This week, Jill answers a listener question about what we can eat to avoid kidney stones.

Have a question? Leave us a voicemail at (773) 789-8763.
 
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Find more episodes of the Kidney Stone Diet Podcast at kidneystonediet.com/podcast

= Who is Jill Harris? =
youtube.com/TheKidneyStoneDiet

Jill is a nurse and health coach that specializes in educating patients on kidney stone prevention. For more than 20 years she’s helped patients understand that kidney stones can be prevented with the right treatment plan. It’s one thing to be told to lower oxalate or drink more water, but HOW do you do it? That’s where she comes in. Through the educational resources at kidneystonediet.com, stone formers can learn everything they need to know to significantly lower new stone risk.

= Who is Jeff Sarris? =
youtube.com/jeffsarris

Jeff’s co-founder of SPYR, a branding agency based out of Chicago, where he and his business partner Dave help awesome people like Jill create online platforms that make an impact.

He’s also a certified health coach, host of the Starting Now podcast, and developing NFTs and community at Badfroot.

Reach out on Twitter! @jeffSARRIS

Transcript

Holiday Travel and Finding Joy in Winter

00:00:00 Jeff Sarris

Welcome back to the Kidney Stone Diet podcast, the show about reducing your kidney stone risk and living your best life. I'm your host and fellow student, Jeff Sarris.

00:00:21 Jill Harris

Hi, Jeff.

00:00:22 Jeff Sarris

Hi, and I always do this with my hands when I say the I don't know why. I just do and I see it in the stream and I'm like, I guess it's just what I do.

00:00:32 Jill Harris

Well, we love we all have our things we do, right? So, I love that about you. And I'm Jill Harris, your kidney stone prevention nurse.

So, what's the problem? We all have our thing. Whenever I'm with Dr.

Co, he's always like he does this. He does this. He rocks back and forth.

Yeah, he goes like this. Yeah, when he's thinking.

So, we'll be writing an article or whatever, or we're having just a conversation, he's like He does this.

00:00:59 Jeff Sarris

Interesting. Yeah, so–

00:00:59 Jill Harris

And then I'm always like moving my legs. Between the two of us, we're like a bounce a bunch of jumping beans. So, yeah.

00:01:04 Jeff Sarris

No, it's perfect. Oh, wait, I actually need to queue this up for one second, so.

00:01:12 Jill Harris

Okay, go ahead. I'm ready for the holidays while you're queuing up, are you?

00:01:16 Jeff Sarris

Yeah, I mean I am looking forward to it. Sorry, let me just get this

00:01:22 Jill Harris

It's December I don't know, 12th. So, when this comes out, I guess maybe this would come out right be- no, I don't know if it's No, it won't come out for Christmas. But anyway, I hope everyone had a good holiday.

I'm time-filling while Jeff figures out his shit over there.

00:01:37 Jeff Sarris

Yeah. Yeah, I just had to queue up this week's voicemail because we want to jump past the beginning where they give their phone number. But, other than that, yeah, we should be we should be good to go now.

But, yeah, I'm I'm excited for the holidays. I don't know. I like it I like it around this time, even though I wanted to travel and go somewhere warm and sunny before Christmas, we're going to go after, shortly.

Probably right around the time this airs, or maybe a week or two after that. We're going to hit the beach in Miami for a little bit, get some sun, and then come back and get back to work for the new year.

00:02:07 Jill Harris

I think that's perfect because, I mean, I love the holidays, so I want to be here. I don't care how nasty it gets here. It doesn't matter to me.

It's the It's the whole end of January, February, March that you're like, "All right, tick tock, this got to stop," you know.

00:02:22 Jeff Sarris

Yeah.

00:02:23 Jill Harris

I mean, it gets a little crazy. But, yeah, the holidays is a special time. I really don't care about presents.

I just really like being with friends and my family. I love seeing the tree in the background. I just I love it.

Makes me so happy. And it's just those simple joys in life that we must be mindful of, especially in the world nowadays, right? So, grab on, and whatever joy you can suck out of a day, make sure you do that.

