# How do you prevent kidney stones on a keto diet? Source: https://kidneystonediet.com/ep/how-do-you-prevent-kidney-stones-on-a-keto-diet/ Published: 2023-03-21 --- [![Kidney Stone Diet Podcast](https://kidneystonediet.com/wp-content/uploads/2024/07/Kidney-Stone-Diet-Podcast-1-1024x1024.jpg)](https://kidneystonediet.com/podcast/) [YouTube](https://www.youtube.com/watch?v=fhRMd-VDhrc)[Apple Podcasts](https://podcasts.apple.com/us/podcast/how-do-you-prevent-kidney-stones-on-a-keto-diet/id1528474326?i=1000605177154&uo=4)[Spotify](https://open.spotify.com/episode/1L5JyG1XXDOy1GnGitjqoU)[Amazon Music](https://music.amazon.com/podcasts/0868148d-adfd-411d-b3f2-71a0ad1461ec) March 21, 2023 --- ![Jeff Sarris](https://kidneystonediet.com/wp-content/uploads/2026/02/Jeff-Sarris-150x150.jpg) Jeff Sarris Host ![Jill Harris](https://kidneystonediet.com/wp-content/uploads/2026/07/Kidney-Stone-Diet-Jill-Harris-150x150.jpg) Jill Harris Host This week, Jill answers a listener question about preventing kidney stones with a keto diet. This podcast is designed to entertain and inform — not provide medical advice. 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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](https://kidneystonediet.com/), stone formers can learn everything they need to know to significantly lower new stone risk. *Some of the links above may be affiliate links which means that we earn a small commission from qualifying purchases at no additional cost to you. Thanks for your support!\*\ —— ***Kidney Stone Diet is a SPYR Podcast _****\*\ [*More SPYR Podcasts*](http://spyr.fm/)*_*\ Starting Now / By Amara ## Chapters - 00:00:00 Podcast Opening and Medical Disclaimer - 00:01:15 Health Perspectives on Low-Carb Diets - 00:02:40 Fitting Keto into Kidney Stone Diet Goals - 00:10:16 High-Sodium and High-Oxalate Keto Foods - 00:10:45 Overcoming Mindsets and Trying New Vegetables - 00:17:23 Using Kidney Stone Pain for Lifestyle Motivation - 00:18:24 Community Support and Accountability Groups ## Transcript ### Podcast Opening and Medical Disclaimer 00:00:00 Jeff Sarris The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting a new treatment. 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. 00:00:28 Jill Harris And I'm Jill Harris, your kidney stone prevention nurse. I You know, so we've been shooting a few shows right now, but I was looking at your face and I'm like, "Oh, I love you!" That's what I was thinking. And, you know, folks, Jeff gets so embarrassed. It's like, stop being embarrassed! I do. We all do. I love you. And I know my mom's watching right now and she's like, "Yeah, we all do." 00:00:50 Jeff Sarris Oh, no! 00:00:51 Jill Harris Yeah, she loves you.. That Jeff, he's so handsome, Jill. Oh god, Mom! But he is. 00:00:58 Jeff Sarris You're just too sweet. I don't I just don't know how to respond to that. 00:01:03 Jill Harris No, but it's all true! 00:01:05 Jeff Sarris No, I appreciate it! I just don't know how to respond. You got me all flustered! 00:01:09 Jill Harris I know! I know. We like seeing you flustered, it's fun! ### Health Perspectives on Low-Carb Diets 00:01:15 Jeff Sarris But, yeah. So, as you mentioned, we've been filming a few today, a few episodes, and we were thinking one more FAQ. And we'll get back to the listener questions, which we always appreciate. But we were thinking specifically to talk We would talk about the keto diet, and how do you prevent kidney stones on a keto diet, being a pretty common question because there's Well, why don't you just take it from here? 00:01:41 Jill Harris Yeah! But I mean, say whatever you want. Nobody ever wants to hear my cackling voice all day long. So, what do you think about the keto diet? 00:01:49 Jeff Sarris Oh, well, yeah, just from a health and just an all-around perspective. Like I come from like the paleo diet space, which is a lower carb It's It's not the It's not the depths of low carb as keto is because that more As far as I understand, came more from a clinical standpoint initially. But I do I do participate in a low-carb diet. Like that's basically what I've done now for a while, I mean, maybe since 2012, 2011 or so. And, yeah, I feel great. I feel so much better than when I when I have a lot more carbs and things. So I do I do have an affinity for it. But I know there's also a connection here that ties into kidney stones, which is something to definitely note and be aware of. ### Fitting Keto into Kidney Stone Diet Goals 00:02:40 Jill Harris Yes. So, this is what people say: "Jill says no keto!"! That's what Jill says. That is not what Jill says. Jill does not say no keto. That is not what I say. Here's what I say: you could do any lifestyle that works for you. You just got to fit them into the KSD goals, Kidney Stone Diet goals. If you notice, we have If you go to kidneystonediet.com, the start page, you're going to see a little handout, and it just puts the goals right there for you. The salt, 1500 mg a day. The added sugar, 25 g of added sugar a day for women, 38 g of added sugar a day for men. It's 37.5, but we just give you the half. Calcium, 1,000 for men and 1,000 for women who still get their periods. Postmenopausal women, 1200 mg of calcium. Get your fluids, we want you to pee out 2 1/2 L to 3 L of urine a day. Oxalate, 100 mg a day you get. And then there's the protein part, meat protein. "Jill, I