Are you struggling to find healthy and tasty low oxalate recipes? Look no further! This article provides a comprehensive guide to kidney stone diet recipes, focusing on low oxalate options and other essential dietary considerations for kidney stone prevention.
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Understanding Oxalate and Kidney Stones
Before diving into low oxalate recipes, it's crucial to understand who needs them. Oxalate is most known for its role in kidney stones. However, only people who have high levels of urine oxalate need to limit how much oxalate they eat. If you have uric acid, calcium phosphate, or other kinds of kidney stones, cutting out oxalate from your diet will not reduce your risk for kidney stones. If you have calcium oxalate kidney stones and high levels of urine oxalate, it is important to follow a low oxalate diet.
A low oxalate diet does not require 100% avoidance of oxalate. For most people, limiting oxalate to around 100-200mg per day (while getting in enough calcium) is sufficient to lower urine oxalate to safe levels. You may notice that these low oxalate recipes do not necessarily completely avoid “high” oxalate foods. Rather, the recipes might have small amounts of some higher oxalate foods. These recipes can easily be incorporated into a diet that limits oxalate to 100-200mg per day.
There are many low oxalate food lists floating around the internet. Unfortunately, many of them are inaccurate. The Harvard oxalate list is considered to be one of the most accurate oxalate lists.
Read also: Managing Stage 3 Kidney Disease with Diet
Beyond Oxalate: A Holistic Approach to Kidney Stone Prevention
Healthy eating for calcium oxalate kidney stone prevention is much more than oxalate. How much calcium, protein, and added sugar you eat all play a role. And, of course, we can’t forget water. A diet correct for the first five components corresponds with present day healthy diet recommendations for all people in the US. Everyone should eat it.
The featured picture shows a new collection of recipes by Melanie Betz that address, excluding fluids, all components of the kidney stone diet. It is well enough to tell patients what a correct diet contains, but quite another to give recipes for actual foods that do the work of it.
The Importance of Calcium
The US population eats too little calcium for ideal bone health. Because of idiopathic hypercalciuria and probably other factors not as well established, stone formers have an abnormally high risk of bone mineral loss and fractures. Most kidney stones contain calcium oxalate, and oxalate absorption is reduced by high calcium intake.
Sodium Intake and Urine Calcium
Because urine calcium tracks with sodium, lowering diet sodium below the US “tolerable upper limit” of 100 mEq (2300 mg) per day, ideally below 65 mEq (1500 mg) per day, can prevent high diet calcium from increasing urine calcium and stone risk. Reduced diet sodium is especially valuable for stone formers.
The Dangers of Refined Sugar
Refined sugar is a world menace. One half of the molecule is fructose, metabolized directly to fat and capable of inducing insulin resistance in healthy people over as little as 8 weeks. After a dose of sugar, fructose or glucose, urine calcium rises and volume falls, so stone risk rises - all this within a hour or so. Your chocolate bar in mid afternoon is risky! Nationally, sugar is a main cause of obesity and diabetes. Stone formers need to limit it, and so does everyone else. Too much added sugar can contribute to kidney stones. Try this low sugar banana pudding recipe for a sweet treat!
Read also: A Review of the Mediterranean Diet in Kidney Disease
Protein and Urine Calcium
Skilled scientists have debated if protein excess reduces bone mineral, but all agree it raises urine calcium.
The Benefits of Potassium
Food potassium parallels food anions that when metabolized produce alkali. Good for bones, alkali also signals kidneys to release filtered citrate into the urine where it inhibits formation and growth of stone crystals.
Moderation with Oxalate
Even high calcium diet will not protect calcium oxalate stone formers against excessive oxalate intakes, so moderation is very important. This site has massive oxalate lists, and our article on low oxalate diet is perhaps the most popular of the over 100 articles here. I have inveighed against a compulsive search for every mg of oxalate in food. It overly constrains diet choices. But diet oxalate matters a lot when stones are calcium oxalate and 24 hour urine oxalate is high enough to convey risk of stone despite that diet calcium has been raised to the US normal range.