It's so important.

00:02:50 Jeff Sarris

Absolutely. Hey, what do you say we dive into the question?

00:02:54 Jill Harris

I'm ready, let's hear it.

Balancing Oxalate and Purine Restrictions

00:02:55 Jeff Sarris

So, this is from David.

00:02:57 Jill Harris

David, okay.

00:02:59 Jeff Sarris

And–

00:03:00 Jill Harris

I don't know what I've been diagnosed with yet, but I did have a kidney stone. Turned out that there's uric acid. Had a 24-hour study done.

Then was told I have to limit my oxalate and purine levels, which makes it quite difficult when one is animal-based and the other's plant-based. What the hell's in the middle?

I am 64 and definitely not overweight. I eat what I thought was a healthy diet. Lots of smoothies.

Turned out I was eating lots of purine and oxalate-type foods.

Makes it difficult. Thanks.

00:04:00 Jeff Sarris

Yeah, that is a great question.

00:04:02 Jill Harris

It's a great question. So, he doesn't He said he made a uric acid stone. That's what he said.

I'm assuming, but I don't know, I'm assuming he had a surgery or he passed a stone and the doctor analyzed it for him, sent it off to a lab, and so he knows he has a uric acid stone.

That's what I'm going to assume he knows that for sure. That's what he said. I'm just going by what he said.

There's a lot to unpack here. Buckle up, people. Buckle up.

I'm going to tell you why I say buckle up. So, again, why we do what we do here. And this always pulls on my heart a little because, being a patient with my cancer stuff, I want you to know that I, too, have been to plenty of doctors' offices and they throw the brochure or they just give this generic advice.

Managing Healthcare System Limitations and Doctor Advice

00:05:04 Jill Harris

Now, I'm not bumming on his doctor. But I just want us to recognize, well, you're a healthcare professional, a nurse, a CNA, a doctor, and then to all of us who are patients, we must be responsible with the advice we give.

People have said to me, "Jill, you're going a little overboard." Have you been sick? Because obviously you haven't, because you wouldn't be saying that to me. The state of affairs is this: There's no time in our healthcare system.

I just tried to make a derm appointment. The next available one is August. It is December 12th.

So, a lot can happen between that and why I'm going to the dermatologist.

I'm just saying, last year I tried to make a colonoscopy. Stage four rectal cancer. Six months wait.

If I don't get it at the top of the line, I don't know who does. So, with what has happened in our healthcare system with COVID and there's not enough help and people didn't go to the doctor for two years, so much, it's it's

It's a travesty that when a patient comes to us, we have to rattle off information in a way that we don't even understand how the patient may or may not understand it. I hope that makes sense. So, I think, you know, one of the reasons that I went rogue and I don't work in hospitals anymore–and this was decades ago–there wasn't time to do or say the things I knew that would make a better, more of a difference in a patient's life.

So, I'm telling you all those words because this isn't anybody's fault. This is just the way it works now. There's no time.

No time! The fact that a doctor even said something or gave a brochure, that's pretty great. But then we're left to go home, look at that ditto, or whatever–I'm old–handout, whatever, brochure, and

Try to decipher it by Doctor Google, because guess what, ain't nobody coming to us in the portal anymore, either. It's There's not enough help. There's not enough time.

So, now we've got to figure out what all this means, purine. What the hell is that? Oxalate, the hell!

David's saying, "I eat a healthy diet. What are you telling me?" David's also saying, "I was told watch your purines and watch your oxalate." And he said, "Watch my meat and watch my plant. What the hell am I doing, stuck on notebook paper over here?"

So, what is David to do? And I get heated or about this, or I have a lot of empathy for it, because we're not only sick, and we're not only trying to prevent more disease, but how do we get the information now? The doctor's just trying to get to room to room to see his or her 20 patients that insurance companies are dictating they see in one day, 30, 50, whatever it is.

Value of 24-Hour Urine Collection Tests

00:08:18 Jill Harris

So, they're doing the very best they can. David wants to do the very best he can by making sure he never goes through that hell of forming another kidney stone. So, I think he also said, he did do the 24-hour urine collection, which all of you should do, you kidney stone formers, otherwise you don't know why you're forming stones.

