Registered Dietitian approved healthy, low oxalate snacks. Along with everything you need to know about a oxalate and kidney stone prevention!
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Table of Contents
What are oxalates?
Before we dive into what foods are high or low in oxalates, it is important to understand what oxalates actually are. Don’t worry, that list of low oxalate snacks, a meal plan and food lists for oxalates are coming!
Oxalates (or oxalic acid) is a non-nutrient found naturally in many foods. Chemically speaking, oxalate is a dianion made of carbon and oxygen molecules.
Oxalate is found naturally in many foods such as almonds, most green leafy vegetables, nuts and seeds. Oxalates form in plants because they serve a critical role for the plant itself. Oxalates may help plants in calcium regulation, help protect the plant from toxic metals and even protect the plant from getting eaten by animals1.
Do we need oxalate?
Although oxalate plays an important role for plants, there is no known function for oxalate in humans. Oxalate is classified as a “non-nutrient”, or something that we eat, but does not have a function in our bodies.
So, the short answer is “no”. We do not necessarily need to consume any oxalate in our diet.
Oxalate and Kidney Stones
Oxalate is most well known for its role in the formation of kidney stones. Calcium oxalate kidney stones are by far the most common type of kidney stone. About 75% of kidney stones are formed from oxalate and calcium2. The second most common stone type is calcium phosphate, at only 12% of stones.
Many factors determine if your body will form a kidney stone. One of the biggest factors is how saturated your urine is with oxalate and calcium. The more calcium and oxalate your urine has in it, the more likely these two molecules will bind (or precipitate) and form a kidney stone.
There are three primary ways to reduce the risk of calcium oxalate kidney stones:
- Decrease how much oxalate is in your urine
- Decrease how much calcium is in your urine
- Increase how much urine you have (aka: drink more water!)
A healthy calcium oxalate kidney stone diet targets your urine risk factors. There is no single diet for kidney stone prevention. A 24-hour urine test will identify your urine risk factors.
How to Increase Urine Volume
Urine volume is the easiest thing to control. You simply need to drink fluids!
Most people with kidney stones (of any type!) should aim for 3 liters of fluid intake per day. Of course, most of this fluid should be good ol’ water. However, feel free to mix it up with unsweetened flavored waters (La Croix*, Spindrift* and Bubly* are my favorite brands) or make infused water at home with fresh or frozen fruit and/or fresh herbs.
Some people find “smart” water bottles useful to help them drink more. The HidrateSpark* water bottle actually tracks how much water you drink and reminds you to drink more by lighting up and connecting to an app on your phone.
Try to avoid drinks with too much added sugar such as regular lemonade, sweet tea, soda, punch, or fruit juice. A high sugar intake can contribute to more calcium in your urine, which is a risk factor for kidney stone formation.
How to Decrease How Much Oxalate Is In Your Urine
Eat More Calcium
The best way to reduce oxalate in your urine is to eat more foods high in calcium. This may seem counter-intuitive. You are probably thinking: “Don’t we want to cut back how much calcium is in our urine!?” This is true, BUT calcium does a few magical things for people with kidney stones.
Firstly, calcium binds to oxalate in our intestines. This causes the oxalate to be excreted in stool and reduces how much oxalate gets absorbed into our bodies – which is great news if you have kidney stones!
Secondly, people with kidney stones are at increased risk of osteoporosis (or weak bones)3. It is very important to eat enough calcium to protect your bones.
Learn more about the best calcium sources for kidney stones.
Reduce High Oxalate Foods
The next best way to reduce oxalate in your urine is to cut back how much oxalate you eat. For many people, simply adding calcium and dairy into their diet brings oxalate down to a safe level. However, for some, they also need to cut back how much oxalate they eat.
How to Decrease How Much Calcium Is In Your Urine
This one is a little trickier. There are medications your doctor may prescribe such as thiazide diuretics to help with this. From a diet perspective, there are two factors that can help reduce calcium in urine:
- Reduce dietary sodium to no more than 2,300 mg per day.
- Avoid excess protein. This looks a little different for everyone. Work with your dietitian to figure out how much protein you need. Good general tips are:
- Enjoy meat (including beef, chicken, fish, pork, etc.) no more than once per day. For non-meat meals, choose other sources of protein such as eggs, fresh cheeses, yogurt or even beans, lentils and nuts (see chart for the best options for these foods).
- Eat meat in proper portions: 3-6oz for most people.
- Avoid excess sugar. I usually recommend limiting sugary desserts to no more than 1-2 times per week and keeping portion sizes reasonable.
My overview of a healthy diet for calcium oxalate kidney stones helps summarize all of this information.
There is no single kidney stone diet that works for everyone. I help people prevent kidney stones with a personalized, research-based and delicious approach in Kidney Stone Nutrition School!
Does Everyone Need to Limit Oxalate?
No! For most people, high oxalate foods such as almonds and spinach are healthy foods. The problem with oxalate is when there is too much oxalate in our urine, which is a risk factor for kidney stones.
Oxalate comes from two sources: our diet and the oxalate our bodies make. There are differences between people for both factors. Some people absorb a lot of oxalate from food while others do not. Some bodies make a lot of oxalate and others do not. There is a rare genetic disorder called Primary Hyperoxaluria Type 1 (PH1); PH1 causes very large amounts of oxalate to buildup in kidneys from a dysfunction in a liver enzyme responsible for breaking down oxalate4. Bottom line: not everyone is going to have too much oxalate in their urine.