Delicious and Kidney-Friendly Recipes
Melanie’s collection includes 4 appetizers, 7 breakfast items, 3 soups, 7 salads and dressings, 7 entrees, and 3 desserts. Her recipes meet all requirements of the kidney stone prevention diet but focus specially on dairy products - the main source of calcium. Each recipe comes with the expected ingredient list for shopping, preparation instructions, and hints for serving. She created all of the recipes, tested them, and made up her collection all by hand without any help. It is a downloaded PDF. She asks we pay for it given her time and effort in doing all the work of the foods themselves and making up the book. Melanie tells me her husband, Eric, likes them, especially the Mac and Cheese and Burrito Bowl.
Recipe Examples:
- Low Sugar Banana Pudding: A healthy alternative to traditional banana pudding, this recipe is low in added sugar, making it a kidney-friendly dessert.
- Panna Cotta: A delightful summer dessert that can be topped with low oxalate fruits like blueberries, strawberries, peaches, or blackberries. I love making desserts in adorable little ramekins*, and panna cotta is perfect for that!
- Kidney Stone-Safe Granola: A great option for long walks, quick snacks, or throwing it in a bag when you need something during the day.
- Kidney Stone-Safe Chili: A delicious fall dish where traditional black beans are replaced with green beans to reduce oxalate content.
- Strawberry Caprese Salad: Swaps out traditional tomatoes for sweeter, lower-oxalate strawberries and is finished with a drizzle of balsamic dressing. I swapped out the traditional tomatoes used in Caprese salads for sweeter, lower-oxalate strawberries, and, for a little tang, we finish it off with a drizzle of balsamic dressing. Balsamic vinegar is wonderful way to add flavor to food without salt.
More Recipes and Meal Ideas
Here are some additional kidney stone diet-friendly meal and snack ideas:
Read also: Nutrition and stage 2 CKD
Breakfast
- Oatmeal: A wonderful whole grain that is low in oxalate.
- Omelets: A great way to sneak some extra veggies in!
- Chai Protein Bars: These bars are high fiber, vegan (use nondairy milk), high protein, low sodium, zero added sugar, and just plain good. If you like chai, these are your new favorite no-added sugar treats.
- Protein Muffins: You might think, “wow, this is pretty high in oxalate, Jill.”Yes, it is. But remember that you have 100 mg/day (unless your doctor has told you otherwise) and you will have this with a calcium-containing beverage and watch your oxalate throughout the day. I took the recipe off the box and changed it so each muffin would have more protein and zero added sugar.
- Pancakes: I must admit, I have never been a fan of pancakes in the morning. They are highly caloric and might as well be cake. I know. I’m a party pooper. But, I know my patients like to eat them, so I made a healthier recipe to make us happy.
Lunch/Dinner
- Turkey Burger: Everyone needs to have a burger here and there. This one is a 4ounce turkey burger, but you can have whatever meat you like. Vegan and vegetarians watch out for all the extra sodium in the meat-free versions.
- Stir Fry: A perfect weeknight go-to low oxalate recipe. Try this stir fry with chicken, shrimp or steak. Feel free to mix up the veggies with your favorite low oxalate options.
- Chicken Soup: I love chicken soup. It is the ultimate low cal, comfort food. I also love that I can find pre-cut soup veggies at Trader Joe’s and a rotisserie chicken at the market, which is a huge time saver.
- Turkey Meatballs: This dish is very low oxalate, yet satisfying and filling. I got 12 meatballs out of the recipe, depending on how big or small you make yours the quantity might differ.
- Mac and Cheese: Who doesn’t love some elbow macaroni? I used Banza chickpea pasta for this dish as I wanted the extra fiber and protein it provides that regular pasta does not. This is a wonderfully comforting dish that is low sodium and kidney stone diet safe.
- Grilled Cheese: Who doesn’t love grilled cheese? I must admit, I don’t usually eat grilled cheese, but I had a taste for one. Since we’re always trying to get enough daily calcium, I thought this would be a gooey and delicious way to do it.
- Alfredo Sauce: I have not eaten alfredo sauce in decades. As a kid, I absolutely loved it. Who doesn’t? It’s rich, creamy goodness! Unfortunately, that goodness comes with a whole bunch of calories, so I’ve avoided it like the plague for most of my life. Lately, though, I’ve been craving it.
Snacks
- Popcorn: One of my favorite Kidney Stone Diet safe snacks is popcorn. However, store-bought popcorn tends to be too salty and caloric-I say caloric because who on earth can only eat the listed serving size?!? Not me. To remedy this, I’ve create my own popcorn seasoning I think you’ll like.
