Beyond Harvard, who can we trust for oxalate info?

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.

And I'm Jill Harris, your kidney stone prevention nurse in the house.

We need a little jingle every time. We like that.

Yeah, I'm going to start making them up.

Yeah. So, we are playing Pam's message today. We've had this is what the third time we're trying this episode.

Rebooted everything, so we should, fingers crossed, be good, and let's see when I hit play here.

Hey, Jill. Hey, Jeff. This is Pam from the Facebook group.

I post a lot. You might be able to guess who I am. I'd say my last name, but Jeff's the nut, too.

So, anyway, this is Pam. And my question is about the oxalate list. I know that you only use the Harvard list, and I've listened to you explain why many, many times.

But, obviously, lots and lots of questions come up on a regular basis from people wanting to know other information. So, my question to you is this: For example, I just checked now to make sure I'm not misspeaking, coconut is not on the Harvard oxalate list, and yet lots of people in the group drink coconut milk, eat coconut chips, and I've seen you comment before that coconut's fine, coconut's low.

So, apparently, there's a study out there somewhere, I'm guessing, that said coconut's low and you trust that information. So, my question is why can't that be added to your list? Instead of having it just be the Harvard list, have it be just a list and have Harvard next to the entries that were tested by Harvard and have, you know, Jill's stamp of approval next to the ones that weren't, but that you still believe are trustworthy, right?

Quinoa comes up a lot. Quinoa's actually high. Oh, you say it's high, everyone says it's high, so obviously there's been studies done on quinoa and people think it's high.

So, why not have quinoa on there, on the not safe list, and just notate that it wasn't from Harvard, right? Macadamia nuts, that's a big one for me. I eat macadamia nuts almost every day, honestly, and they're not on the list.

But I found studies on my own that said they were low, actually lower than a lot of the nuts that are even on the safe list, so I eat macadamia nuts. Like, what I'm just wondering in an effort to help people more, why don't you take some of this information from other sources and include it so that it's readily available for people?

Is what I'd like to know. Another example is things like probiotics. You know, there's another doctor I had asked you about recently to see if he was, you know, legitimate or a quack, and you're like, "No, he's a legit guy." So, I've been reading about some of his stuff, and he talks about probiotics being helpful in degrading oxalate.

Like, and people ask about that a lot, and the answer's always, you know, "I don't really know. They're probably safe, blah, blah, blah." Why not include research from other people? Why only Harvard if there are, in fact, other legitimate people out there looking into this stuff?

That was a long question, and I apologize, and you're going to make fun of me, and that's what I look forward to. I hope this makes it on the show. I'll talk to you soon.

Probiotics, Quinoa Oxalate Data, and Urine Collections

Bye.

Frickin' Pam! She knows! Okay, Pam.

So,

I like Pam extra because she always asks interesting questions. So, I hear what she's saying. My job, and it makes perfect sense what she's saying.

My job is to keep things as easy as possible for people. So, first of all, I'm not going to speak about pills as far as probiotics are good or bad. I personally believe, there's been a lot of studies that say probiotics, they're kind of out if they're really that helpful.

Prebiotics, on the other hand, are in right now. So, there's conflicting studies on a lot of things.

We talk about diet as in food. So, you know, if people want to take probiotics or prebiotics, then they can discuss that with their doctor. That's the end of that.

As far as the foods, I don't think I've ever said quinoa is high. I know people say quinoa is high.

I have always said we don't know because Harvard didn't study it. So, because I'm promoting that list, I really like to keep it concise. It's Harvard's list.

I don't touch it. This is what they say. Now, she's saying, could I add the list that have, could I add on that list or put a little asterisk or something else, here was a study that says these things are okay?

You know, for every study that says something's okay, there's a study that says it isn't. So, it gets confusing, so I like to keep the information the same. Why?

Because, again, I'm looking at the follow-up. So, coconut milk, I don't think anybody's ever studied coconut milk, but I know a ton of my patients drink it and continue to have low oxalate. So, that's what I'm basing that on.

The other thing, macadamia nuts. I mean, you know, look, if you want to try nuts, do it. Do your urine collection to see, or if you want to try anything that's not on the Harvard list, I always tell people make sure you're doing eating those foods that have not been studied by Harvard when you do your follow-up collection.

Get your normal amounts of calcium,

And you'll see what it does to you. I've never had somebody come back with a higher oxalate level because they're eating it within portion size. I don't want to confuse it.

It's easier for me to say Harvard hasn't studied it, have it in a portion size once or twice a week, normal portion size, because you're still getting to add it to your diet. I'm just telling people not to overdo it, right? So, coconut milk, they Somebody should study it

Because my patients drink a lot of it and they're not having any oxalate problem. For people who have cholesterol issues, though, that may not be the best choice for you because of the high saturated fat. So, I understand what Pam's saying.