Limiting dietary oxalate is not even necessary for everyone with kidney stones. The best diet to prevent kidney stones is based on the type of stone your body forms. Although most kidney stones are made of calcium oxalate, there are many other types of kidney stones including calcium phosphate, struvite, cysteine and uric acid. If you form any of these other types of stones, there is no reason to limit how much oxalate you eat as it will not reduce your risk of stones.
The best way to figure out if you have too much oxalate in your urine (and therefore, need to limit how much oxalate you eat) is a 24-hour urine test. Your nephrologist or urologist may ask you to do this test to figure out the best treatment for your kidney stones. A 24-hour urine test will quantify how much oxalate is in your urine. If it is elevated (usually more than 55 mg/day), this means you likely should cut back how much oxalate you eat.
A 24-hour urine test will measure many other stone risk factors such as: urine pH, volume, citrate, potassium, phosphate, how much protein and salt you eat and how saturated your urine is with minerals. Litholink is a common company used to perform this test5.
More about who needs a low oxalate diet.
Safely Eating High Oxalate Foods
The safest way to enjoy foods higher in oxalate is to eat foods high in calcium with meals. This will block the oxalate in foods from being absorbed, allowing you to enjoy MANY more healthy foods that may be moderately high in oxalate. Aim for 1 serving of dairy with each meal, 3 meals per day. Three servings of dairy will help you get to the recommended daily intake of calcium for adults of 1,000-1,2006. More about calcium & kidney stones.
Good dairy sources for people with kidney stones include:
- Fat free or low fat milk
- Plain low fat or fat free yogurt (try adding fruit for some sweetness!)
- Kefir
- Low sodium cottage cheese
- Low sodium cheeses
- Fresh cheeses, such as fresh mozzarella or queso fresco
- Low sodium varieties of cheese
- Cheeses naturally lower in sodium (Swiss, goat, ricotta)
Be careful of excess sodium in these dairy sources:
- Processed cheeses (Velveeta®, American cheese, nacho cheese sauce)
- Aged cheeses (Parmesan, feta, aged cheddar)
- Regular cottage cheese
If you have a hard time tolerating dairy, Lactaid* helps many people with gas and bloating.
If you struggle to fit in your 3 servings of dairy every day, check out my eCookbook! I’ve compiled low oxalate recipes that slip dairy into your diet!
Importance of Low Oxalate Snacks
It is very important to have dairy with meals. If you eat dairy between meals, the calcium will not be there to block the oxalate in the other foods you eat. This is way it is very important to eat low oxalate snacks OR be careful to incorporate dairy with your snack. For example, nuts are a common (and delicious!) snack food. Nuts tend to be higher in oxalate, but most can be safely eaten if eaten with dairy. Maybe try adding yogurt to your mid-afternoon snack of trail mix or walnuts!
Calcium Supplements
Patients often ask me about taking calcium supplements to bind oxalate instead of dairy. Unfortunately, calcium supplements increase the amount of calcium in your urine more than natural calcium found in dairy, which increases the risk of kidney stones. For people who cannot tolerate or consume dairy for other reasons, calcium supplements can reduce urine oxalate, but they are not my first choice.
Note that only cow’s milk is naturally high in calcium – all alternative milks such as soy, oat, almond, rice, etc. are supplemented with calcium as calcium does not naturally occur in these foods. Therefore, using alternative milk is essentially just like taking a calcium supplement.
Broccoli & Green Leafy Veggies for Calcium
Broccoli and some other green vegetables are surprisingly high in calcium and can be a decent source of calcium for many people. However, I do NOT recommend them as a calcium source for people with kidney stones.
Firstly, there is much less calcium in these foods compared to dairy, so we won’t get as much oxalate binding. Also, much of the calcium is already bound to oxalate in these foods, which completely negates the purpose of eating calcium block oxalate absorption.
Boiling Out That Oxalate
Boiling foods can also reduce the oxalate content. Boiling can reduce the amount of oxalate in food by more than 50%7. This may be a good option for certain high oxalate vegetables such as spinach and other greens, potatoes, okra or rutabaga.
Low Oxalate Foods
Trying to figure out which foods are high in oxalate can be incredibly frustrating. There are endless lists available online, many of which contradict each other. Unfortunately, much of this information is inaccurate. It is critical to make sure the list comes from a reliable source.
Some high oxalate foods tend to sneak into foods and we don’t even realize it! For example, many veggie burger patties may contain spinach or bran flakes. Always look at the ingredients on a food label to find those hidden high oxalate foods.
