No plants, no meat, what do I eat

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

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.

Jill Harris: Hi, Jeff!

Jeff Sarris: Hi! 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 screen. I’m like, “Eh, it’s just what I do.”

Jill Harris: Well, we all have our things we do. 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. Coe, he’s always like he does this. He does this.

Jeff Sarris: Oh, really?

Jill Harris: 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. I’m always like moving my leg. Between the two of us, we’re like a bunch of jumping beans.

Jeff Sarris: No, it’s perfect. Oh, wait, I actually need to queue this up for one second.

Jill Harris: Ok, go ahead. I’m ready for the holidays while you’re queuing. Are you?

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

Jill Harris: It’s December, I don’t know, twelfth. So, when this comes out–I guess maybe this would come out right before–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.

Jeff Sarris: 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. Other than that, we should be good to go now. I’m excited for the holidays. I like it around this time. Even though I wanted to travel and go somewhere warm and sunny before Christmas. We’re gonna go after, 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.

Jill Harris: I think that’s perfect. I mean, I love the holidays. So I want to be here. I don’t care how nasty it gets here. Doesn’t matter to me. It’s the whole end of January, February, March that you’re like, “Alright. Tick tock. This’s gotta stop!” 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 love it. It makes me so happy. And it’s just those simple joys in life that must be mindful of, especially in the world nowadays. So grab on and whatever joy you can suck out of it, make sure you do that. So important.

Jeff Sarris: Absolutely. What do you say we dive into the question?

Jill Harris: I’m ready. Let’s hear it!

Jeff Sarris: So, this is from David.

Listener Voicemail: I don’t know what I’ve been diagnosed with yet, but I did have a kidney stone. Turned out that it was a 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 is plant-based. What the hell’s in the middle? I am 64 and am 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.

Jeff Sarris: Yeah, that is a great question.

As patients, we need to be self-reliant

Jill Harris: It’s a great question. So 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. 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 bit because being a patient with my cancer stuff, I want you to know that I, too, have been to plenty of doctor’s offices. They throw the brochure or they just give this generic advice.

Now, I’m not bumming on his doctor, but I just want us to recognize–whether 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? Obviously you haven’t or you wouldn’t be saying that to me. The state of affairs is this: there’s no time in our health care system. I just tried to make a dermatologist appointment. The next available one is August. It is December 12. 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 appointment. Stage 4 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 health care system with COVID, and there’s not enough help, and people didn’t go to the doctor for two years, so much! 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, 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 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 handout, whatever, brochure, and try to decipher it by Dr. Google because, guess what? Ain’t nobody coming to talk to us in the portal anymore either. 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? What the hell?

David’s saying I eat a healthy diet. What are you telling me? David is also saying, I was told, “Watch, your purines and watch your oxalate.” And he said, “Watch my meat and watch my plants? What the hell am I doing? Sucking on notebook paper over here?!” So what is David to do? And I get heated 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 out? The doctor’s just trying to get to room to room–or her 20 patients that insurance companies are dictating they see in one day. Whatever it is, 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 it. Go to a different one, meaning go to your primary. They can order it, too. I digress as usual. So, David also said these things, he’s not overweight. He’s been eating a healthy diet. David also said this, which is very common, “I eat accept smoothies.” And what I’m guessing here is David probably overate the highest oxalate foods. So people who eat healthy tend to overeat–you will see a pattern if you’ve watched more than one of our videos here–people tend to over eat 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 oxalate, it’s too much spinach, too much almond products, sweet potatoes every day–for my personal trainer friends, sweet potatoes as much as they can eat every day. That’s their carb. So, they’re overeating high oxalate foods without getting any calcium sources. 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.

What does “lower your purines” mean?

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. So the advice he got was lower oxalate and lower purines. What does lower mean? What does lower mean? Where’s 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?

So the doctor said lower purines, lower oxalate. But David said, “So what am I supposed to eat?” Lowering means the Kidney Stone Diet goals. Get to 100 milligrams 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 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. And get your calcium needs met every day. You’ll find the goals for calcium on my blog at kidneystonediet.com. Go to the blog. So, your goal is 100 milligrams 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 purines. Purines also will be booze.

So if one drinks a six pack a day, we’re going to say lower to 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 every day. It just means eat within your normal portion size. We have a meat protein calculator aat 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 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. So, it makes sense. There’s high purine vegetables, too, people, but they have been shown 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 7, 8, 9, 10 cups of mushrooms a day. Again, I’m always going to say about food in general, eat the portion size. Trade up your food, so let’s not eat the same food every day, folks. Let’s move it along. There’s no super food. 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. 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 buildup of uric acid as well. So all of these things–follow the Kidney Stone Diet. That’s what you do, David. So you’ll have your goal of 100 milligrams of oxalate. You’ll see 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 this spinach and almond milk because that’s typically what–cashew milk. Cashews are in there.

People say, “Jill says no smoothies.” 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. 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 urinalysis with me at kidneystonediet.com, so I can go over your urine collection and see what’s going on. That will prompt even a better conversation with your doctor going forward as well. Also, we’ve got to be careful here. Lots of times–this 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. I want to be very clear about that. I’m 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 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 getting hundreds of emails a day, you can 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 about 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 do you actually do–how do you actually make all those goals? Well, you take the Kidney Stone Prevention Course. You go to YouTube. You stay here and you start learning from the free videos. You go to kidneystonediet.com.

That’s how you start then, learning about “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, it was 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 a 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 that, you know, again, you know, plants and meat, what am I supposed to eat? I don’t know what I’m supposed to do now! What do I eat bananas all day? I mean, right? So it’s complicated, right? We’ve got to pay attention to how we give advice and how patients interpret our advice. And, you know, I’ve learned that from being a patient myself and also doing the work I’ve done so long.

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 it’s funny because this week came across someone looking for smoothie recipes. It’s someone who means well. She’s a nutritionist and everything. She was like, “Every day, two or three large handfuls of spinach, almond butter, almond milk, and then whatever else you put in.” And that’s so common because we think is more is better.

I think it was in the last episode when I mentioned that I knew nothing about oxalate before, so, 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 eat? That’s why we have the Meal Plan as well. It’s like you answered that call after so many people were like, “Okay, what is there?” So at 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 just to show that there’s so much more that can still be eaten. Despite what feel like really just–it can feel like restrictions, like our hands are tight, like there’s nothing left, but there’s 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 that are set out.”

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 friggin’ good, too. So it’s a beautiful ebook that you download, and it comes to meal plans. So we’re giving that away for free, just for getting the meal plan. And when you cancel the meal plan, you get that as a gift because we’re cool like that at the Kidney Stone Diet.

Jeff Sarris: Yeah, it’s always yours! 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. We definitely 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 podcast, Spotify, if you leave reviews, their ratings, all of that helps. 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.

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’ve worked with a lot of people who just do weight loss, the Kidney Stone Diet’s gonna 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, 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 just feed off of it and it means so much to us. So thank you so much for subscribing. Thank you for so much for leaving comments, and we appreciate all the kindness you show us. Wonderful. Thank you, David, great question.

Jeff Sarris: And we will see you all next week.

Jill Harris: Bye, guys!