Who Should Eat Low Oxalate Bread?
As always, I start my low oxalate posts with a disclaimer. Not everyone who has kidney stones needs a low oxalate diet. In fact, not even everyone with oxalate kidney stones needs low oxalate bread.
A healthy diet for kidney stone prevention must be individualized to your urine risk factors and medical history. And, a diet for calcium oxalate kidney stones is a lot more than oxalate!
Always work with a Registered Dietitian or doctor familiar with your medical history to learn what is best for you.
Can I Eat Bread with Kidney Stones?
Absolutely! In fact, bread and other healthy carbs are an important part of a healthy diet for most people.
Unfortunately, bread and other carbohydrates are often demonized. But, healthy whole grains are an important part of nearly any healthy diet. Whole grains are an important source of fiber, vitamins, minerals and energy!
The keys to healthfully eating bread and other carbohydrates are to:
- Make sure you get most of your carbohydrate from healthy, whole food sources with fiber (such as whole grains and fruit!)
- Eat them as part of a well balanced plate that includes protein and vegetables
Kidney Stone Friendly Bread: More Than Low Oxalate
Whole grains, such as whole grain bread, are recommended for a general healthy diet because whole grains are higher in fiber and other healthy nutrients than white or refined grains.
Even though whole grains are a bit higher in oxalate, I recommend whole grains for the vast majority of patients with calcium oxalate kidney stones.
To understand why, let’s dive into the anatomy of whole grains.
What Is a Whole Grain?
Whole grains are any grain (such as wheat, rye, rice or barley) that includes ALL parts of the kernel. Whole grains include the endosperm, germ and bran. During processing of refined grains, the germ and bran are removed, leaving just the endosperm.
The germ and bran have nearly all of the healthy fiber, vitamins and minerals in them! They also have most of the oxalate.
Even though refined grains such as white bread, white pasta and white rice are lower oxalate, they are also lower in these important nutrients. Because of this, they are not recommended for most people with kidney stones.
For most people, the benefit of all that extra fiber and other nutrition outweigh the slightly higher oxalate content of whole grains.
Benefits of Whole Grains for Kidney Stones
Perhaps most importantly, whole grains are a better source of fiber than refined grains. Diets adequate in fiber help combat much more than constipation. High fiber diets can help prevent cancer, aging, cardiovascular disease, diabetes and most other chronic conditions. (1)
Along with fruits and vegetables, whole grains are an important source of fiber in our diet.
It is well known that magnesium plays an important role in kidney stone prevention. Magnesium inhibits kidney stone formation. (3) And, lower blood levels of magnesium are associated with kidney stones – even when magnesium levels are in the “normal” range. (4)
Whole grains, nuts and seeds are the primary source of magnesium in our diet. (5) Nearly half of Americans are not eating enough magnesium. (5) Completely avoiding whole grains (or, nuts and seeds!) because of the oxalate content also removes magnesium.
Importantly, magnesium supplements have not shown consistent benefit for stone prevention. (6) Try to get enough magnesium through healthy foods.
Phytate (or phytic acid), is compound found in many plant foods. It is known for being an “anti-nutrient” because it blocks the absorption of some important nutrients such as calcium, magnesium and zinc.
Phytate is found in many healthy plant foods, such as whole grains, nuts, seeds and legumes.
Importantly, the exact role of dietary phytate in kidney stone prevention is still up for debate, but it is clear there some connection. (10) In general, diets higher in phytate are associated with lower risk of kidney stones. Avoiding whole grains reduces phytate in your diet.
Tips for Finding Low Oxalate Bread Good for Kidney Stones
It is nearly impossible to know exactly how much oxalate is in commercial breads. Unless we have the exact recipe (which, most companies would not be willing to share, for obvious reasons!), it is impossible to calculate exact oxalate counts.
But, you can do your homework and try to find a healthy bread lower in oxalate – while balancing the need for fiber and good nutrition!
Tip 1: Hunt for High Oxalate Ingredients
Look at the ingredients in whatever bread you are eating – this is the first step to finding low oxalate bread. If the bread contains lots of very high oxalate ingredients, that bread will likely be high in oxalate!
It is unlikely that you’ll find a healthy bread that is completely free of very high oxalate ingredients – unless you choose highly refined white bread – which isn’t ideal.
Instead, look for a bread that has fewer very high oxalate ingredients.