Low Oxalate Food List
Low Oxalate (10mg or less per serving) | Medium Oxalate (11-29 mg per serving) | High Oxalate (30g or more per serving) | |
---|---|---|---|
Grains | Biscuits, 1 each, 6 mg Blueberry Muffins, 1 each, 9 mg Bran Muffins, 1 each, 5 mg Cheerios, 1 cup, 8 mg Cornbread, 1 piece, 4 mg Cornflakes, 1 cup, 1 mg Couscous, ½ cup, 8 mg English muffin, white, 1 each, 8 mg Oat bran, 1/3 cup, 0 mg Rice krispies, 1 cup, 3 mg Spaghetti, ½ cup, 6 mg Wheat bread, 1 slice, 5 mg | Brown rice, ½ cup 12 mg Cream of Wheat, 1 cup, 18 mg English muffin, whole wheat, 1 each, 12 mg Farina, 1 cup, 16 mg French Toast, 2 slices, 13 mg Granola, 1 cup, 20 mg Pancakes, 4 each, 11 mg | Bagel, 1 large, 40 mg Barley flour, ½ cup, 41 mg Bran cereal, 1 cup, 52 mg Bulgur, ½ cup, 43 mg Corn grits, ½ cup, 49 mg Cornmeal, ½ cup, 32 mg Millet, ½ cup, 31 mg Raisin Bran cereal, 1 cup, 46 mg Rice bran, ½ cup, 140 mg Shredded wheat cereal, 1 cup, 28 mg Soy flour, ½ cup, 47 mg Wheat berries, ½ cup, 49 mg |
Protein | Flaxseed, 1 tablespoon, 0 mg Pecans, ¼ cup, 10 mg Pumpkin seeds, ¼ cup, 5 mg Sunflower seeds, ¼ cup, 3 mg Walnuts, ¼ cup, 8 mg | Peanuts, ¼ cup, 27 mg Pistachios, ¼ cup, 14 mg Tofu, 3.5 oz, 13 mg Veggie burger, 1 each, 24 mg | Almonds, ¼ cup, 122 mg Cashews, ¼ cup, 29 mg |
Fruits | Apple, 1 fruit, 1 mg Apricots, 1 fruit, 0 mg Applesauce, 1 cup, 2 mg Banana, 1 fruit, 3 mg Blackberries, 1 cup, 4 mg Blueberries, 1 cup, 4 mg Cantaloupe, 1 cup, 0 mg Cherries, 1 cup, 3 mg Cranberry Sauce, ½ cup, 2 mg Figs, 1 fruit, 9 mg Grapes, 1 cup, 2 mg Honeydew Melon, 1 cup, 1 mg Lemon, 1 fruit, 4 mg Lime, 1 fruit, 3 mg Mango, 1 fruit, 1 mg Nectarine, 1 fruit, 1 mg Papaya, 1 fruit, 1 mg Peach, 1 fruit, 0 mg Pear, 1 fruit, 2 mg Pineapple, 1 cup, 4 mg Plantain, 1 fruit, 1 mg Plum, 1 fruit, 0 mg Tangerine, 1 fruit, 10 mg Raisins, 1 oz, 3 mg Strawberries, 1 cup, 4 mg Watermelon, 1 slice, 1 mg Canned cherries, ½ cup, 7 mg Canned peaches, ½ cup, 1 mg Canned pears, ½ cup, 1 mg Fruit cocktail, ½ cup, 1 mg Dried Apples, 13 rings, 2 mg Dried Apricots, ½ cup, 1 mg Dried Cranberries, ½ cup, 1 mg | Avocado, 1 each, 19 mg Dates, 1 each, 24 mg Grapefruit, ½ fruit, 12 mg Kiwi, 1 fruit, 16 mg Orange, 1 fruit, 29 mg Dried figs, 5 each, 24 mg Dried prunes, 5 prunes, 11 mg | Raspberries, 1 cup, 48 mg Canned pineapple, ½ cup, 24 mg Dried pineapple, ½ cup, 30 mg |
Vegetables | Alfalfa sprouts, ½ cup, 0 mg Artichoke, 1 heart, 5 mg Asian mixed vegetables, ½ cup, 6 mg Asparagus, 4 spears, 6 mg Bok choy, 1 cup raw, 1 mg Cabbage, ½ cup, 1 mg Carrots, ½ cup cooked, 7 mg Cauliflower, ½ cup cooked, 1 mg Celery, ½ cup cooked, 5 mg Chili peppers, ½ cup, 5 mg Chives, 1 teaspoon, 0 mg Collard greens, ½ cup cooked, 5 mg Corn, ½ cup, 1 mg Cucumber, ¼ each, 1 mg Endive, ½ cup, 0 mg Green beans, ½ cup, 9 mg Green pepper, ½ cup, 5 mg Iceberg lettuce, 1 cup, 0 mg Kale, raw, 1 cup, 2 mg Mixed vegetables, ½ cup frozen, 5 mg Mung beans, ½ cup, 8 mg Mushrooms, 1 each, 0 mg Mustard greens, 1 cup raw, 4 mg Onion, 1 small, 1 mg Peas, ½ cup, 1 mg Tomato, 1 each, 7 mg Radish, 10 each, 0 mg Romaine lettuce, 1 cup, 0 mg Scallions, ½ cup, 1 mg Sea vegetables, 1 cup, 3 mg Water chestnuts, 4 each, 0 mg Yellow squash, ½ cup, 4 mg Zucchini, ½ cup, 1 mg | Bamboo shoots, ½ cup, 18 mg Broccoli, 1 cup raw, 12 mg Brussels Sprouts, ½ cup, 17 mg Carrots, ½ large raw, 15 mg Fava beans, ½ cup, 20 mg Kidney