An exciting new article was published in the Journal of Renal Nutrition this month. Yes, I know I am a nerd – who else gets excited about scientific research papers?
This article is so exciting because it finally gives us an accurate amount of oxalate in coconut milk and other common plant based milks! Read on to learn about coconut milk in a healthy diet for kidney stones and finally get clarity about oxalate differences in plant based milks!
*Please note that this post contains clearly identified affiliate links. As an Amazon affiliate, I may earn a small commission on qualifying purchases (at no extra cost to you).
Table of Contents
Popularity of Plant Based Milks
No doubt about it, plant based milks are popular. Sales of plant based milks reached $20 billion in 2020, a 20% increase from 2019. Plant based cheese and yogurt sales are also going up quite a bit. (1)
People report choosing plant-based milks due to perceived higher sustainability, animal welfare concerns, and generally trying to eat fewer animal products (2) (3) Almond milk tends to be the most popular plant-based milk, but coconut milk sales have also grown about 5% since 2016. (4)
How do these plant based milks stack up for kidney stone prevention?
Why Drink Coconut Milk for Kidney Stones?
Good Source of Calcium
The most important reason plant-based milks are good for kidney stone prevention is that they are a good source of calcium.
Eating (or drinking!) enough calcium is very important for people who have calcium kidney stones. Eating enough calcium has been shown to lower the risk of calcium oxalate kidney stones by about 50%. (3) Eating enough calcium can help reduce oxalate absorption, and is important for bone health! (4)
Generally, people with kidney stones should consume 1,000-1,200mg of calcium per day. (4)
One cup of So Delicious Unsweetened coconut milk* has about 100mg of calcium. Calcium will vary by brand of coconut milk.
Alternative for Dairy Intolerance
Although dairy is a wonderful source of calcium for kidney stones, not everyone can tolerate dairy. Or, you may avoid dairy for cultural reasons.
Coconut milk can also be a fun way to add variety to your calcium routine. Plain old cow’s milk can get boring!
Coconut Milk is Delicious!
If you are a coconut lover (as I am!), you’ll absolutely love the flavor of coconut milk! Coconut milk is delicious all by itself. Or, a great way to add calcium to oatmeal, cereal or other recipes that traditionally use cow’s milk.
Cow’s Milk vs. Coconut Milk
Plain old fashioned cow’s milk is a healthy source of calcium and is usually the first recommendation for calcium stone formers. Of note, dairy has not been shown to cause inflammation in rigorous scientific studies. In fact, dairy has been shown to be anti-inflammatory in some cases. (5)(6)(7)(8)
However, some people cannot tolerate cow’s milk. Or, choose plant-based milk for cultural reasons.
Both cow’s milk and coconut milk are very low in oxalate. Cow’s milk tends to have much more calcium, potassium and sodium. Coconut milk tends to have more fat compared to low-fat or skim milk. Fat content is similar between coconut and whole milk.
Oxalate & Kidney Stones
Why do we care about oxalate and kidney stones? Calcium oxalate stones are the most common type of kidney stone. They account for about 80% of kidney stones in the United States. (4) For some people, limiting the amount of oxalate can help lower urine oxalate and may reduce the risk of forming kidney stones.
Not everyone with kidney stones needs to limit oxalate. Learn more about who needs a low oxalate diet.
Oxalate in Coconut Milk
Researchers found that coconut milk had such little oxalate in it, it couldn’t be picked up by the analyzer!
For our purposes, the oxalate in coconut milk is 0 milligrams. (9) If you need to limit how much oxalate you eat, coconut milk is a great choice!
Oxalate in Dairy Free Coconut Yogurt
Because coconut milk is oxalate free, other dairy substitutes made with coconut milk are also great low oxalate options!
I love So Delicious Coconut Yogurt*. This yogurt has twice the amount of calcium (200mg) as coconut milk. To keep added sugar in check, I recommend going with plain yogurt and adding some sweetness and flavor with fruit. Blueberries, peaches and strawberries are my favorite additions.
Other Dairy Substitutes for Oxalate Kidney Stones
If you don’t love coconut milk, there are definitely other plant-based options for you! Here are how other popular plant-based milks stack up.
Almond Milk
Almond milk is very high in oxalate. One cup (8 fluid ounces) of almond milk has 27mg of oxalate. Almond milk had the most oxalate of any plant-based milk. (9)
Flax Milk
Flax milk also has 0mg of oxalate. (9) One of the more popular brands is Good Karma Unsweetened Flaxmilk*.
