Is the Low Oxalate Diet Healthy?

by Heidi on August 29, 2012

Healthy low oxalate fruits.

Healthy and yummy fruits you can enjoy on the low oxalate diet - blueberries (low), strawberries (medium), cantaloupe (low), grapes (low), honeydew melon (low) and pineapple (low).

One of the first complaints the low oxalate dieting community hears from newbies is “I can’t eat healthy foods anymore!” or “How can this low oxalate diet be healthy?”  In fact, the medical community often echoes this sentiment by stating that the low oxalate diet isn’t healthy over the long run or by expressing concern about putting their patients on a diet that limits healthy foods.  This is absolutely crazy and to me signifies that these doctors either don’t understand nutrition or don’t understand the low oxalate diet – two unfortunately common problems in the medical community.

Other newbies to the low oxalate diet are just plain confused.  They lament the fact that they thought they were eating healthy foods when they filled their plates with spinach, buckwheat and almonds.  Now they learn that many of the things they thought they were eating for their health may have been causing their symptoms.  Some are angry. Some are sad.  All are confused and upset.  They wonder what they will eat now and if some day they will learn it is “unhealthy,” too.

I will start out by saying I understand and sympathize with each new low oxalate dieter.  Changing your way of eating can be extremely difficult.  You have beliefs, traditions, emotions and comfort wrapped up in your food choices and changing these is an emotionally and physically challenging thing to do.  Top this off with having to give up foods you’ve been taught were healthy or hearing a doctor say that the low oxalate diet isn’t healthy, and it makes you even more resistant to change.  What I want each new low oxalate dieter to hear most is that the low oxalate diet can be followed in a healthy way for the long term by almost anyone.  In addition, if it can heal the symptoms you now suffer from, it is the most healthy diet possible for you!

low oxalate zucchini sandwiches

Healthy low oxalate zucchini sandwich bites with zucchini, tomato, low oxalate hummus and fresh basil.

I’m going to admit I started this post as a rant then did some serious editing because I remembered my initial impression of the diet.  I was a tea-swigging, spinach-popping,  whole grains-loving vegetarian and nothing I ate except apples and bananas seemed to be on the low oxalate diet.  With further exploration, I found plenty of healthy alternatives for my favorite foods, but it wasn’t easy.  Part of the problem for me, and most other people, is that we tend to concentrate on the foods we can’t eat on the low oxalate diet and not on the ones we can.  This is where I believe most of the misconception that the low oxalate diet is unhealthy comes from.  We read that we can no longer eat spinach, whole wheat, blackberries and sweet potatoes, and we immediately think the diet is unhealthy because it doesn’t contain some foods that conventional wisdom  considers healthy.  We don’t look at the hundreds of other healthy foods we can eat.  Hopefully, this post will help you turn that kind of thinking around.

What Makes A Diet Healthy?

Everyone has a different idea of what makes a diet healthy, so I’ve divided the following list into sections depending on how controversial the health claim is.  We will start with the things a diet must include to be healthy, and see how the low oxalate diet holds up.  Then we’ll move on to what a healthy diet should not include.  Please try to keep an open mind as you read this, and remember that there is no “one healthy diet fits all” here. Each body is different and what may be healthy for you, may not be healthy for someone else.

Things a Healthy Diet Should Include:

Least Controversial:  Almost everyone will agree that the following items are necessary for good health.  Following each item, you’ll find out how the low oxalate fares.

1.) Includes plenty of water:  Yes, low oxalate dieters are encouraged to drink lots of water.

2.) Includes a wide variety and ample amounts of fruits and vegetables:  Yes, the LOD includes hundreds of fruits and vegetables, such as cabbage, kohlrabi, apples, blueberries, cauliflower, acorn squash and peaches.  As long as the low oxalate dieter chooses most of her fruits and vegetables from the low oxalate list (and a wide variety over many days from the medium oxalate list), she can eat 5 or more servings of vegetables/fruits a day and include plenty of variety (I often eat more than ten servings of vegetables/fruits a day).

healthy low oxalate dino kale

Low oxalate dino kale is just one of the many healthy leafy greens you can eat on the low oxalate diet.

3.) Includes leafy greens.  Yes, the LOD includes over 30 varieties of leafy green vegetables.  See my Guide to Low Oxalate Greens for more information on low oxalate greens.

5.) Includes essential fatty acids.  Yes, the LOD includes many foods that contain the essential fatty acids DHA and Omega-3s, including salmon, other fatty fish, flax seed, eggs and fish oil.  Vegans and meat-eaters alike can find a source of essential fatty acids on the LOD.