Beans, ½ cup, 15 mg Olives, 10 each, 18 mg Parsnip, ½ cup, 15 mg Potato chips, 1 oz, 21 mg Potatoes, mashed, ½ cup, 15 mg Refried beans, ½ cup, 16 mg Sweet potatoes, ½ cup, 14 mg Tomato sauce, ½ cup, 17 mg | Beets, ½ cup, 76 mg Navy beans, ½ cup, 76 mg Okra, ½ cup, 57 mg Potato, baked w/ skin, 1 each, 97 mg Potatoes, French fries, ½ cup, 51 mg Rhubarb, ½ cup, 541 mg Rutabaga, ½ cup, 31 mg Soybeans, ½ cup, 48 mg Spinach, ½ cup cooked, 755 mg Spinach, 1 cup raw, 656 mg Turnip, ½ cup, 30 mg Yams, ½ cup, 40 mg |
Snacks | Popcorn, 1 cup, 5 mg Pretzels, 1 oz, 5 mg Ritz crackers, 5 crackers, 3 mg Saltines, 5 crackers, 5 mg Tortilla chips, 1 oz, 7 mg Triscuits, 5 crackers, 5 mg Wheat crackers, 5 crackers, 5 mg | Potato chips, 1 oz, 21 mg | - |
Desserts | Chocolate pudding, ½ cup, 2 mg Custard, ½ cup, 0 mg Fig bar, 1 cookie, 4 mg Fruit roll up, 1 roll, 2 mg Graham cracker, 1 sheet, 2 mg Jello, 1 cup, 1 mg Milk chocolate candy, 1 oz, 5 mg Oatmeal cookie, 1 cookie, 3 mg Pie, 1/8 pie, 5 mg Popsicle, 1 each, 0 mg Pudding popsicle, 1 each, 5 mg Rice cake, 1 cake, 2 mg Rice krispie treat, 1 bar, 1 mg Sherbet, ½ cup, 0 mg Snack cake, 1 cake, 3 mg Vanilla pudding, ½ cup, 0 mg | Cake, 1 oz, 15 mg Chocolate chip cookie, 1 medium, 10 mg | Brownie, 1 oz, 31 mg Candy with nuts, 1 piece, 38 mg Chocolate syrup, 2 tablespoons, 38 mg Stevia artificial sweetener, 1 packet, 42 mg |
Beverages | Apple juice, 1 cup, 2 mg Apricot juice, 1 cup, 2 mg Beer, 12 oz, 4 mg Chocolate milk, 1 cup, 7 mg Coffee, 1 cup, 2 mg Gatorade, 1 cup, 0 mg Grape juice, 1 cup, 1 mg Grapefruit juice, 1 cup, 0 mg Kool-Aid, 1 cup, 1 mg Liquor, 1 oz, 0 mg Mango juice, 1 cup, 1 mg Milk, 1 cup, 1 mg Orange juice, 1 cup, 2 mg Pineapple juice, 1 cup, 3 mg Prune juice, 1 cup, 7 mg Soda, 1 cup, 0 mg Wine, 4 oz, 1 mg | Black tea, 1 cup, 14 mg Carrot juice, 1 cup, 27 mg Lemonade, 1 cup, 15 mg Rice milk, 1 cup, 13 mg Soy milk, 1 cup, 20 mg Tomato juice, 1 cup, 14 mg | Hot chocolate, 1 cup, 65 mg |
Condiments & Other | Apple butter, 1 tablespoon, 0 mg Butter, 1 tablespoon, 0 mg Cream cheese, 1 oz, 1 mg Cream sauce, ¼ cup, 0 mg Gravy, ¼ cup, 1 mg Horseradish, 1 tablespoon, 0 mg Jam/jelly, 1 tablespoon, 1 mg Ketchup, 1 packet, 1 mg Mayonnaise, 1 tablespoon, 0 mg Mustard, 1 teaspoon, 1 mg Salsa, 1 tablespoon, 1 mg Soy sauce, 1 tablespoon, 3 mg Syrup, 1 tablespoon, 0 mg Whipped cream, 2 tablespoon, 0 mg | Peanut butter, 1 tablespoon, 13 mg Tahini, 1 tablespoon, 16 mg | Miso soup, 1 cup, 111 mg |
All dairy (milk, yogurt, cheese) and animal proteins (chicken, turkey, fish, seafood, beef, pork, etc.) are low in oxalate.
How Much Oxalate Can I Eat?
This really depends on your urine oxalate levels. For many people, simply adding a serving of dairy to your diet will cause urine oxalate levels to come tumbling down. Other people require more strict dietary restriction of oxalate to see normal urine levels.
For most patients, I DO NOT recommend strictly following this list or trying to count how much oxalate they eat. Doing this will unnecessarily cut out many healthy foods and, lets face it, isn’t fun at all! Instead, it is best to work with your doctor track how much oxalate is in your urine after you increase dairy and take out those very high oxalate foods.
For you numbers people, it is reasonable to limit oxalate to 200mg/day. Some may need more severe restriction down to 100mg/day.