Remember, ingredients are listed on food labels in order of how much is used. So, ingredients listed first are more important. And, ingredients listed further down are less important.
Very High Oxalate Bread Ingredients
To find low oxalate bread, look for bread that doesn’t have these ingredients, or has them further down the ingredient list.
- Almond Flour
- Soy Flour
- Brown Rice Flour
- Rice Bran
- Cornmeal, Corn Flour & Corn Bran
- Teff Flour
- Amaranth Flour
- Sorghum Flour
- Wheat Berries
- Sesame Seeds
Lower Oxalate Bread Ingredients
Look for bread made from these ingredients.
- Whole Wheat Flour
- White Flour
- Wheat or Wheat Flour
- White Rice Flour
- Bread Flour
- Coconut Flour
- Chickpea Flour
- Tapioca Flour
- Cassava Flour
- Arrowroot Flour
- Oats or Oat Bran
- Sunflower, flax seeds or other lower oxalate nuts & seeds
Tip 2: Check For Fiber
Bread, and other carbohydrates, are an important source of fiber – if done right! Make sure whatever bread you choose is a good source of fiber.
A good rule of thumb is to look for bread that has at least 3 grams of fiber per slice.
Tip 3: Don’t Forget to Check Sodium
Keeping sodium in check is an important part of kidney stone prevention. Bread can be surprisingly high in sodium.
Always check the Nutrition Facts label to see how much sodium is in your bread. Both the general recommendations for healthy people, and people with kidney stones, suggest limiting sodium to no more than 2,300mg per day. (11)
Tip 4: Avoid Added Sugar
Sugar is another sneaky bread ingredient. Most breads have some sugar or sweetener, like honey or molasses, because yeast needs sugar to make bread rise. But, some breads have more sugar than others.
Look for bread with no more than 4 grams of added sugar per slice.
Top 5 Healthy Low Oxalate Bread Recommendations
My personal favorite go-to for healthy bread. This low oxalate bread is made primarily from whole wheat flour, wheat flour and oats. Most other ingredients are lower in oxalate such as hazelnuts, walnuts and sunflower seeds.
This fiber packed bread has 5 grams of fiber per slice! Most of the fiber is from lower oxalate ingredients such as whole wheat flour, oat fiber and wheat bran.
This low oxalate bread is made of just whole wheat flour and wheat flour. Likely one of the lowest oxalate bread options in my top 5!
Made from whole wheat flour, this tasty bread had just a touch of honey for a bit of sweetness! Even with the added sugar, this bread only has 4g of added sugar per slice.
Again made from essentially only whole wheat flour, this bread is a healthy low oxalate bread choice. This is also the lowest in sodium, with only 115mg of sodium per slice.
Low Oxalate Bread Recipe
Of course, you can always make your own low oxalate bread at home! Make your own bread at home to control the ingredients – especially that salt and sugar! Plus, what tastes (and smells!) better than homemade bread!?
Try this simple whole wheat bread recipe!
(Healthy!) Low Oxalate Bread
- 1 cup water warm
- 2 tablespoons sugar
- 1 packet active dry yeast
- 1 1/2 cup whole wheat flour
- 1/2 teaspoon salt
- 2 tablespoons vegetable oil
- 1 1/2 cup white flour
- 2 tablespoons oatmeal
- 2 tablespoons sunflower seeds
- In a large bowl, combine water, yeast and 1 cup whole wheat flour. Let rest for a few minutes, until bubbles start to form. Add remaining 1/2 cup whole wheat flour, salt and oil.
- Add 1 cup white flour. Mix with a spatula. Pour dough onto floured surface and sprinkle remaining 1/2 cup white flour, oatmeal and sunflower seeds over dough. Knead for 5 minutes, until all the flour, oatmeal & seeds are incorporated and the dough is elastic.
- Rinse large bowl and spray with cooking spray. Place dough in the bowl and cover with a damp towel or plastic wrap. Set bowl in a warm place and let dough rise until doubled in size, about 1 1/2 hours.
- Spray a loaf pan with cooking spray. Punch dough to deflate and shape into a 8-9" log. and place dough into pan. Cover with damp towel or plastic wrap and let rise another 30 minutes. Meanwhile, preheat oven to 375'F.
- Uncover the bread and bake about 30 minutes, until golden brown. To make sure bread is cooked, remove from loaf pan, and gently tap on bottom – the loaf should sound hollow.
- Slice and enjoy!