Oat Milk
Oat milk was another low oxalate option, at only 4mg oxalate per cup. (9) Oat milk is known for being an especially creamy plant-based milk option! It also tends to be higher in calcium than other plant-based milks. Oatly Oatmilk* is a good one to try!
Oxalate in Other Plant Based Milks
Here is a complete list of all the plant-based milks that were tested for oxalate. You can compare the amount of calcium, potassium, phosphorus and sodium as well to help you find the best plant-based milk for you!
| Plant Based Milk | Oxalate (mg)* | Calcium (mg) | Potassium (mg) | Sodium (mg) | Phosphorus Additives** |
|---|---|---|---|---|---|
| Almond Milk (Silk Original) | 27 | 300 | 0 | 150 | No |
| Cashew Milk (Forager Unsweetened) | 17 | 20 | 94 | 10 | No |
| Coconut Milk (So Delicious Unsweetened) | 0 | 100 | 0 | 25 | Yes |
| Flax Milk (Good Karma Unsweetened) | 0 | 250 | 20 | 190 | Yes |
| Hazelnut Milk (Pacific Foods Original) | 11 | 100 | NS | 115 | Yes |
| Hemp Milk (Pacific Foods Unsweetened) | 5 | 200 | 145 | 130 | Yes |
| Macadamia Milk (Milkadamia Unsweetened) | 1 | 350 | 10 | 115 | Yes |
| Oat Milk (Oatly Original) | 4 | 250 | 390 | 100 | Yes |
| Rice Milk (Rice Dream Enriched) | 1 | 300 | NS | 100 | Yes |
| Soy Milk (Silk Original) | 10 | 300 | 390 | 90 | Yes |
| Cow's Milk (Skim) | 1 | 300 | 410 | 130 | No |
| Nutrition information based on 1 cup portion size. *Oxalate Information obtained from Borin et al. Plant Based Milk Alternatives and Risk Factors for Kidney Stones and Chronic Kidney Disease. J Ren Nutr. 2021:S1015-2276(21)00093-5 . **Phosphorus additives should be avoided for people with kidney disease . |
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Happy Eating!
Melanie
Thanks for all the valuable insights on how to avoid more kidney stones. I drink 2% dairy milk and flax milk. My question is whether or not the New Chapter Plant Calcium “Bone Strength” supplements (formulated for absorption) are a good idea for kidney stone formers? If we need food-based sources of calcium, my hope is that the calcium from organic algae would help and not hurt? Thank you!
I can’t say for sure without knowing more about your medical history and urine test – but I’d be skeptical of any calcium supplement. Even this “natural” supplement.
Hi! Thank you for amazing info! My bladder reacts with pain to high oxalate foods and I was recommended the 24-hour urine test to find out whether I generally have high levels of oxalate and am potentially at risk for stones. Because of pain I’m already lowering my oxalates for the past 3 weeks – will this disrupt the test? I’m worried it will show normal results and I’ll never know what’s actually going on 🙈 should I eat more oxalate foods 2-3 days before and during test to see how my body processes it in urine? That will require bearing with the pain though… thank you in advance!!!
I’d probably just eat your current regular diet – but ask your doctor to make sure!
Hi! My Urol printed and gave me your food list today so found your website and spent hrs reading – thank you! The plant milk comparison is great. I tried pistachio milk to replace years of almond milk drinking. After reading, I just bought whole milk lactose free since cow milk hurts my stomach. I’m gonna give that a try and introduce some amount of dairy with each meal! Dr didn’t seem the 24hr test was necessary but glad I asked for it. Lemons/not lemons – gotta know which is best and until I get results not sure how else to know. Anyway, after reading the comments I wonder how many times you have or will say “cow dairy is best”! Ha. I heard you sister!!! Hope I never have another stone!!! 🙏❤️
Hi Cindi! So good to meet you! I’m SO glad you’ve been enjoying my content and learning. Thanks to your doctor for sharing my stuff 🙂 Just in case you didn’t see it, I had a class today I think you might like. Here is a link to get a recording (it’s free!).
Is goat’s milk a good source of calcium? I do have peripheral artery disease in my right leg and I am concerned with saturated fats.
I also had a high urine calcium oxalate on a recent test and vaginal burning. I figure the burning was from the oxalate crystals. I also experienced facial burning and a rash on my leg at the same time. Again, I figure this was from high oxalates. I have eaten chia seed, spinach, dark chocolate, quinoa, sweet potatoes, raspberries, etc in abundance for several years.
Yep! Goat cheese is a great source of calcium. There is no research to show that oxalate could contribute to burning or rashes.
There are several calcium supplements added to non-dairy milks. The most popular one is calcium carbonate but I have also seen tricalcium phosphate (I think that is the correct one). I wonder about consuming the calcium carbonate because it is also an antacid. Do you recommend one over the other or does it not matter?