Low Oxalate Meal Plan
Day 1 | Day 2 | Day 3 | Day 4 | Day 5 | |
---|---|---|---|---|---|
Breakfast | 1 cup oatmeal made with skim milk ¾ cup blueberries 2 tablespoons unsalted walnuts 1 cup coffee w/ 1 Tbs cream & 1 tsp sugar | 1 boiled egg 2 slices whole wheat toast w/ 2 teaspoons margarine 1 banana 1 cup skim milk 1 cup coffee w/ 1 Tbs cream & 1 teaspoon sugar | 1 cup cornflakes 1 cup sliced strawberries 1 cup skim milk 1 cup coffee w/ 1 Tbs cream & 1 tsp sugar | 1 scrambled egg with 1 oz mozzarella cheese 1 slice whole wheat toast w/ 1 tsp ½ cup canned peaches ½ cup orange juice 1 cup coffee w/ 1 Tbs cream & 1 tsp sugar | ½ cup plain low-fat yogurt ½ cup mandarin oranges 1 slice whole wheat toast w/ 1 tsp margarine 1 cup coffee w/ 1 Tbs cream & 1 tsp sugar |
Lunch | Low Sodium Turkey Sandwich w/ whole wheat bread, 2 oz low sodium turkey, lettuce, tomato, 1 slice swiss cheese & 1 tablespoon mayo 1 cup baby carrots 1 small bag unsalted pretzels 1 cup skim milk | 3 cups salad w/ ½ cup black beans, mixed greens, cucumbers, carrots, onions & 1 tablespoon oil/vinegar dressing 1 whole wheat roll with 2 tsp margarine 1 pear 1 cup skim milk | 1 cup low sodium chicken noodle soup with carrots & celery 1 slice whole wheat bread w/ 2 tsp margarine 1 cup melon 1 cup skim milk | 2 small tacos with roasted poblano peppers & onions, lettuce, tomato, onion and 1 Tbs sour cream ½ cup corn ½ cup brown rice 1 cup skim milk | Egg salad sandwich with whole wheat bread 1 cup cucumber slices w/ 1 Tbs oil & vinegar dressing 1 apple 1 cup unsweetened iced green tea |
Dinner | 2 oz whole wheat pasta with cottage cheese sauce and roasted asparagus 1 cup arugula salad with walnuts, tomatoes & balsamic vinegar 1 cup sugar free lemonade | 2 cups Indian veggie curry made with cauliflower, green beans, onion, chicken and plain yogurt ½ cup brown basmati rice | 3 oz broiled tilapia w/ lemon 1 cup brown rice 1 cup green beans w/ 1 tsp margarine ½ cup sorbet 1 cup skim milk | 3 oz grilled chicken ½ cup green peas ½ cup egg pasta Romaine salad w/ 2 tsp oil & vinegar dressing 1 cup skim milk | 3 oz baked salmon 1 cup sautéed kale w/ garlic and 1 tsp olive oil and garlic ½ cup wild rice 1 whole wheat dinner roll w/ 1 tsp margarine ½ cup chocolate pudding 1 cup skim milk |
Snack | 1 orange | ¾ cup low-fat plain yogurt with ½ cup mixed berries | ¼ cup unsalted trail mix | ½ grapefruit | 2 cups low sodium popcorn |
Click here for a PDF of this meal plan.
Low Oxalate Snacks
Some great ideas for low oxalate snacks:
- Fruit! Fruit is the perfect snack as it is portable and most are already in the perfect portions. Grab an apple, orange, banana, plum, peach, bunch of grapes or a nectarine.
- We know how important dairy is for most people with kidney stones, so using a snack as an excuse to get in dairy is perfect! Mix plain yogurt with blueberries or your favorite fruit.
- Homemade trail mix. Make your own trail mix to make sure you are choosing low oxalate ingredients. Try combining dried apricots, dried cranberries, unsalted walnuts and unsalted sunflower seeds. You could even throw in a few M&Ms for an extra treat! Check out my low oxalate trail mix recipe.
- Low sodium crackers and fresh cheese. Try Hint of Salt Triscuits* (only 50mg per 6 crackers!) or Hint of Salt Wheat Thins* with fresh mozzarella.
- Popcorn made from kernels on the stovetop or with an air-popper. Microwave or pre-popped popcorn can be full of added sodium and fat. Making it at home allows control over these ingredients. Use just a pinch of salt or experiment using dried herbs and spices to flavor your popcorn. If you prefer commercial popcorn, Skinny Pop* is my favorite road trip snack!
- Low sodium pretzels. Try Snyder’s of Hanover Unsalted Mini Pretzels* (0 mg of sodium per 19 minis!)
- Raisins or other low oxalate dried fruit. Try dried apples, cranberries, strawberries, apricots, mango or peaches. Be careful of portion size here!
- Harvest Snaps* – these pea pods are made into a tasty, low sodium snack!
Other Oxalate Considerations
Vitamin C and Oxalate
Large doses of vitamin C may contribute to extra oxalate in urine. Oxalate is a byproduct of vitamin C metabolism. There are cases of very high vitamin C supplementation causing excessive amount of oxalate in urine and kidney damage8.
It would be difficult to ingest excess vitamin C from food, but very easy to do from supplements. Most multivitamins have at least 100% of your daily vitamin C. In addition, you might be getting vitamin C from supplemented orange juice, breakfast cereals, cough drops and supplements such as Emergen-C®. It adds up quickly!
As always, it is best to get vitamins and minerals from food instead of supplements. This is easy to do for vitamin C if you are eating the recommended 5 servings of fruits and vegetables per day. One orange or bell pepper has almost your entire day’s worth of vitamin C.
Probiotics and Oxalate
Did you know the bacteria in our intestines can impact oxalate too? Oxalobacter formigenes (O. formigenes) is a bacteria in our gastrointestinal tract and part of our microbiome. O. formigenes breaks down oxalate from food in our intestines.
Studies have shown that antibiotics can reduce the amount of O. formigenes in our intestines. Less of the bacteria can lead to higher absorption of oxalate and subsequent higher urine oxalate9. However, more research needs to be done to figure out if supplementing O. formigenes with a probiotic causes a decrease in urine oxalate. Probiotics are not a proven treatment for kidney stones at this time.
Summary
In summary, oxalate can be a tricky thing for people with kidney stones. Those with high urine oxalate should be careful to avoid foods very high in oxalate (spinach, almonds, beets and rhubarb). It is also very important to eat dairy with meals to block oxalate absorption and help with bone health.
For other resources about a low oxalate diet:
Check out information from The University of Chicago or Cleveland Clinic.
Peruse my low oxalate recipes.
Consider joining my Kidney Stone Facebook Community on Facebook.
Happy Eating!