6.) Includes anti-oxidants.  Yes, the LOD includes many strong anti-oxidants including blueberries, rooibos (African red bush tea), broccoli, herbal teas, watermelon, pumpkin and collard greens.

More Controversial:  Most people will either agree that the following items are necessary in the diet for good health, or they will agree that the “health properties” of these items are necessary (such as their protein, fiber, vitamins, minerals etc.) and if the item itself is left out, then some substitute should be eaten instead.  Please note, however, that some people believe that these items cause more damage than good and should always be left out of the diet.

7.) Includes Meat: Yes, the LOD includes all unprocessed meats such as pork, chicken, beef and fish.  You may choose from lean cuts or more fatty cuts depending on your tastes and your health beliefs about fat.  You may also eat some processed meats on the LOD although I personally try to limit these to all natural, low sodium, locally-produced products such as all natural, low sodium bacon and deli turkey.  If you do not eat meat, you may get protein on the LOD from other protein sources such as eggs, cheese, yogurt, milk, black-eyed peas, lentils and spit peas.  You may get iron from low oxalate leafy greens and B12 from eggs and dairy.  If you are a vegan, however, please make sure you take a vitamin B12 supplement.

9.) Includes Whole Grains: Yes, the LOD diet includes whole grain corn products such as tortillas and cereals, whole grain oatmeal, whole grain brown rice and whole grain brown rice pastas.  If you choose not to eat whole grains, you may get plenty of fiber and vitamins from low oxalate fruits and vegetables, legumes, and coconut flour.  One caveat here.  Although I personally believe you can skip whole grains completely without jeopardizing your health (and in fact will increase your health by skipping them), I do not believe you can replace them with highly-processed grains like white bread without jeopardizing your health.  White rice is an exception to this rule (see “safe starchs”).  Otherwise, I recommend you eat low oxalate whole grains or ditch the grains completely.  Many people successfully combine the LOD with grain-free diets.  Read this article, this article or this article for more information on grain-free diets.

10.) Includes Legumes:  Yes, the LOD diet includes many legumes such as black-eyed peas, split peas, green peas, pigeon peas, lentils and chick peas.  Although many legumes are high oxalate, you still have plenty of legumes to choose from if you wish to include legumes in your diet.  If you choose not to eat legumes, you may get fiber from low oxalate fruits and vegetables and protein from meat and dairy.

Most Controversial:  Some people will claim the following are necessary for good health and others will claim they are the destroyers of health.  If you want to eat them, you can!  If you choose not to, you have healthy alternatives on the LOD.

11.) Includes Dairy:  Yes, the LOD includes dairy products.  If your body does well with dairy, you may eat any plain dairy product available including plain milk, yogurt, cream and cheese.  Please note that many people do not tolerate dairy, however, including many who think they tolerate it just fine. If you are unsure, you might want to try a 30-day dairy-free trial and see if you feel better or if unwanted symptoms decrease.  Many low oxalate dieters do well on a gluten-free, casein-free diet (GFCF) and the low oxalate diet accommodates this well.  If you choose not to eat dairy, you can still get protein from meat, legumes or eggs; you can get calcium from bone broths and leafy greens, and you can get fat from meats, avocados, eggs, olives and coconuts. Low oxalate coconut milk also makes a good dairy substitute in cooking and in products such as yogurt and ice cream.

12.) Includes Fats:  Yes, the LOD contains fats.  Some very respected scientists believe fat is bad for us.  Other very respected scientists believe fat is very healthy and that many us don’t eat enough of it.  Whatever type or amount of fat you want to eat, the LOD has you covered! All fats are low oxalate and most of them are very low oxalate.  Even the oils from otherwise very high oxalate foods, such as sesame oil, are low oxalate. If you choose to continue reading my blog you will learn that I’m in the “fat is healthy” camp and that I eat plenty of healthy fats.  I also avoid industial-processed oils such as canola oil, vegetable oils, safflower oil etc. because they can contribute to inflammation and oxidative stress (which can cause endogenous oxalate production)–two things low oxalate dieters want to avoid.

13.) Includes Safe Starches:  Yes, the LOD includes the number one safe starch, white rice (although most other “safe starches” are not safe for low oxalate dieters!  The “Perfect Health Diet” would be a Perfect Nightmare for us.).  Safe starches are starchy foods that don’t have most anti-nutrients or other things that are that bad for us, but neither do they contain many things that are that good for us either like vitamin, minerals or protein.   In fact, you could consider them health neutral in most instances.  They are just calories in the form of starch.  See Mark’s Daily Apple for more information on white rice as a safe form of starch.