Honestly, from a kidney stone standpoint it doesn’t matter. If you have kidney disease, I would avoid any ingredients that include phosphate. Depends!
I don’t have kidney disease but I have osteoporosis. I’m trying to avoid oxalates because they are considered “anti nutrients” and from my understanding they block calcium absorption or at least prevents the body from utilizing the calcium. That probably is why people get kidney stones because the calcium is excreted in the urine. My question is how does one get enough Calcium in their diet if they can’t tolerate milk products? Thank you
Hi Claudia- People with osteoporosis REALLY do not need to limit oxalate. Yes, they do somewhat reduce calcium absorption. But our bodies only absorb around 30% of the calcium we eat anyway. Oxalate is definitely not going to reduce bioavailable calcium enough to limit how much gets into your body. There is also not a single study to show that a low oxalate diet helps bone health – or that people who eat a lot of oxalate have bone issues. I hope this helps simplify things for you!
This article about calcium sources might help!
Thanks for this article! Very helpful! However, I think the distinction needs to be made between coconut beverage and coconut milk. Coconut beverage is what’s discussed in this article, it comes in a carton. Coconut milk comes in a can and needs to be shaken vigorously to distribute the thick layer of coconut fat that accumulates on top. This is not what most people drink, it’s used in cooking. There’s a lot of saturated fat in the canned coconut milk.
Good point!
Melanie – Thank you for another great and informative article. It sounds like you support the use of Coconut Milk as a good source of calcium. My concern is that coconut milk is very high in fat. I have a heart condition (arterial sclerosis) which causes me to minimize fat intake. I have had a 24 hour urine test and have high oxalate level (and calcium oxalate stones). Although coconut milk may be good for kidney stones, wouldn’t the fat level make it a poor choice for someone like me with a heart condition?
Thank you VERY MUCH.
David
Hi David! I’m glad this was helpful to you. I agree coconut milk is likely not the best option for you. I always recommend dairy for calcium stone formers first (whenever possible). You can choose fat-free or low-fat options!
Thank you for all your information about kidney stones. My 24 Hr. Urine showed High
SUP24, HYDROXYAPATITE CRYSTAL 6.69 DG
Reference Mean= 3.62 DG H
My stone analysis was 60% calcium phosphate (apatite), 20% calcium oxalate dihydrate, 20% calcium oxalate monohydrate. Dr. tells me that my stone is not the normal type most people have. That being said, I was using lemon juice in my water (I drink over 100 oz/day), and I’ve heard ACV is also good for kidney stones. My Dr. said not to use lemon because it is high is citric acid which I don’t want. What is your advise on this type of kidney stone. I have stopped calcium supplements, but I do drink unsweetened coconut milk, and use plant protein powder to boost calcium and protein. Is plant protein powder or whey better for kidneys with my type of stone. Which is processed better, or does it make a difference? My Dr is not a dietitian and doesn’t know answers to these types of questions. Thank you for any help you can give me.
Hi Vicki! This type of stone is just a specific type of calcium phosphate. And yes, this is not the most common type of stone. The concern with lemon juice for SOME with calcium phosphate stones is it could raise urine pH, which is not ideal for CaP stones – despite the benefits of citrate for all calcium stones. There is really lacking data on apple cider vinegar and stones. I’d love to help you figure out what is best for you! ALL of my answers would depend on your 24-hour urine test results. There is no one “diet” for calcium phosphate stones (or, any type of stone, for that matter!). Nutrition is completely different for each person depending on those urine test results. I help people figure all of this out in Kidney Stone Nutrition School!
Hi Melanie,
If my 24 hr urine oxalate was normal and I have a single 4 mm renal stone, can I have almond milk ? Is walnut milk lower in oxalates ( it’s not on your list).
Thanks
There is really no reason to limit dietary oxalate unless that urine oxalate is high. You can learn more about oxalate and nuts here! I can’t specifically say what is best for you without working with you more directly – but hopefully these resources help!
how much Oxalate in Ripple milk made from peas?
I can’t know for sure! Green peas are generally on the lower oxalate side, so this milk would likely be lower as well!
I like Ripple and asked them about its oxalate content. Here is what they said, “We’re unable to detect the level of oxalates in Ripple, but calculate that the absolute maximum that could possibly be there is about 0.04 mg per 8 oz serving. The real number is likely much less.”
If the coconut milk we use has “calcium carbonate” instead of “calcium phosphate” (what the So Delicious brand has), does it have the same affect as a calcium supplement, or is it still okay to consume?