You can guess, you can surmise, you can think, but you don't know. There could be medical conditions that predispose you to form kidney stones and you won't know until you do the urine collection. Get it done.

"My doctor won't order it." Tell the doctor you want it again, because you want to do everything you can to prevent kidney stones.

Never had a doctor say no after that. And if the doctor says no, any doctor can order, go to a different one, meaning go to your primary. They can order it, too.

All right, I digress, as usual. So, David also said these things, he's not overweight, he cares he's been eating a healthy diet. David also said this, which is very common, "I eat lots of smoothies, lots of smoothies." And what I'm guessing here is David probably overate the highest oxalate foods.

High Oxalate Foods in Daily Smoothies

00:09:39 Jill Harris

So, people who eat healthy tend to overeat You'll see a pattern if you watch more than one of our videos here. People tend to overeat healthy foods because they think it's the right thing to do. It makes perfect sense, until you're a kidney stone former.

So, some people, when they're overdoing oxalates, it's too much spinach, too much almond products, sweet potatoes every day, my personal trainer friends, sweet potatoes as much as they can eat every day, that's their carb, you know, so they're overeating high oxalate foods without getting any calcium sources.

And so, the only way oxalate can leave our body is to bind with calcium in our GI tract and leave through the stool. If there's no calcium there, because we didn't eat or drink any, then oxalate gets reabsorbed back into our body, and that's what can cause higher numbers. So, the other thing he said the doctor said is watch your purines.

Typically, that means somebody's overeating meat protein. "I don't eat red meat, Jill." Nobody's talking about just red meat. Meat is meat–chicken, turkey, pork, seafood,

All of that can be higher in purines, okay? So, that doesn't mean, so the advice he got was lower oxalate and lower purines. What does lower mean?

What does lower mean? Where is the goal, dear doctor? How much should I be striving for?

You said my stuff is high looking at my urine collection. How high is high? Where do you want my results to be?

How do I get there?

Dietary Targets for Oxalates and Purines

00:11:26 Jill Harris

So, the doctor said, "Lower purines, lower oxalates." But, David says, "So, what am I supposed to eat?" So, lowering means the Kidney Stone Diet goals. Get to 100 mg of oxalate a day. Super easy to do, people, super easy.

That's not hard to do. You take away spinach and almonds, those go away. You can eat other nuts and seeds within normal portion size.

Get your oxalate list at kidneystonediet.com, the start page. Get it, so you see.

We also have a handy dandy app you can put on your phone that can count the Harvard oxalate foods, too, so you can quickly look up and see what your favorite food is in oxalate. For all the foods that Harvard doesn't study, we say have that food once or twice a week, twice a week, because I'm practical. You might have a leftover.

Do not throw them out. Have that food once or twice a week, not a problem. When you eat sp- and get your calcium needs met every day, you'll find the goals for calcium on my blog, kidneystonediet.com, go to the blog.

So,

Your goal is 100 mg of oxalate a day. That is your goal, David. As far as purines go, it doesn't mean you can't eat foods that are higher in purine.

Purines also will be booze. So, if one drinks a six-pack a day, we're going to say lower that to one or two beers a day, right? So, it's not that you can never have these foods.

It doesn't mean you can't eat meat any e- every day, it just means eat within your normal portion size. We have a meat protein calculator at kidneystonediet.com, the blog, so you can see what's cool for you.

Now, what we really have to be careful of with David is, he said, "I'm not overweight." So, what I fear, and what I see every day in my practice, is people who do not have a weight problem are then told watch your meat, whatever that means, watch your oxalate, people go home and they stop they really limit those two things to the point where they don't have to, to the point where they're really losing more weight and they don't need to.

A big bulk of my practice is having people come to me needing to gain weight,

Because they're so afraid of eating or they took the doctor's orders and made up their own thing with it, okay? So, it makes sense. So, other high pur- there's high purine vegetables, too, people, but they have been showed not to really increase your uric acid, so I don't want you to worry about the high purine vegetable as much.