don't eat red meat." Well, chicken's meat, too, people! All meat, plus some seafood. You don't want to overeat it. And this is where we go into keto and paleo. You don't want to overeat it because it can increase your risk for uric acid stones and calcium oxalate stones. So, keto, here's what I officially think of keto: most people can't stay on it a long time. It's very difficult to not eat That's That's a very low-carb diet. Wow, is it a low-carb diet! If you can do it, and you're happy on it, and this is your lifestyle for the rest of your life, then you can continue doing it. You just got to fit into my Kidney Stone Diet goals. And the way that keto people overeat spinach and almonds, they're going to break that oxalate, they're going to be withdrawn on that oxalate bank account with one spinach salad. Just because there's over 600 mg of spinach for a cup of oxalate for a cup of spinach. So, if you want to do keto, you can do it. You just can't overeat all that meat. Not that's It's not a high-protein diet, it's a high-fat diet. People also do keto wrong. So, let's just say this: I, like Jeff, I also do a very low-carb diet. So I'm not opposed to low-carb diets if that diet works for you. Now, if you're somebody that's like, "I need to lose 50 lb and I'm going to go on keto or paleo, and I'm going to give up bread, but every day all you think about is bread, and/or you lose that 50 lb and you go back to eating all those carbs, you're going to gain your weight right back. So, what I'm saying is, if paleo or keto, and in this case we're talking about keto, is not something you can sustain long term, you shouldn't be doing it. What I'm trying to teach you is long-term dietary changes, figuring out a lifestyle that works for you, and it can be any lifestyle you want as long as you fit in those KSD goals. So, for keto, what happens? Why do keto patients make kidney stones? Because they overeat all the almonds, almond flour, cuz they're baking now, cuz they can't have their carbs, so they're going to bake with almond flour, and a lot of it. Almond milk, almond flour, almond just almonds, handfuls of almonds, is what I'm told every day. Spinach, spinach, spinach. So, what they're doing is they're overeating the higher calcium the high Sorry, people. We've taped a few shows. They're overeating the highest oxalate foods in any and all amounts they want. Because remember, when you disclude a whole food group, you going to be overeating the ones you can have, which in this case, people, even though it's a high-fat diet, they will overeat things like They'll still overeat meat, okay? They're overeating avocados. Avocados as a kidney stone patient, there's a video on it, you can certainly have an avocado, you just can't have four of them a day. And, believe me, I've dealt with keto patients that were like, "Well, I was eating four of them a day because it's high fat, good fiber, you know." So, that's what they're doing. So, it's not necessarily keto that caused your stone. So, the keto people are going to be like, "Oh, okay!" It's how you interpreted keto and did it. So, if you want to eat a higher fat diet because that works for all your things, your cholesterol, your heart disease, if that's working for you, is it? But if it is, is it, all that saturated fat? Is it? But if it is, then continue doing it! If all your numbers look good and you feel great, and, most of all, you're happy with it, you feel satisfied, and it's something you're enjoying, then you should do it. You just can't overeat meat. And again, I know keto is high fat, but people overeat meat because they're not eating any carbs, and they overeat the highest oxalate foods. So, I work with people that stay on keto. I just tell them, "You're going to have to have other nuts. There's other nuts you can have, but you can't have handfuls and bushels of anything, all day long. And you must get your calcium needs met." So, Jeff and I both do low-carb diet, but we're not overeating foods we are allowed to have. We're not doing that. We eat all food within normal portion size. That's what a healthy diet is no matter what lifestyle you're trying to lead. So, if you want to do keto, you certainly can. You just have to fit in the Kidney Stone Diet goals. Also, a lot of keto patients are eating so much salt because they're sucking down cheese all day long. Cheese, cuz it's higher fat, they're eating cheese, and a lot of the meats they're eating, they're all they're high salt. So, it's a very high-salt diet. And listen, you can't blame people. I'm not mad about that. Unless we have high blood pressure issues or we have too much calcium in our urine or we have heart disease, nobody's talking to us about a high-salt diet. So you So, patients say, "Well, I didn't realize anything about salt. My blood pressure's fine, so I didn't think anything about it." So, it's not until things go wrong with us that we're told to change something. But everybody should be paying attention to sodium, okay? And so, keto can be a very high-salt diet with even though you didn't even think that mattered until you got a kidney stone, and we overeat the highest oxalate foods on keto, that's what we do. So, keto, if you want to do it, just fit into the Kidney Stone Diet goals. I don't necessarily have a problem with it, if it's it's not something I would enjoy, but if it's what