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!
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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 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 also has 0mg of oxalate. (9) One of the more popular brands is Good Karma Unsweetened Flaxmilk*.
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 .
24 thoughts on “Oxalate in Coconut Milk & Other Plant Based Milks”
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?
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?
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!