Melanie
References
- Nakata PA. Advances in our understanding of calcium oxalate crystal formation and function in plants. Plant Sci. 2003;164(6):901-909. doi:10.1016/S0168-9452(03)00120-1
- Worcester EM, Coe FL. Nephrolithiasis. Prim Care Clin Off Pract. 2008;35(2):369-391. doi:10.1016/j.pop.2008.01.005
- Carbone LD, Hovey KM, Andrews CA, et al. Urinary Tract Stones and Osteoporosis: Findings From the Women’s Health Initiative. J Bone Miner Res Off J Am Soc Bone Miner Res. 2015;30(11):2096-2102. doi:10.1002/jbmr.2553
- Primary hyperoxaluria type 1 | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. https://rarediseases.info.nih.gov/diseases/2835/primary-hyperoxaluria-type-1. Accessed March 29, 2020.
- Home | Litholink. https://www.litholink.com/. Accessed March 29, 2020.
- Office of Dietary Supplements – Calcium. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/. Accessed March 29, 2020.
- Shi L, Arntfield SD, Nickerson M. Changes in levels of phytic acid, lectins and oxalates during soaking and cooking of Canadian pulses. Food Res Int. 2018;107:660-668. doi:10.1016/j.foodres.2018.02.056
- Lamarche J, Nair R, Peguero A, Courville C. Vitamin C-Induced Oxalate Nephropathy. International Journal of Nephrology. doi:https://doi.org/10.4061/2011/146927
- Siener R. The role of Oxalobacter formigenes in calcium oxalate stone disease. https://books.publisso.de/en/publisso_gold/publishing/books/overview/52/5. doi:10.5680/lhuii000001
Is there any keto sweeteners that are low oxalate?, is grassfed gelatin & grassfed collagen & bone broth low or high oxalate?.
Nearly all sweeteners, natural or artificial are low in oxalate.
Which keto natural sweetener do you think is the lowest in oxalate? & what about the grassfed gelatin & collagen & bone broth are they low in oxalate?.
Any animal food has essentially zero oxalate. Oxalate is only found in plant foods. So gelatin, collagen and bone broth would all have zero oxalate. Sugars also have zero oxalate. However, know that for stone prevention, the amount of added sugar or protein in some of these foods could be much more of an issue than oxalate!
Hi
Is this diet suitable for reoccurring utis?
I predominantly eat high oxalate foods and am coeliac. I do not eat dairy due to intolerance and I eat little meat but some fish. I am also a breast cancer survivor of 3 years and currently take anastrozole.
Thanks any help would be greatly appreciated
Claire
Hi Claire! I really can’t say what is best for you without a complete review of your medical history, labs and current eating habits. I can say that nutrition for UTIs is completely different than kidney stones. I’d highly recommend working with a dietitian to know what is best for you!
In 2021 I had kidney stones removed. Left side 1 calcium oxalate 8mm. Right side staghorn 4cm it filled the entire inside. After my 24 hour urine test he put me on a no-oxalate and no- dairy diet. Not low but “no”. He said Not to worry about bone loss because that happened years ago. If Dairy and oxalates bind together to form stones how do they also bind together to remove oxalates? I’m not sure what staghorn stones are made of, but one calcium oxalate stone in seven years does that warrant this strict of a diet?
Oh gosh! Bone loss should be of high priority for ANY woman – especially one with a history of kidney stones. This article might explain the dairy question a bit more. In terms of such a strict diet – only a current 24 hour urine test would tell you. This test would give you tons of info about how likely you are to make stones again, as well as what changes you could make to mitigate that risk!
I have to tell you that I am a pediatric nurse practitioner working in nephrology and specializing in stone prevention and WOW you are right on with ALL of your information. It is so rare that I find a resource that is 100% accurate, and it felt like I was reading something I wrote myself! You say literally EVERYTHING that I tell my patients in clinic! I will be using you as a resource for my patients!! Thank you for this amazing blog post!
Oh my goodness! Thank you SO very much for your kind words. It is always good to meet other healthcare professionals working with stone patients. Glad you found my site!
I had high oxalates show up in an OAT test. I have never had kidney stones. I am also gluten free, dairy free and low sugar. How important is the oxalate issue if I’ve never had kidney stones. It is very difficult to figure out what to eat with the oxalate issue on top of the everything else, what do you suggest I do?
I wouldn’t be at all concerned about high oxalate on an OAT test. This test will essentially show up “high” if you eat a lot of oxalate (which is usually an indicator of a very healthy diet!). There is really very little science to back up OAT tests in general. Of course, ask your doctor or dietitian what is best for you.
Very helpful site on kidney stones. There are lots of confusing information online. The best part is the meal plan and amounts of servings to take.
Hi Melanie! I have to do a low salt diet less than 2 gms daily. Dairy 1-2 servings daily. Low carb less than 60 g. daily, low sodium less than 1.5 g daily and low oxalate diet. I’m so frustrated. Can you help me put a meal plan together?
Hi Vicki! Helping people understand what they can eat with kidney stones is exactly what I do in Kidney Stone Nutrition School! Here is the link to learn more.
Hi Melanie,
I am Rachel and i am 55 years old. I have problems with my kidneys since i was 20 years old. Only my left kidney is functional. The last six years i create oxalate stones in the left kidney, although i follow a distinct diet, low in oxalate. I would like to ask you what more can i do in order to provide the creation of that stones. Also, I want to ask you if i can eat whole grain products and nuts such as walnuts, because the food list I follow doesn’t include them.