All plant based milks are fortified with calcium, as they are not naturally high in calcium. I do have concern that using any plant based milk (regardless of the type of calcium type) is more like taking a calcium supplement compared to “natural” calcium – but we truly don’t have research to know if it is! I touch more on this in this article!
Thinking about it… At this point my stone was found to be < 1 mm via a CT scan. As of 5 days ago it was still near the outer part of the kidney. Currently, I'm drinking water like crazy (some with added TRUELemon powder for its citric acid), stopped my 500 mg vitamin C supplement, and limiting spinach and almonds. As a vegan, I already think I'm not getting *enough* protein, but it's usually 70 – 85 gm per day. My PCP Dr. was hemming and hawing about the usefulness of getting a 24 hour urine test, but if this stone doesn't pass in another week or two I'm going to ask to be sent to a urologist and convince him to do it.
Hi John! I hope your stone passes quickly! That urine test is ALL about preventing future stones. It won’t really help pass current stones. I have a list of talking points and more info about why that 24 hour urine test is so important. It is recommended in the official guidelines for the medical management of kidney stones. I’m not sure why doctor’s have such a hard time with it!
Yes, I ‘ve already read your very useful “talking points” doc. Hopefully my urologist is more inclined to “letting” me getting the test (though you’d hope s/he would also think it useful for their own treatment prescribing purposes!). And I do realize that getting the test now won’t help my current stone situation, but can I assume that if the urine test shows low levels of oxalate that I *don’t* have to limit my consumption of high oxalate foods? If so, it would be really nice to know that as soon as possible to avoid needlessly complicating my diet!
One more question for you: if it’s true that consuming calcium with food will bind the oxalate (or at least some of it) and prevent it from forming stones, why doesn’t the natural calcium in, say spinach, do that? Is it just not enough calcium? But if so, then why wouldn’t drinking a big glass of cow’s milk with a cup of spinach make it much safer to eat spinach?
– John
PS – best of luck with your impending twins!
Great! Glad you already had that resource. In general yes, if your urine oxalate is low or normal, avoiding oxalate will not prevent stones for you. This is part of the reason why I’m so passionate about that test – SO many people are overcomplicating and over-restricting their diet. This incessant focus on oxalate not only adds undue stress, it usually results in an overall LESS healthful eating pattern!
I could spend a lot of time on your second question, but in short, the answer is that calcium in these plant sources is just MINIMAL compared to the amount in dairy. And yes, a big glass of milk would make spinach safer to eat for most people – but I really can’t say what is safe for you without working more closely with you and knowing more about your stone and nutrition history!
Understood. Thanks for you site and your replies. Very helpful.
Hi. This site is a cornucopia of info about kidney stones, that’s for sure. There’s almost TOO much stuff here, so much so that I find myself going off on long tangential links and forgetting where I was to begin with! 🙂
I have a question about calcium supplements and why they would increase the risk of kidney stones as opposed to calcium in food. Do you consider the calcium that is added to most plant milks to be a supplement or “natural”. I ask because, for example, the link to Silk soy milk has calcium carbonate added to boost the calcium to a level equivalent to cow milk. If that’s ok, why wouldn’t using pure soy milk (unsweetened, nothing added but water) combined with a calcium carbonate supplement also be ok? Especially if consumed at the same time. I’m a heavy user of Trader Joe’s unsweetened organic soy milk, but also use a cal-mag-zinc supplement to get my calcium.
My interest here is not merely academic: I was recently found to have my first small kidney stone at the ripe old age of 58. Yes, I know soy in its various forms seems to have a lot of oxalate (though the references are conflicting), but do I really have to be concerned about where my calcium comes from too?
– John
Haha. Thank you, John! I’ll take your first comment as a compliment 🙂
Great questions about supplemental calcium in foods. We are concerned about calcium supplements because we know that calcium supplements increase urine calcium much more than calcium from actual foods. There are NO studies that compare supplemented food products with actual “natural” calcium or calcium supplements. This is why I always recommend actual “natural” sources first, as I do have concerns that these supplemented foods are more like taking a pill than drinking a glass of milk. However, my fear of a NO or low calcium diet for calcium stone formers outweighs these concerns – and so many people avoid dairy for a plethora of reasons. Ultimately, the answer of what is best for you would lie in your urine test results and a good analysis of your current eating habits!