Now, if you're eating mushrooms, I've actually had people that eat seven, eight, nine, 10 cups of mushrooms a day. Again, I'm always going to say about food in general, eat the portion size, trade up your foods. Let's not eat the same food every day, folks.

Let's move it along. Let me get There's Go to the produce section. There's no superfood.

All those foods are having their own little capes. Mix it up. Get rid of spinach and almonds, and mix up your fruits and vegetables.

Let me see here. I pulled up Mayo has a nice little purine list. I want you to go to mayoclinic.com, put in "high purine food list" and go through it.

I'm not going to waste our time here. But, red meat, seafood, organ meat, all of those things, alcohol, sugary foods and beverages, that will decrease your chances to have a build up of uric acid, as well. So, all of these things, follow the Kidney Stone Diet!

Modifying Smoothie Bases for Stone Safety

00:15:20 Jill Harris

That's what you do, David, so you'll have your goal of 100 mg of oxalate. You'll see you can you can eat so many of your favorite foods. Stop eating the same things in your smoothies.

Do I care about smoothies? No, I do not. I don't care about them if you're mixing them up and get rid of the spinach and almond milk, cuz that's typically what cashew milk, cashews are in there.

So, it's the type of People say, "Jill said no smooth-." Jill doesn't say no smoothies. Jill says, "Look at what your smoothie base is." Stop using the high oxalate foods day in and day out. Get your calcium needs met.

Also, do not use smoothies as a meal replacement. It's not sustainable long-term.

It's not sustainable. We are meant to chew our food. If David wants to use that for breakfast, because that's what his breakfast is, that's beautiful.

Fine, okay? That's not a problem. He seems to enjoy what he's eating.

He made a kidney stone, though, so he could be overeating certain foods, like high-oxalate foods, without getting enough calcium, and maybe he's overdoing his meat protein. David, schedule a urine analysis with me, kidneystonediet.com, so I can go over your urine collection and see what's going on, and that will prompt even a better conversation with your doctor going forward, as well, so you can see exactly.

Also, we've got to be careful here. Lots of times, there's just This is has nothing to do with what David's doctor said, meaning this isn't about David's doctor, this next statement. This is just in the world.

Just in the world, I want to be very clear about that. I am not dogging on any medical professional, being very clear about that. But I, as a nurse, when I'm talking to people, I'm very clear, "You might want to limit, you might want to go lower." I'm very clear on how much, so a patient knows, because sometimes when you're giving advice to a patient, they're not thinking.

They're they're so listening to you, they're not thinking about a lot of stuff until they go home and they're like, "Oh, I should have asked this, this, and this," because that's what they tell me, so I know. So, over the years of talking to all of these patients for 24 years, I really know where to go in my consultations because I have learned from mistakes I made or things that, you know, once you get off the phone with somebody and then they email you 20 times and you're already getting hundreds of emails a day, you learn quickly how to incorporate information into a call so they get everything, okay?

Because I certainly don't have time to email people all the follow-up stuff. So, I'm very thorough in my phone calls, and I know how to talk to a patient in a way that they can understand, because everybody's different.

And so, the goals of the Kidney Stone Diet are very specific so patients know what to try to get to. Specific, concise information so they can be successful. And then, how you actually do, how you actually make all those goals, well, you take the Kidney Stone Prevention Course, you'll go to YouTube, stay here, and you start learning from these free videos.

You go to kidneystonediet.com. That's how you start, then, learning the how-to. But the Kidney Stone Prevention Course, also $40 off right now.

That will eventually go up, people. And you know what, when we raise prices back up, people email, "Jill, was it on sale? Can I get it for that?" No, you can't.

It's been on sale for the last several months. When it's off sale, it's off sale. So, get it while you can because $40 off won't last forever.

We're giving it away.

So, I totally understand where David's coming from. David, all food within portion sizes. Perhaps, you're going overboard on certain high-oxalate foods and maybe overeating meat protein, based upon your weight and your genetic makeup.