Hi Rachel! I’m sorry to her about your history with kidney problems! There really is no single diet for oxalate stones, and nutrition really needs to be personalized to your urine test results. So, I really can’t safely say what is best for YOU! I do think that my articles about who needs a low oxalate diet, why you might keep getting stones on a low oxalate diet, low oxalate bread and low oxalate nuts might be helpful! You can also find my oxalate list with a guide for use at my resources page. If you would like to dive into what you can really do to stop stones for YOU, I’d check out Kidney Stone Nutrition School!
I have passed many small kidney stones back in 2019 without any problem. Then this year I wound up at urgent care in pain thinking it was a UTI. After almost 8 hours and many tests they discovered I had 3 large stones in my utterer and a 10mm one in my kidney. I had emergency surgery 5 months ago and have started looking into what calcium oxalates are. I also have assorted other health issues, but I’ve lost over 100 pounds this past year which has helped with those problems. It’s still rather frustrating trying to juggle all the different things. I’m off insulin now and watching any sugar intake, so I thought I was doing well with using Stevia. Then I found things like Monk Fruit and the myriad of other sweeteners while looking into Keto diets.
What I’d like to know is if you would be kind enough to share your sources for the low oxalates in processed Stevia. Just as with many others, I have been unable to locate an answer except from your site.
Thank you in advance for any info/answers you can provide.
Sincerely,
Denise
Hi Denise! Stevia (the plant) does have a lot of oxalate, but the oxalate is removed in processing. So, Stevia (the sweetener) is not high in oxalate. Since you mentioned a keto diet, I thought I’d point you to this article. Oxalate may not be the cause of your stones if you’ve been dabbling with a keto diet!
What do you do if you have high oxalate in your urine and have high calcium in Urine but you also have osteoporosis and you need to have calcium and if oxalate can be reduced by eating calcium with oxalate food don’t you lose the benefit of having calcium so how do you get the calcium but reduced to oxalate
Hi Kerri! Great question. High urine calcium is NOT a reason to limit how much calcium you eat – in fact, this is a reason to make sure you are getting enough calcium! Counterintuitive, I know, but you identified the 2 reasons why: bone protection and helping block oxalate absorption to reduce urine oxalate. This article dives into calcium a bit more. I think you also might be interested in my article about interpreting those 24 hour urine test results!
Are black olives allowed with a calcium based stone?
I would just be mindful of the sodium in them!
My question is if I’m not supposed to eat wheat, or cornmeal what can I eat? I was so excited to find low sodium Fritos, but now I’m wondering should I eat them?
Hi Gwyn! Nutrition for kidney stones is very different for everyone – based on the type of stone you have and your urine risk factors. If you really want to dive into what healthy eating looks like for YOU, I’d recommend checking out my course, or my kidney stone guide!
Your article was very informative! My concern is not kidney stones but adequate calcium intake from food. Since oxalates bind to calcium is it correct to assume that any calcium consumed with a high oxalate food should not be counted toward the 1200 mg of calcium per day recommended for me (ie a glass of milk with chocolate cake means the calcium in the milk doesn’t count as calcium intake)? Also do you have any info on the amount of calcium bound by the oxalates? For instance, does it only take 4oz of milk to bind the oxalates in choc cake so if I drink 8 oz with my cake I get to count 4 oz as calcium intake?
Hi Marion! Thank you for your message. All calcium counts towards that 1,000-1,200mg daily goal. It doesn’t matter if it is consumed with a high oxalate food (some of it still gets absorbed – NOBODY absorbs all of the calcium we eat anyway, so the recommendation takes this into account). The research isn’t advanced enough for me to say “x” amount of oxalate with bind with “x” amount of calcium. Instead, we encourage people consume 3 servings of high calcium foods per day, ideally 1 with each meal to help lower urine oxalate amounts. This article discusses this more. I hope that helps!
Hi. Interesting, albeit disappointing article for someone with an allergy to dairy. For other reasons I avoid fortified non dairy beverages. Can I take a powdered calcium citrate supplement, dissolved in water with my meals instead? If so, how many milligrams of calcium per meal? I believe a serving of dairy, say a cup of yogurt, has about 300+ milligrams of calcium. And a related question is, when should I take my vitamin D and K supplement? With meals, or away from meals. I would not want to increase oxalate absorption. Thank you.
Hi Liz! As a general rule, calcium supplements should be avoided for people with calcium stones. I can’t safely or legally say what is best for you in terms of taking any supplement without a complete review of your medical history and current eating habits. This article about calcium gives you lots of good information.
Thank you for compiling all this detailed information regarding oxalates. As a calcium oxalate stone producer, I’m not totally convinced though that the 2 Stevia packets, used to sweeten my morning coffee, are low in oxalates. Everything I’ve read (which may be inaccurate) indicates it is quite high. As a pre-diabetic, I am also concerned about using regular sugars and I prefer not to use chemical sweeteners. Can you please address this concern? Thanks very much!
Hi Eric! Thank you for your comment! Stevia (the plant) is high is oxalate, but the oxalate is lost in processing. So, Stevia (the sweetener) is fine. When it comes to using the “real thing” for sugar, I usually advise that is completely fine, as long as you don’t use a ton. The AHA recommends no more than 25g of added sugar for women (38g for men) per day, so this absolutely allows for a little actual sugar if you prefer. It’s really a personal preference!
We have been told that chocolate is very high in oxalate, is it ok to have the occasional piece of chocolate or chocolate cake (birthday cake). When my husband was first put on the low oxalate diet by an internist, there was definite do’s and don’ts, and somethings in moderation.