- Munchster Mix: Enjoy this crunchy, savory snack, perfect for movie night or a midday treat. Directions: Preheat the oven to 275°F. In a large bowl, combine cereal, pretzels, and popcorn. Melt margarine in a saucepan over medium heat, then remove from the heat. Stir in the Worcestershire sauce, Tabasco sauce, onion powder, and garlic powder. Pour the seasoned mixture over the dry ingredients and toss to coat. Spread evenly onto an ungreased cookie sheet. Bake for 45 minutes, stirring occasionally.
- Cucumbers: Cucumbers are one of my favorite go-to snack veggies. Try cucumbers as a side dish too!
- No-Salt Seasonings: Students in my prevention course always want to know…“What no-salt seasonings should I use?” I have used many over the years and here is my list of favorites.
- Lunch Meat and Cheese Wrap: Here is a lunch option that is quick and easy for diabetic and keto diet peeps. You can do whatever lunch meat you like with any cheese you like. You’ll note that this is a higher sodium option.
- Breakfast Wrap: I love having breakfast for lunch or a snack and this wrap satisfies. They are kidney stone diet simple, safe, and satisfying. Notice that lower carb tortillas can definitely be higher in sodium.
- Grilled Romaine Salad To Prepare Salad Preheat the grill to medium-high. Rinse and pat dry romaine. Slice heads lengthwise into thirds. Brush with 2 tbsp olive oil and grill for 4-5 minutes, turning once. Serve on plates, top with remaining berries, and drizzle with vinaigrette
Specific Ingredients and Their Benefits
- Arugula: Arugula is one of my favorite low oxalate greens.
- Kale: Kale is another great low oxalate green veggie! Use it in salads or cooked as a side dish.
- Chickpeas (or, garbanzo beans): Chickpeas (or, garbanzo beans), are a very low oxalate bean choice. I used Banza chickpea pasta for this dish as I wanted the extra fiber and protein it provides that regular pasta does not.
- Broccoli: Broccoli is another surprising low oxalate recipe choice. A 1/2 cup of chopped broccoli only has 1mg of oxalate. Enjoy it roasted, steamed, grilled, or sautéed!
- Brussels sprouts: These amazing Brussels sprouts have been in my regular rotation for years.
- Balsamic vinegar: Balsamic vinegar is wonderful way to add flavor to food without salt.
- Cranberries: And, cranberries are a great low oxalate fruit.
- Cod: Tender, flaky cod with an amazing low sodium spice rub.
- Sweet Potatoes and Sunflower Seeds: I know many of you will say, “Oh my, she has finally gone off the deep end. Sweet potatoes AND sunflower seeds in the same dish?” Why yes, guess what, you can have it. Notice the oxalate level in one bowl is around 23mg.
- Low-Sodium Soy Sauce Stir in vegetables and soy sauce.
Key Considerations for a Kidney Stone Diet
- Hydration: Drink plenty of water throughout the day to help flush out your kidneys.
- Limit Sodium: Reduced diet sodium is especially valuable for stone formers.
- Moderate Oxalate: Aim for around 100-200mg of oxalate per day, unless otherwise directed by your doctor.
- Balance Nutrients: Pay attention to your calcium, protein, and sugar intake.
- Read Labels: Be mindful of sodium and sugar content in processed foods.
- Consult Professionals: Work with a registered dietitian or healthcare provider for personalized dietary guidance.
Expert Advice
Melanie Betz MS, RD, CSR, FNKF, FAND is a nationally recognized kidney stone expert and dietitian with over 12 years of experience. She is the Founder & CEO of Melanie Betz Nutrition, LLC & The Kidney Dietitian blog that and has helped thousands of people prevent kidney stones with food. As a leader in the field, she has published her research and speaks at numerous local, state and national professional conferences about kidney nutrition. She also holds an elected or appointed position in the National Kidney Foundation, Renal Practice Group, American Kidney Fund and the National Kidney Foundation of Illinois.
Vincent was dumbfounded when he was told to follow a low oxalate diet and couldn’t find accurate information. Matt is a trained chef who creates low oxalate recipes and meal plans.
Melanie works in the Nephrology Section as our dietitian, so is part of our team. She mainly cares for kidney disease patients in whom an error of diet can be dangerous. Melanie has counseled a number of our kidney stone patients, and I believe that led her to create these recipes. Since age 3, Melanie has cooked, she told me, and she is a foodie.