from monk fruit. Do you have any references for this fruit, also known as Luo Han Guo? Thank you very much.
Sweeteners tend not to have oxalate after processing.
Why did my comments and questions disappear after submission? I submitted my comments, they posted for the rest of the day and then disappeared.
Fredric L Coe, MD
Hi Cheryl, I guess the answer is that I am slow and answered your question to day. It was posted Jan 10th and I see it on this article right now. It did not disappear and is right at the top of the question list. Best, Fred
Thank you, Dr. Coe and Ms. Harris, for this fantastic website. Anyone who spends five minutes viewing the well-organized, comprehensive body of information provided can tell what a labor of love it is. To the point . . . In one of the responses, you refer to “synthetic stevia, “not from the plant”, having no oxalates. It was also implied in the material above that Halo ice cream contained a small amount of “chemical stevia” (which I’m assuming means the same as synthetic stevia) which has no oxalates.
I happened to have some Halo ice cream in my refrigerator and read the label information. The last item read: Organic Stevia Leaf Extract, suggesting it was plant sourced by extraction. Also, after some intense internet searching, I could not find the terms “chemical stevia” or “synthetic stevia” defined anywhere. Would you kindly clarify what is meant by chemical and synthetic stevia? And what product labeling terms tell the consumer a specific product contains a non-oxalate form of stevia? Thank you very much.
Fredric L Coe, MD
Hi Cheryl, plants use oxalate like a fat store. Stevia does this. The sweetener from the plant can be from the plant tissues or extracted as a pure chemical or even synthesized as a pure chemical stevia sweetener. Oxalate is only from the plant, as in organic stevia leaf extract – that can have oxalate from the plant. But I doubt the bit from ice cream caused your stones. Be sure and get fully evaluated as to their cause. Regards, Fred Coe
Hello Dr. Coe, I red your documentation on the pathways and mechanisms of citric acid, oxalate and calcium binding with a lot of passion tonight! I work in animal nutrition, and we work at improving their health. I am looking at your work in humans to make a similar understanding and story telling for pigs. We feed them stomach bypass acids (citric, malic, fumaric and orthosphosphoric acid) protected in a triglyceride matrix, that slowing releases the acids in their active form in the gut. We have an impact on the gut microflora (reducing pathogenic bacterias) and we improve feed efficiency, weight gain and reduction of antibiotic uses in piglets and finishing pigs. We have also realized that feeding it to sows improves not only the manure bacteria content, but also the urogenital health. Unfortunately, urinary tract infections may be unseen in sows and result in vaginal discharge. Our product considerately improves the health of sows, eliminates vaginal discharges and improve the citrate content of urine, with a however stable urine pH. We also improve urine transparency. We also improve the urine bacterial count.
Looking at your documentation online, all the pathway is well described from the blood concentration of citric acid to the kidneys, to the urine, but do you have also some information from the uptake of citric acid from the gut? This seems to be a missing link we want to explore, to better be able to explain the mode of action of our product.
We have also used our product one ourselves (although not sold actually for humans) when we have a gastroenteritis, or a urinary tract infection, in hopes to save a visit to the doctor. Most of the time, this treatment works on humans as well. We are very close to pigs!
Thank you so much for your time and congratulations for your amazing work,
Fredric L Coe, MD
Hi Emilie, We study – indirectly – absorption of food anions like citrate, but not the acid itself as it does not relate to our usual work. I know it is absorbed but in a routine search pigs were most prominent. Charles Pak contrasted citrate and citric acid long ago in humans, and this routine summary article has links to his original research. Surely citric acid is either absorbed per se or as citrate with the protons otherwise absorbed so urine pH does not increase. In human kidney stone work citric acid absorption has not been of obvious interest but your remarks are important for all of us to consider – sometimes we really want to lower urine pH. Best, Fred
I am officially confused. I landed in the ER a few days ago due to a 3 mm kidney stone.
I LIVE ON TRUVIA. I’m talking about 20 packs a day. Everything I have read said it had 46mg Oxalates per pack.
I need a safe sweetener! Artificial. Does the stevia liquid have zero Oxalates? I’m desperate. I’m on low saturated fat 15mg daily, I have the MTHFR gene so I’m gluten free. What’s left in this world to eat?? No my Swiss miss sugar free hot chocolate is off the table too? Can’t find Oxalate levels in that either. Someone please reach out to me.
Fredric L Coe, MD
Hi Sherri, synthetic stevia has no oxalate – not from the plant. So that change is obvious. But let’s not assume too much. Be sure and get fully evaluated as to the cause of your stone. Then, treat what is abnormal. Regards, Fred Coe
So synthetic stevia is the liquid form?
Now my blood pressure has elevated since I went cold turkey off of the packets of stevia.
By the way, I saw a urologist yesterday and he has ordered another CT next week.
I was totally disappointed with this visit. I asked him questions about oxalates in regards to stevia. He told me to go on the net and look it up as he is a surgeon.
I asked him about doxylamine and pepcid as well as turmeric supplements.
No answer except telling me tumeric is fine! Well everything I’m researching tells me tumeric is high in oxalates!
Gee wiz… I just want to raise my GFR from the 50s back to 70s and 80s at age 55.
Im so stressed.
Fredric L Coe, MD
Hi Sherri, turmeric does indeed have a lot of oxalate. Your urologist is there to be sure stones are not obstructing your kidneys and reducing their function – I am sure that is the case else she/he would have done something. Synthetic stevia lacks oxalate altogether. As for doxylamine, it is an approved OTC allergy drug and useful for vomiting with pregnancy, but has no role in stone disease. Pepcid likewise has no relationship to stones that I know of. Although acid blockers may damage kidneys, Pepcid – an H2 blocker – does not. So I guess this leaves us with: be sure stones are not obstructing; get your blood pressure controlled; get your physicians to figure out why your kidney function is below normal. Regards, Fred Coe
Fredric L Coe, MD
Hi Sherri, I know of no relationship between stevia and blood pressure. But if yours has risen your physicians should strive to help you control it. Regards, Fred Coe
What terrible advice. Oxalate overload is on the rise. To say skip the silliness is absolutely silly in itself. No one eats hug ox foods? Almonds? Spinach, Beets, many greens? Believe me, the almond moms are consuming dangerous amounts of oxalates. I recommend you read the book Toxic Superfoods before handing out such poor advice. UC —Do better.
Fredric Coe, MD
Hi Nancy, Jill Harris has an immense experience in kidney stone diet work. Her article is for stone formers where we have very large data sets on 24 hour urine oxalate losses. Among stone formers, diet oxalate excess, especially in the absence of adequate calcium, is well recognized. But much fuss is made by this patient group over very modest oxalate intake variations. It is to that Jill was speaking. Outside of stone disease, and given normal kidney function (fortunately most people) I am not aware of general health risks from oxalic acid. Some websites, and some books propose it is a hazard but do not provide what I would consider especially convincing data. The molecule has no biological outcome (further metabolism) as it is an end product in humans. Kidneys remove it by secretion and filtration so plasma levels approximate 2 – 6 ummol/l are way below the level needed to create crystallization. Sans crystals, I know of no effects of oxalate in humans that causes disease. A PubMed search: “oxalic acid AND toxicity AND human disease NOT kidney disease NOT cancer” found 19 entries none of which described food oxalate risks. (oxalic acid will include oxalate in this kind of search). Since PubMed is public you may wish to search on your own. I do want to thank you for taking an interest in an important issue and offering constructive criticism. As best I can I have tried to offer back an appropriate answer. Regards, Fred Coe