Doing some of our own research we have found so much conflicting information about avoiding kidney stones and diet. As a family we are figuring the diet out, so we are not having to make separate meals. He does track is oxalate content just so he can keep a handle on it for his own piece of mind. He has a 24 hour urine collection coming up so he wants to have good results.
Thanks for your information.
Hi Crystal! Yes, unfortunately there is SO much conflicting (and, inaccurate!) information out there about kidney stones and nutrition. I hope you’ve found this site helpful. Truly everyone is different in terms of what they “can” and “can’t” eat for kidney stone prevention. Even if your husband’s urine oxalate is high, it is 100% okay to enjoy a small piece of chocolate occasionally. Just make sure to have a glass of milk with that cake! If you haven’t already, make sure to check out this article for a more comprehensive overview of how nutrition can impact kidney stone risk. Good luck on the urine test!
Hi. Love your website. It’s very informative and fun! I’m wondering…I have had kidney stones and restrict high oxalate foods. However, I am allergic to dairy products…I can’t have them in any form. I’m also vegan. My only options have been calcium-fortified plant milk etc. Have you advised others in this situation? So many mixed messages from doctors and the forums online so..I hope you don’t mind me asking. Thanks again for your website. Keep up the good work!
Hi Jay! Thank you so much for your comment! It made my day to know my site is helping people out there!
Yes, I’ve certainly worked with many people who have issues tolerating dairy. If we can’t do any dairy at all, I usually recommend fortified oat, rice or coconut milk. I’d stay away from soy or almond due to concern for possibly high oxalate amounts. Hope that helps!
Hello, What can I replace stevia with regarding my 1 cup of coffee. Also tea what kind.
Fish?
Thanks so much
Wendy Lomassaro
Hi Wendy! Although Stevia (the plant) is high in oxalate, the oxalate does not transfer to the sweetener. So, you can use Stevia! Green or herbal teas are good replacements for black if you are concerned about the oxalate amounts. Any kind of fish would be low in oxalate. Salmon, tuna and mackerel are especially heart healthy choices!
Hello, I am confused about the use of Stevia. In the charts Stevia is listed as 42 mg per packet. I want to use a liquid drink flavor enhancer and most brands contain Stevia. I appreciate any info to help me limit my oxolate intake.
Hi Michelle! Stevia (the plant) is high in oxalate. However, the oxalate is considered by most to be lost in processing. Stevia (the sweetener) is low in oxalate.
Hey Melanie- enjoying the information you provide – there is so much conflicting info out there.
I had a kidney stones about 6 yrs ago and ended up in hospital – just in time to pass it with a little help from meds. Year later another one and was able to “catch” enough of it to find out I had calcium oxalate stones. I was on a calcium supplement at the time for osteopenia- so I quit taking it. 6 years later back at doc with kidney infection and have two more stones- did another “catch “ and now have high oxalates. I did that collection while taking antibiotics for the infection. Have since heard that the infection could have made my oxalate a high. So repeated the collection about 2 months later after watching my oxalates . That time my oxalates were fine, but magnesium was also low- their recommendations was to eat certain items – but they are high in oxalates! My urine citrate was also low both of the last two times. I am allergic to milk but seem to tolerate cheese and yogurt so eat that with most meals and snacks. Lab recommended something for my low citrate but doc didn’t order anything as really didn’t mention it. Plan is to do another collection in about a month. Very confused on what my issue really is! For the last two years have really watched the carbs and added sugar – yet still stones!! Recommendations?
Hi Brenda! I’m so glad you’ve found my site helpful! It certainly sounds like you’ve had quite an unwelcome history with stones 🙁 I’d love to work with you to help put together the magnesium, oxalate, citrate and other seemingly contradictory advice (or lack thereof!) you’ve been given and really get to the bottom of that 24 hour urine test. The best way to work with me is via my online course – you can learn more about it here!
Hi, I have two questions, a 2 cup portion of popcorn is popped or un-popped?
Also, what is the oxalate content of 1 cup of cooked oatmeal?
Thank you so much; glad to find your website!
Hi Jackie! I’m happy you found me as well! That is a popped popcorn portion size. 1 cup of cooked oatmeal would only have about 4mg of oxalate. Oatmeal is a GREAT way to get in whole grains and fiber!
Hi Melanie,
What about uncooked oatmeal? I like to make overnight oats in a decent sized batch and eat that for breakfast a few days in a row. Adding fruit and some nuts…so yummy!
Thanks!!
Hi Cheryl,
That sounds delicious! And, a great way to get in some calcium too! If your urine oxalate is high, do make sure to check out my low oxalate nut options too!
If soda is low oxalate, why did my doctor tell me to stop drinking Coke? Is root beer or black cherry soda better?
Hi Robert! Thank you for your comments. A healthy diet for calcium stones is SO much more than low oxalate (in fact, for most people, that is the least important part!). The biggest concern about soda from a kidney stone perspective is that lots of added sugar can increase urine calcium (the biggest driver of kidney stones for most people). All regular sodas are going to have this issue. In addition, all the added sugar in cola can contribute to heart disease and other nasty things. I recommend avoiding it. If you really love it, enjoy a can once in awhile!
You are awesome! So thorough, so detailed, so organized, explaining every point you make. You are so generous with the information you share. You provide complete information with clarification.
This report is the best most complete I have ever read. Food portions listed; Sample meals listed;
cookbook recipes offered! Amazing!
Thank you!!!
Hello Stella. Thank you so very much for your kind words! I am so glad you fond this information helpful!