“Jill, am I ever going to be able to eat normally again?”
I understand why people ask this. After a kidney stone, food can suddenly feel complicated. People start searching the internet, downloading oxalate lists, cutting out foods they have eaten for years, and wondering whether every meal will cause another stone.
So what is “normal eating”?
For many people, normal means not having to think very much about what they eat. And while I don’t want anyone obsessing over food, I do think most of us should pay some attention to what we eat, whether we are trying to prevent kidney stones, high blood pressure, diabetes, heart disease, or bone loss.
The wake-up call.
“Jill, I never really worried much about my diet. I take medication for my blood pressure. My cholesterol is treated. My blood sugar is being watched. I figured I was taking care of those things.”
Then they make a kidney stone and suddenly they start paying special attention to how they eat. They want to know how much sodium they’re eating, whether they’re drinking enough, how much calcium they need, how much meat is appropriate, and whether they really need to be afraid of oxalate.
Let your kidney stone be the reason you finally learn to eat well.
This does not mean medication is bad or unnecessary. Sometimes medication is very important. But doctors also have limited time during office visits, and advice such as “eat less salt,” “drink more water,” or “eat healthier” is often not specific enough to help someone make real changes.
Patients need actual goals. If someone is eating 8,000 mg of sodium a day and lowers it to 6,500 mg, they did lower their sodium, but they are still nowhere near where we want them to be.
Knowing the target matters.
The same is true for fluid, calcium, meat protein, added sugar, and oxalate. The more specific we can be, the easier it becomes for someone to know what they are actually trying to accomplish.
I get why changing the way you eat feels so hard. It is hard.
The diet industry has spent years telling us that changing our habits should be quick and easy, but it is not. I think of it much like learning a new language. If you do not understand Spanish today, you are not going to wake up tomorrow speaking it fluently. You learn, practice, make mistakes (and don’t beat yourself up when you do), and keep going until it feels more natural.
Food habits are the same. Most of us have shopped, cooked, ordered, and eaten a certain way for decades. Of course it takes time to change.
Most of my private patients are very motivated because they never want to go through another kidney stone again, but even highly motivated people need time to learn. Eventually, though, the changes begin to feel much less like a special “diet” and much more like the way they normally eat.
This is what normal eating looks like.
Eating normally after kidney stones doesn’t mean eating without regard for your health. It means still enjoying food, going out to dinner, having dessert, traveling, celebrating holidays, and eating foods you love while also forming the habits that lower your stone risk.
This is why I talk so much about portion, not perfection.
You do not have to eat perfectly to prevent kidney stones. You do, however, need to understand your own risk factors and make good choices most of the time. And when you don’t, that’s ok. Simply get back on track with your next meal.
That’s normal eating in my book. It doesn’t matter what you’re treating.
Your friend and advocate,
Nurse Jill
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