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Low Oxalate Diet

w
wintersweet Dec 7, 2013 11:21 PM

Anyone else on a low oxalate diet? I know that some people believe it to be a magical cure-all for all sorts of things, but I'm on it due to pesky kidney stone issues, per my urologist. At first I was just frustrated by the massively conflicting lists online, even from universities and famous hospitals, and the vague info from my doctor ("chocolate...berries...spinach...nuts..."). Eventually I found a group that does testing and makes spreadsheets with better data. But it's still pretty darned annoying, since I'm supposed to limit or avoid
- whole grains
- nuts
- berries
- spinach and many other green vegetables
- chocolate
- turmeric/curry powder
- beans
- soy
- nori
- potatoes
and many more of my favorite things.

On the other hand, it's fine if I have butter, steak, sugar, cheese, beer...haha. It sounds great except for the fact that I'm trying to get healthier and more fit!

I lost a lot of weight a few years ago by having oatmeal with almond butter every morning. But that may be part of what caused the kidney stones in the first place. Argh!

Anyway, I'm trying to focus on what delicious foods I can eat (e.g. salmon, cabbage, egg noodles, etc.) and which I can eat in small quantities (no one eats very much nori, in terms of mass) or which I can eat in small quantities with dairy (calcium reduced oxalate uptake, so yes, I'll have cheese on my sope with beans).

I miss nuts. :(

Anyone else out there in the same boat?

  1. k
    kerj Jan 20, 2014 12:21 PM

    Umm yes, same boat but w/ some holes in the bottom. I'm a type 2 diabetic & have had a heart attack in '06. Of course I'm on meds to control cholesterol, blood sugar & blood pressure. They do help a lot but the dietary restrictions just continue to add up. I went in for lithotrypsy on my 5/8" kidney stone last Th. & would love to get back to a "normal" life, but to no avail. Thinking I was including "healthy " foods in my diet for many years, I included nuts, spinach, whole grains, dried beans, soy & even turmeric in my smoothies.
    So now I need to eliminate them as well as anything that's high in salt.
    I've been to see the "nutritionist" my medical plan recommended & she was less than helpful.
    So to clarify... strawberries are high in oxalates but I've never seen blueberries as being high.
    Dino Kale is OK, but what about seaweed ?
    Seeds are OK but not nuts ? (almonds were my go-to snack )
    Dried beans are not Ok, but are garbanzos ok ?

    Mucho Thanks !

    3 Replies
    1. re: kerj
      paulj Jan 20, 2014 01:04 PM

      Have you had a 24hr urine test? What about an analysis of the stone? Without concrete data like that, blaming oxalates is just guess work. And since stones usually grow slowly it is hard to pinpoint one diet item (or subset) as being the cause. Calcium intake (and elimination) might also be a factor.

      As for the nutritionist being less than helpful, that may be because the medical literature itself is not very helpful. wintersweet mentioned a yahoo diet group that seems to have a lot of data, but is it reliable? Do plants differ by variety, species, location, or sampling method?

      My approach is to stay away from the obvious culprits (eg. rhubarb, spinach), eat a varied diet, drink lots of water, and take the pills my urologist prescribed.

      1. re: paulj
        k
        kerj Jan 20, 2014 01:42 PM

        Oh yes, I've had the 24 hr. urine test, It's oxalates all right! They want another.
        The best thing the nutritionist told me was that the calcium in the milk (dairy) will bind with the oxalates in the intestines and eliminate them & I need to consume at least 2 glasses / day. thanks.

        I guess what i need to do i develop my own diet & stick w/ it.

        1. re: kerj
          paulj Jan 20, 2014 01:53 PM

          That fits with the articles I found last month
          http://chowhound.chow.com/topics/9270...