you enjoy and you're doing it that fits into the goals, god bless, go for it! That's what I say, okay? You just cannot eat as much as you want of those high-oxalate foods anymore. You can eat some of them, not spinach products or not spinach stuff or almond products, but everything else can. You can eat an avocado, just not four anymore. Get your calcium needs met, and not just through salty cheese. ### High-Sodium and High-Oxalate Keto Foods 00:10:16 Jeff Sarris Well, yeah. And the salt is a great point because people hear like, "Oh, I can eat all the bacon I want." And that sounds phenomenal. And then you have a bunch of bacon. You, "Oh, I'll throw some spinach in my smoothie. It'll be all almond milk or almond butter in the smoothie." Like all these things that it's like, "Oh, this is healthy." And sure, there are there are parts of these things that are healthy. But when it comes to kidney stones, there are very specific red flags that go up right away. ### Overcoming Mindsets and Trying New Vegetables 00:10:45 Jill Harris Absolutely! Absolutely. And so, people will say, "Keto caused my stones!" Keto didn't cause your stone, it's the way you did it. So, and I'm not and I'm also not blaming you guys, cuz you don't know what you don't know. So, I'm not blaming you. You just took it to a We, as human beings, tend to find something that works for us, and again, especially if it's a healthy food, we're just like, "It's a free food." There is no free food. I know Weight Watchers will say, "There's zero points. Eat as much spinach as you want!" Weight Watchers gave me a stone. No, it's the way you did it. We should not eat any food, there is no one superfood that we should be eating all day. All foods, all fruits and vegetables—in this case, no spinach because of kidney stones—all fruits and vegetables, normal portion sizes of varying amount of fruits and vegetables. "I don't like fruits and vegetables!" Well, could you try? Could you just see one vegetable? And you might find, and don't pick corn. Just pick a vegetable and try it. I can't tell you how many patients are like, "I don't eat vegetables." Okay. Well, how long have you been saying that, Henry? "Well, since I'm seven." Well, you might want to pick up your pen and write a different story cuz now you're just a 70-year-old man that doesn't eat vegetables. How about just try a vegetable. Email me in a couple weeks and tell me what you tried, tell me how you feel. Dear Old Lady, it's been two weeks. I hated you the first week and a half, and then finally after the 12th day, I said, "Ugh, let me try some zucchini." I tried it. I have to tell you, I liked it. I'm going to keep on trying. That's all I'm asking! That's all I'm asking. No matter what it is, whether it's food or, you know, "I'm not somebody who swims, I'm not somebody who does this." Sometimes we need to revisit our stories and think to ourselves, "Holy Toledo, I've been saying this for decades!" Maybe that's not, and then you become that character. Maybe it's time to pick up a pen and write a different story. Just like I was the kind of person that said, "I just don't cook." Well, when I got divorced, I had to learn how to cook, and my friend said to me, "If you can read, you can cook." Changed my life. I got a meal plan now! Who would think? Okay? I might freaking do a cooking show, one never knows. But we got to write, we got to write a different character for ourselves sometimes, right? So, that's all I'm saying. Keto, it will not cause a kidney stone unless you're doing it and overeating the highest oxalate foods and not getting any calcium. You will get kidney stones, but the most people do keto, and they do exactly what I just said. How do I know? Because they tell me: overeat spinach, almond products, got no calcium except salty cheese, and also, you know, they're not drinking their water maybe, or whatever. But it's always the high oxalate and high salt part. And, you know, they're overdoing meat, even though keto isn't a high-protein diet, they're overdoing meat because, again, when you take away carbs, which, guys, carbs are a great freaking energy source. But when you take away a whole food group—and I'm saying that as a low-carb person, but the we I don't know why we vilify carbs. Jeff and I choose low-carb diets because they make it makes us feel good, and with my bowel issues, that works for me, okay? But if I want a bun, I have a bun. I mean, I'm not, you know, I will have I just made something for the meal plan today. It's was a sourdough, I grilled it up, piece of sourdough bread with avocado, mozzarella, a balsamic, and tomatoes. And I never have bread, but I wanted it! So, that's another thing. No one asked, but I'm going to tell you anyway. It's another thing. Sometimes, we are creating such a box for ourselves that I'm like, "I really have been hankering a piece of sourdough bread." I've had sourdough bread maybe twice in 60 years. Today was one of the days, I had to get it. I made it, I moved on. I probably won't ever I'll probably die before I hanker it again. But we should also have things that we crave sometimes because we won't stop thinking about it. And that's also how diets don't work, and lifestyles get messed up. Enjoy your food. Move on. I may not feel so great in my belly, but it was I don't care, whatever. I mean, it's one piece of bread, what's