I don't want to toy with that Harvard list too much. I just don't. It's not my list.

I like to keep things as easy as possible.

I have found Pam is somebody who likes to really delve deep. Most people do not. So, I have found in 21 years that when you keep things, of course, correct, but also simple, you get longer-term compliance, okay?

Pam will not be happy with that answer because I know Pam and I understand that she won't.

But since she's so great at researching and doing her own stuff, and being compliant, and doing urine collections, she can continue on her merry way, you know? So, if I have really valid studies for something, maybe I'll think about that going forward. But right now, I'm not ready to tinker with that list because my advice has been working so far for two decades.

Now, I invite her to write me in an email and challenge me on that. But I and I mean that. So, she can say, "Listen." I'm not, I can be I can be persuade is what I'm saying.

But for now, I'd really like to leave that list as it is. The oxalate portion of this is so simple and so overdone as it is.

I'd just rather do it that way.

Yeah, for sure. Yeah.

And I and I could Maybe I'm being like really inflexible here. Like I said, I'm open, people.

Well, yeah, you've trusted it, though, for over 20 years, so it makes sense because this is from the follow-ups, like you said, and all of the experience with thousands of patients. Like, you know for a fact that those are the concrete sort of answers to the questions for those specific foods.

Yeah, and what people come to me with, they're so confused as it is by oxalates. So, I have just learned to really streamline this as much as possible, right? So, that's why I don't tinker with their list or add things.

You know, on Dr. Coe's list, we did do a couple things on the original article, "How to Eat a Low Oxalate Diet," on his website at kidneystonediet.uchicago.edu,

And he and I authored an article over there. And we did make some changes to a couple foods that have, and maybe we'll do it in the future. I'm out on it right now, though.

Yeah. Yeah, for now, yeah, it's it's sort of, "Don't don't fix what ain't broken," kind of thing for right now. But there is, like she's very like very right on point.

There is so much other information out there. It's just, yeah, right now the focus is on the single source of Excuse me. The single source of information regarding oxalate.

And like you said, it's one part of a much larger picture for the Kidney Stone Diet itself.

Yes, the more I am changing things about oxalate or discussing oxalate, I like to calm people down, give them the basic rules about it. And from there, they can they find themselves, "Oh, I get that." And then they can also tackle the other things that are so extremely important like the salt and the sugar part, and overeating meat protein, and not getting enough fluids, and getting some calcium because they haven't their whole adult life, you know?

So, those are the things I'm much more focused on. Again, I understand what Pam's saying and it makes perfect sense, and Pam is another level, which I really appreciate about her. That's not a That's a wonderful thing that she really takes what she learns and then just brings it into She hones down into it.

Most people are not like that, and they really just want some basic information so they can start their journey, and then maybe later on. So, so I challenge her to challenge me if she'd like to do that. I'm open to it.

Yeah, for sure. Yeah, because this is this is the framework of the Kidney Stone Diet and how you've experienced it, but I mean, who knows? Maybe there is actually room for like an advanced framework for people who are really like already super health-conscious, very dialed in on like fine detail.

Like maybe down the line that is something that would be part of the platform.

100%. That's why I'm saying I think it's a brilliant question. I'm thrilled that she asked it.

I'm I'm I'm open to it. I'm not doing anything right now, but I'm open to it. I understand what she's saying.

It makes perfect sense.

Yeah, for sure. And it's all about the results. Yeah, whatever gets the best results, that's the path that you're going to take.

So,

Exactly.

Yeah, thanks so much, Pam, for the question. And for anyone else with a question, it's 773-789-8763 is the phone number where you can where you can leave a question for Jill to answer in a future episode.

And if you're watching on YouTube, we'd love a thumbs up and subscribe and hit that little bell to be notified when the next episode comes out. We drop a new episode every Tuesday. We're also everywhere: Apple Podcasts, Spotify, anywhere that you listen to podcasts.

And then you have the website, kidneystonediet.com, where there's the free weekly newsletter, the free recipes, the all the blog posts, all the content, and then we also have the Kidney Stone Prevention Course, the Kidney Stone Diet meal plans, so much information out there and all the different resources like the oxalate list, like the protein calculator, all of these things where we really we've done our best to make kidneystonediet.com the central hub where you can find everything that you need whether you want to go a completely self-directed route or if you want to work with Jill through the course and through group calls and everything.

But everything's there at kidneystonediet.com. So, yeah, I think that's a good place to wrap for this week.

Thank you, Pam!

Thanks so much. Yeah, thanks for your call, and we will check in with everyone next week.

See ya.