Things Healthy Diets Should Not Include:

I’m not going to lecture you about what you shouldn’t eat here.  Although many fake “foods” such as Pepsi, bubble gum, sugar and white bread are low oxalate, we all know that these either aren’t very good for us or are down right bad for us and that we should avoid them or only eat them occasionally.  You make the decision folks, although I personally recommend that you save your daily oxalate allotment for foods that are nourishing for your body, not just foods that “aren’t that bad.”

What you really need to avoid, however, are:

1.) Foods that cause pain

2.) Foods that damage your body

3.) Foods that cause disease

If you have oxalate-related symptoms, then high oxalate foods are unhealthy for you.  It does not matter if most people can eat them without hurting their body.  If you have oxalate-related symptoms, then high oxalate foods such as spinach and whole wheat will cause pain, disease and/or damage to your body.  They are not healthy for you, and luckily the low oxalate diet doesn’t allow them.  Yay!

I hope this article has helped you see the low oxalate diet in a new light.  Although the low oxalate diet does restrict some foods generally considered healthy (i.e. spinach) and allows some foods that are downright unhealthy (i.e. sodas), it can be an extremely healthy diet no matter what “health paradigm” you follow.  Every category of food that is generally considered healthy can be eaten on the LOD, plus if you choose not to eat some category such as grains or legumes, you can find healthy alternatives for the fiber,vitamins etc. on the LOD.  The only low oxalate dieters who really have a tough time are vegans, but that is a whole other post!  (one I hope to write soon. . .)

Have fun enjoying your healthy low oxalate diet!

 

{ 11 comments… read them below or add one }

Joanna August 29, 2012 at 5:37 am

Thanks for your post. I admit I thought the low oxalate diet was unhealthy at first glance also, but now that I’m used to it I eat a very healthy diet filled with lean meats, healthy fats, fruits, vegetables and legumes. I occasionally eat rice and corn but I’m playing with the idea of going grain-free myself. I really liked the NurishedKitchen article you linked to on grainfree diets. Thanks!

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Julia October 1, 2012 at 9:36 pm

This post was so helpful for me. Thank you. I have rheumatoid arthritis and have been exploring how best to nourish my body and promote healing through the dietary choices I make. I have been getting no help from my doctors and there is so so much information out there on sooooooo many different ways to eat “healthy.” What I struggle with is how to determine what the healthy way for ME to eat is. It’s overwhelming but exciting, too. I haven’t had relief for about two years and to think MY choices can make a difference in my symptoms is very exciting. I have taken a huge step in eliminating processed foods and I am in the middle of determining whether I tolerate diary and gluten. So far, I’m feeling better avoiding all these groups, so I may just never introduce them again! This is the first diet I have come across that seems like a more balanced fit for me. I have one question: Are all foods high/medium in oxalate considered “pro-inflammatory” foods?

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Heidi October 3, 2012 at 8:52 am

Oxalate is a toxin and causes pain, inflammation and energy metabolism problems such as fatigue and trouble concentrating when oxalate is absorbed in high quantities. Many if not most people’s bodies do a pretty good job of keeping the oxalate in the gut where it can pass out without harm. (Although it may cause some gut irritation/inflammation if you have a sensitive gut.) But some people absorb way too much oxalate through their gut and into their bloodstream, usually due to poor intestinal function. Many doctors believe that people who have autoimmune diseases like RA, undoubtedly have poor intestinal function and/or leaky guts, so it is quite common to find people with both oxalate issues and autoimmune diseases. The big question to ask is what causes the leaky gut and intestinal malfunction in the first place, and that could be hard to pin down. Gluten is an obvious choice. Other grains can be just as irritating, however, as can dairy or legumes or nightshade vegetables for some people. An autoimmune-Paleo diet is designed to heal the gut and help heal the symptoms of autoimmune diseases. GAPS also heals the gut. Both are grain-free and gluten-free. Adding low oxalate may also help (I’m on a low-oxalate Paleo diet). Oxalate can be stored in the joints and surrounding tissues, so some people with arthritis often report feeling much better within weeks or months of starting a low oxalate diet, although others who eventually have a good result can take longer. It depends on how much oxalate you have stored in your tissues (which will determine in part how long it takes to detoxify your system through the dumping process). It also depends on whether you truly have an oxalate problem to begin with.