it going to do? So, I'm just saying, sometimes we have to, if we're having a craving, we should have it, move on, get right back on your lifestyle. That doesn't create any illness either, okay? 00:15:13 Jeff Sarris Yeah. Yeah, absolutely. Yeah, we're not depriving ourselves. It's, we've found 00:15:16 Jill Harris No, I don't feel I never feel deprived, no. 00:15:19 Jeff Sarris Yeah. Yeah, we've just found the things that make us feel good, so then the cravings may have shifted even with time. But that's just how it is. But, yeah, I think it's great to also say that we tell ourselves we write the story at some point of who we are, and that is always changing and we can change at any point. And it's just that it's it's scary to change. It's like it's a lot to be like, "Well, no, this is me," because sometimes we wrap up our identity in something like, like, "I don't eat vegetables," or something along those lines. 00:15:52 Jill Harris Right. Right. 00:15:53 Jeff Sarris So, very important stuff to consider. 00:15:56 Jill Harris Yeah, no, I mean, I'll say, "Well, Henry, you know, I will say this to patients. How long have you been saying that?" "Well, ever since I was a kid." "And, well, you might want to revisit a vegetable." I mean, you know, it's so sad that somebody has deprived themselves of so many foods they may really enjoy. And then the next thing I can't tell you how many of my patients I've done this with, and then, you know, some of them even became vegetarians! They're like, "My whole world opened up, and I'm so glad you were such a witch to me because th- they're like they're grateful that I pushed them a little. It's like, you just might want to rethink this, especially now because you got this heart disease here, okay? So, you know, there's other things going on with them, too. Nobody at my age and above is just a kidney stone former, typically. They are getting other medical conditions now based upon what their dietary habits have been. And so that's why I say that is the one thing I'm grateful for kidney stones, because that is the time This is the time where people are like, "Never again!" People who are even diabetics, you're taking insulin, you know, you're not having that intense pain. It's a chronic disease, diabetes. Kidney stones knock you upside your head and will make you rethink your whole existence. That's how bad the pain is. And so that prompts the diet change, where no other medical condition they had ever did before, okay? So, that is why I am grateful for this disease for that, that alone. But it does get people to wake up and change their lifestyle, so that I'm grateful for. ### Using Kidney Stone Pain for Lifestyle Motivation 00:17:23 Jeff Sarris Yeah. And with that, I think we will close for this week. If you have a question, the number is 773-789-8763, and we'd love to hear your voice in the future. And if you have more if you have want to dive deeper, you can go to kidneystonediet.com where you can find all of the resources. You can find the Kidney Stone Prevention group on Facebook, which is a thriving group that constantly has new people coming in with questions, and it's a community-driven experience there, completely free. Jill's there curating and contributing, but it's also it's very community focused, so a lot of times it's just helpful to realize that we're not alone in our struggle. Which along those lines, too, you have the accountability calls, where people come together every week, and you discuss where you are, where you can help people on their journey. And again, that can be found at kidneystonediet.com. ### Community Support and Accountability Groups 00:18:24 Jill Harris That's a very valuable piece of the thing the services we have, that accountability group, because people lose 50 lb, 100 lb, and then they're there, and they're, you know It doesn't mean once you lose weight, by the way, then you've got the hard work, the hardest work is maintaining that. And that's why with the course, I give that for the first month free, and then thereafter it's only $19. I mean, I give that away. And sometimes we're in those calls for two hours. You come and go as you please, they're office hours. But we're talking about real life stuff. People at our age that are dealing with older parents and also still have kids at home, and dealing with a lot of things, right? We're still working, all this stuff, and it's a stressful time. How do we maintain our lifestyle changes? What do we do when obstacles come up? We talk about real life things and it's a very that accountability group is I just love it, and the people that are in there, we all become a family together. It's amazing. Very vulnerable, wonderful. You learn about kidney stone stuff, of course, but we talk about real life and what are the obstacles get that get in the way of maintaining a healthy lifestyle, and we deal with it so then that person who's maybe having an obstacle can get remotivated, get back to work after the call, and they feel good and invigorated, and it's very it's a very loving, supportive group. I get just as much out of it that I give to it. It's amazing, really. 00:19:45 Jeff Sarris Absolutely. Yeah. So, thanks again to everyone out there listening, liking, commenting, subscribing, and we'll see you next week. 00:19:53 Jill Harris Bye, Jeff. 00:19:54 Jeff Sarris Bye. See ya.