Schedule the consult with me, if you'd like, and we can go over it more in depth. I think that's about it for David. But I understand, you know, again, you know, plants and meat, what am I supposed to eat?

I, you know, I don't know what to do now. What do I eat? Bananas all day?

I mean, right? So, it's it's complicated, right? We've got to pay attention to how we give advice and how patients interpret our advice.

I've, you know, I've learned that from being a patient myself and, also, doing the work I've done so long, right?

Replacing Spinach and Almonds in Diet Plans

00:19:49 Jeff Sarris

Yeah, yeah. And, like you mentioned with the smoothies, the big thing tends to be like spinach is healthy and almonds are better than other things and like it's funny because just this week I came across someone looking for smoothie recipes and like someone who's means well, she's nutritionist and everything, she's like, "Oh, every day two or three large handfuls of spinach, almond butter, almond milk, and then whatever else she put in." And like course.

And that's so common because we think it's more is better. But, and like I think it was in the last episode when I mentioned, like I knew nothing about oxalate before. So, like I would have been like, "Oh, that sounds great.

Let me try this recipe for this smoothie." But we don't know what we don't know until we start to learn those things. But what's left to eat? That's why we have the meal plan as well.

It's like you sort of you answered that call after so many people were like, "Okay, what is there?" So, kidneystonediet.com you can find the meal plans where every single day you'll get breakfast, lunch, dinner, and a snack as inspiration. It's not what you have to eat, but it's it's just to show that there's so much more that can still be eaten.

Despite what feel like really just they can feel like restrictions, like our hands are tied, like there's nothing left, but there is so much that is left. And that is a very practical approach to every week having the inspiration. And even just a few weeks in, like one month in, you have so many recipes and so many things, it can help recalibrate where you are and then be like, "Okay, I don't need this anymore.

I don't need the meal plan. I get it. Like I see how much diversity there is within the Kidney Stone Diet parameters, the goals that are set out."

00:21:33 Jill Harris

Yes, absolutely. And right now, we're also giving a 30 recipe snack and dessert book that will come with the meal plan, which is, they're freaking good, too. So, it's a it's a beautiful e-book that you download and it comes with the meal plan.

So, we're giving that away free, just for getting the meal plan. And when you cancel the meal plan, you get that as a gift because we're we're cool like that at Kidney Stone Diet.

00:21:58 Jeff Sarris

Yeah. It's always yours. But, yeah, I think that was a great question.

Thank you so much, David, for calling in. And if you're out there and you have a question, the number again is 773-789-8763, and we definitely want to hear want to hear from you. There's a lot of people out there.

It's wild to think how many people are watching these videos, how many subscribers across all platforms, audio, video. And we love hearing as many voices as possible. So, thank you to everyone, everyone who's subscribed, everyone who listens, everyone who calls in.

And if you're watching on YouTube, subscribe, thumbs up, comment below. It goes a long way. If you're on Apple Podcasts, Spotify, if you leave reviews there or ratings, all of that helps.

Like every little bit helps us reach more people, and we are eternally grateful because we just want to together improve the landscape here and help people live better lives and not be suffering.

00:22:54 Jill Harris

Yep. I mean, look, kidney stones can be prevented. Of course, we can reduce up to 80%.

We get up to an 80% reduction rate, so it's really important with a treatment plan. But, you know, a doctor has to order a urine collection so you know what treatment plan you need to go on, whatever treatment plan you go on, it will include diet. And also, for those of you, I work with a lot of people who just do weight loss, Kidney Stone Diet's going to help you lose weight, too.

Again, it's not magical. We're telling you to pay attention to how you feed your body with lowering salt and lowering added sugar. When you do that, you're typically have no choice but to eat healthier foods.

So, everybody that's watching, thanks so much for all the love and support you give us. We are just We just feed off of it, and it means so much to us. So, thank you so much for subscribing, thank you so much for leaving comments, and we appreciate all the kindness you show us.

Wonderful. Thank you, David, great question.

00:23:49 Jeff Sarris

Yeah, and we will see you all next week.

00:23:52 Jill Harris

Bye, guys.