Thanks for the quick reply! It’s too bad the studies haven’t been done yet, but in the meantime, I think the sensible thing for a vegan to do to make sure of getting enough calcium in addition to decreasing the chance of kidney stones is to simply add a calcium citrate / magnesium citrate powder (such as this one from NOW Supplements – https://www.amazon.com/gp/product/B000) to a healthy smoothie or drink of choice, whether that’s lemon juice, green or white tea, or any of the various plant milks (those with zero added ingredients on their own!). From my limited research, the citrate forms of both calcium and magnesium are well absorbed, and the powdered forms of them would seem to be most likely to be able to bind in the stomach with the oxalate content of whatever they are eaten with at the same time. Plus, I assume it would provide citrate as well, which is also good for kidney stones! And I suppose you could even add potassium citrate powder as well for even more protection from kidney stones. Is my logic sound?
Honestly, this completely depends on your 24 hour urine test results. Your protein intake, urine citrate, urine calcium, urine and serum magnesium and many other factors would come into play. If you would like to work more with me to figure all of this out, please check out Kidney Stone Nutrition School!
I am diabetic, have acid reflux, lactose intolerance, high oxalates, and CKD ( creatinine 1.35). I have been using Oat milk unsweetened Vanilla which has 350 mg of calcium. It also has 390 mg of potassium. I put the milk in my cereal almost every morning and drink. a glass whenever i happen to eat potatoes. Should i consider an alternative to this milk because of the potassium?
Hi Ed! Your potassium question really depends on your labs. This article about potassium might be helpful to you!
I use Ripple milk made with pea protein as I’m diabetic and some coconut milk products have too much sugar for me. It has a lot of calcium too.
I love your joyful attitude too! 😀 I love coconut & flax milk alternatives, & coconut milk yogurt too — truly sooo delicious! Also am getting into probiotic dairy yogurt… it’s the only dairy I’m doing right now — not cheese cuz it’s high in sodium, and cow milk doesn’t make my digestion very happy. 😀 FYI, I’ve read that blueberries & strawberries are quite oxalate-y? I’m not 100% sure though, plus in low portions oxalate is always reduce, right? How do they even measure oxalates?? So many online charts don’t even agree about if some things are low/medium/or high oxalates… so confusing! I wish they’d start listing official verified oxalate counts on Nutrition Fact labels! :O I’m rereading a book I found a the library called “No More Kidney Stones” (revised/expanded) by some doctor experts in the kidney/urology field… it helps guide my meal plan adjustment (including WAY more water than I used to drink… hey anything to avoid future kidney stone pain! Am I right or am I right! haha). And I wasn’t even TRYING to lose weight, but my effort to reduce sodium/sugar/processed foods/portions etc. just made it happen naturally! 😉 There are so many fresh yummy foods I can still eat — I wasn’t giving them a chance before the whole kidney stone thing set me straight. 😀
Thank you Michelle! You are very right that there are a TON of conflicting oxalate lists out there. Apparently the way they used to measure oxalate was inaccurate, and QUITE a bit of this bad info is still floating around – even from highly reputable sources. Blueberries and strawberries are actually quite low in oxalate. I also ALWAYS like to point people to this article, because I find that most people are massively overdoing a low oxalate diet, and many people don’t even need a low oxalate diet. Unfortunately, generic “kidney stone diet” information is given out so frequently, and nutrition for kidney stones really has to be personalized to each person!
Do you what the ratio of calcium-oxalates stones are? Are they 1 part calcium for 1 part oxalate? Or is there more of one than the other?
Hi Chandler! This is different for different stones. Getting your stone analyzed is really the only way to know this.
Thank you for all this information. I make my own coconut milk using shredded coconut and water. Will this also contain a similar amount of calcium?
Also, I make my own yogurt with organic oats, full fat coconut cream and flax seeds. I know that without testing, the amount of calcium is impossible to gage, but I would think that it would provide enough to make it worth making.
I avoid processed foods due to added sugars and unnatural ingredients that they contain.
Unfortunately, all milk substitutes are only high in calcium because they are supplemented. So, homemade versions wouldn’t be a good source of calcium.
Isn’t calcium carbonate the source they use? I’ve read multiple times that this is the worst form of calcium to take.
They use different forms of calcium to supplement plant based dairy replacements. And yes, calcium in supplemental form is not ideal. This is why I recommend dairy first! Natural calcium doesn’t seem to raise urine calcium as much as supplements. However, many people avoid dairy for cultural reasons or intolerance. These dairy subs are our next best option. Some calcium is CERTAINLY better than no calcium!
Thought coconut milk high in potassium. As listed in a other comment/ chart on this blog.
Hi Carol! Coconut milk is actually much lower in potassium than cow’s milk. The exact amount is going to differ based on brand and type. I think this article is the one you are referring to – this analysis found only 90mg potassium in coconut milk compared to 342mg in cow’s milk!