So this is my very long answer to your question which really is “it depends.” If you have a leaky gut and/or poor intestinal function (which is likely), then high oxalate foods could be causing a lot of inflammation in your body. Oxalate is very inflammatory once it gets into your tissues. If you have rock-solid digestion (unlikely), then most of the oxalate never reaches a place in your body where it will cause inflammation.

Hope this helps. And good luck! I’m sure switching to a natural, whole foods diet will help no matter what else you decide to do.

Heidi

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helen sena February 8, 2013 at 7:14 pm

Hi, just stumbled on your website and you have answered so many of my questions(like can you get enough protein on a low oxalate diet if you eat primarily vegetables). Thank you for the much needed information. My gyno just put me on the low oxalate diet and I have seen improvement after 2 weeks. I will continue to access your website. You really provide an important service to women like me. Best Regards, Helen

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Heidi February 9, 2013 at 2:27 am

Thank you, Helen. Glad to hear you are already seeing results!

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David July 5, 2013 at 6:06 pm

Wow! Am I confused! My doctor, well as the numerous food oxalate level lists that I downloaded, all tell me that many of the things that you say are low in oxalates are high in them and to be avoided–stuff like flaxseed oil, bananas, all berries, and more. What’s a guy to do? It doesn’t help that I’m not the most creative person when it comes to planning meals and grocery lists, either.

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Heidi July 6, 2013 at 1:49 am

Hi, David.
You’re not alone. Most doctors and many websites are using outdated oxalate lists that use oxalate levels from old testing methods from as early as the 1930′s. These lists are not accurate. For example, blue berries are low oxalate and strawberries are lower medium oxalate. Both are perfectly fine to eat on a low oxalate diet. If you would like a free up-to-date list you need to join the Trying Low Oxalates Yahoo Group. This list compiles oxalate values from two non-profit groups that are actively testing oxalate levels of foods – The Vulvar Pain Foundation and the Autism Oxalate Project, plus some recent values from the scientific literature. I can’t publish the list here because of copyright issues and because it is massive (quite comprehensive for whole foods and plenty of commercial foods also). But I can report oxalate values for some ingredients in my recipes and for the foods I review. All of my values come from the master list and were from the most up-to-date list on the day I published my post. A few of these may be slightly out of date now, and off by a few mg. oxalate. But if it’s a huge change I go back and fix or up-date the posts as soon as possible.

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David July 10, 2013 at 2:49 am

I’m sure the information at the Yahoo! Groups is great, but Yahoo! and I don’t mix. I have endless password and sign-in headaches with them. I gave up trying to use their e-mail, and want nothing more to do with them. What other solid sources of oxalate info do you have?

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Heidi July 21, 2013 at 8:40 am

Hi, David.
The next best ways to find out oxalate content information are to join the Trying Low Oxalates Facebook page and ask about specific foods you are concerned about, to join the VP Foundation and buy all the back copies of the newsletter (It was only 5$ for all the back copies last time I checked), or from the Autism Oxalate Project’s website.
Hope one of these works for you.

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Jeanne August 6, 2013 at 6:49 am

Yes, this article is all well and good but don’t expect me to be turning cartwheels over a low oxalate diet anytime soon or using annoying terminology like “this is an adventure!” I just started eating primal and have no problem avoiding grains and wheat, but you are also supposed to avoid legumes as well. Then add in the “autoimmune protocol” (hypothyroid over here) which removes potatoes and eggs. Eggs, you know, the low oxalate food. Oh, and dairy. Yeah, that whoooole other group of low oxalate foods. And so since I can’t have regular potatoes and frankly need to get carbs from something other than squash, well, sweet potatoes. Uh nope, sorry, high oxalate! Oh, you say, don’t worry you can have delicious fruits like pineapple. Sorry, pineapple allergy. Well, wait a minute, you can always get carbs from healthy veggies like our lower oxalate cauliflower, broccoli and cabbage. Um, wait, they are goitrigenic! Sorry, out of luck! Oh, unless you boil everything! Yay! A boiled pile of mush! Eat up!

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Heidi August 7, 2013 at 7:26 am

Hi, Jeane.
I can tell by the anger in your post that you are in a state of grief over being told to give up yet another group of foods for your health. Hopefully, you don’t suffer from oxalate toxicity and can find healing another way. If you do suffer from oxalate toxicity, however, the only way you will truly feel better is to follow a low oxalate diet until you detox your system (some people can add back more oxalate once they’ve regained their health.) If this is the case for you, I hope you can work through your anger and grief and find healing with the low oxalate diet.

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