    2. m
      MsTiger Jan 8, 2014 04:14 PM

      I'm on low oxalate because otherwise I get water retention all over and in particular my feet balloon up so they don't fit in my shoes... And then my skin starts to itch constantly. I know the group you're talking about and they're really the best place to ask. There are some veery accomplished cooks who'll know your best alternatives. Some tips tho... It's cumulative so if you eat very low oxalate for a while you'd be able to have a treat of something like a chili. Mustards and peppers are all low to medium Oxalates... I don't know if Sichuan pepper has been tested but I'm choosing to believe it's included. Chestnuts are also ok. As is coconut and seeds are ok too in reasonable servings. You could use sunflower spread instead of almond spread... And I like coconut oil too. By. The way with the kale it's only the Dino kale that's low oxalate the other sort is really quite high.

      1. firecooked Jan 5, 2014 09:35 PM

        Yes... but not for me, for my dog who is on a low oxalate diet due to bladder stones. And due to multiple health issues I have been cooking his food for about 3 years now. The charts are maddening! I like the Havard spreadsheet the best, as it gives numbers (and note that the "very high" range starts at 15, but some things, like cooked spinach have 755mg in a 1/2 cup serving). And the vet could not give me a target number of what constitutes "low" for a daily total.

        My strategy -- avoid the foods that are really high, like beets and spinach. Vegetables that are moderately very high, like sweet potatoes get boiled in water and drained, which removes significant amounts of oxalates. This might work for beans too. Of course, the dog is happy getting lots and lots of ground beef.

        1. paulj Dec 8, 2013 10:26 AM

          Sort of. I have along history of kidney stones, and was finally diagnosed with, if I recall correctly, an idiopathic calcium oxalate stone. So while the stone type was identified, the cause is unclear (based on lab tests). Since my last attack, a simple diuretic to regulate calcium clearance is keeping me stone free.

          The last time I looked at oxalic acid, Litholink was the best source of information I could find, but that was a number of years ago. ohf.org is new to me, and seems to be legit (with Mayo connections). But notice that they make a distinction http://www.ohf.org/treatment.html between people who should avoid a (very) high oxalate foods and those who should eat a low oxalate diet.

          All lists agree that spinach and rhubarb are high. Kale, on the other hand, appears to be a green with low.

          I'm a little surprised that ohf puts nuts and whole grains in the high to very high category. http://www.ohf.org/docs/Oxalate2008.pdf
          And considering that other health studies find that those are valuable for issues like cardiovascular health, it would unfortunate if we had to limit those.

          I wonder if various studies of oxalic acid levels focus on the content of the food as measured in the lab, or whether they try to account for how much is absorbed. If, for example, the acid is mostly in undigestable fiber of grains and nuts, then they might not a significant dietary source.

          While spinach and some other greens are high, kale is low.

          And if stone formation is a slow long process, the long term average intake is more important than level in any one meal or serving.

          2 Replies
          1. re: paulj
            paulj Dec 8, 2013 03:37 PM

            A couple of relatively recent articles on dietary intake of oxalates.

            http://www.iksi.org/images/uploads/Origin_of_Urinary_Oxalate.pdf
            http://jasn.asnjournals.org/content/1...

            Some things I get from these:
            - there are endogenous (produced in the body) oxalates, though the processes are poorly understood
            - calcium intake affects oxalate levels both in urine and intestines. A low calcium diet is not necessarily good.
            - one study sees moderate connection between diet and stones, the other little to none.
            - it's not easy to study the connection between diet and slow processes like stone formation (at least for most people).

            1. re: paulj
              w
              wintersweet Dec 11, 2013 07:15 PM

              Good questions. The low-oxalate diet group that posts test results to the Yahoo group I'm following supposedly tries to account for absorption and average portion size.

              I am not avoiding whole grains or nuts, but I'm restricting them somewhat. Trying to get fiber from veggies. (And good thing I like kale, which became a staple after the change.)

              But I miss my vegetarian chili. :(

              I'll check out the links. It's hard to know what to think given all the conflicting information. Guess it's still early days for understanding nutrition in general, never mind the interactions of foods with various conditions and medications!

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