How to get enough fiber on a low oxalate diet

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.

Hi! I am so happy to be here. I am Jill Harris, your kidney stone prevention nurse.

I love when we get a little musical interlude [laughter] at the beginning, that's perfect.

Sometimes, sometimes I just get burst of energy and happiness, so I need to let it out. I'm not one to keep that in.

Yeah, for sure.

So, I'll go with it.

Yeah, and now, it's a little bit that you're in your new place, how's it been going?

You know, I really like it. So, all that stress, right? When we, we all get so stressed in our lives about stuff, you know, the stuff that's about to happen, "Holy Prijole, how am I going to get all this stuff done?" And then you get it done, you're like, "Oh, it wasn't so bad." And you're so happy in the new space.

I had a friend that said, "Jill, [laughter]

Be happy wherever you go, you just need to calm the heck down." And I knew that was true, but I really reflected on that ever since that was told to me, and it's so true. I'm very happy with my new neighborhood, I'm close to my son's school, he actually walked home from school yesterday, so happy about that. The neighborhood is safer overall, so, I mean, I love my neighbors, I'm like, it's a three-flat,

So, I'm like the grand, they're like 14, not really, but young. So, they call me, you know, I'm like, the Charlotte Rae of this house. What was that girl's, Mrs.

Garrett, they basically call me Grandma Jill. "Grandma Jill, you got a strainer?" "Yes, honey, come on down and get it." "Grandma Jill, what are you baking?" "Oh, come on down, you'll have some." So,

It's really nice. It feels very tiny, and community, and all that, everything that I love, right? Coming from that big, old high rise, Jeff, it's like I asked a five-second question, really, [laughter]

But, coming from that big high rise, which I loved seeing people all the time, I mean, it just feels tighter, and closer. You know, I like community, so it makes me very happy to be here. And, I'm telling you, Jeff, it honestly feels like living smack-dab in the middle of New York because there isn't anything I can't walk to.

Yeah, see, that's nice.

So, that for me, who loves walking so much, forget about it, baby. Love it! Love it!

Yeah. And, actually, Saturday we'll be in your neck of the woods, so we may have to at least swing by and just say hi if you're around.

Oh, really, you're by? What are you going to do, or maybe you don't want to say in the podcast?

Oh, no, it's all good. I mean, we're going to a, a little museum that's right up there by you. So, it's, it's right, like right down the street from the park itself.

So,

How awesome.

Yeah. So, we'll, yeah, I'll definitely text you, maybe swing by. But, yeah, anyway, for the people listening, [laughter]

Okay, let's do it.

I guess we could get into kidney stones for this week.

Oh, and I will say this, Luke has actually lost a couple pounds because he's so happy walking, too. Yeah, I bring him down the block, so when we're getting ready, I'm like, "Dude, I have calls, we got to go!" He sits down, and he's, you know, 95 lbs. So, it's like I'm like,

Oh, no! [laughter]

"Oh, my god, we got to go home, Luke!" So, it's so adorable. He's, he loves it, too, so I'm very happy with all of it.

Yeah, and it's less–

Anyway, thanks for asking.

It's, it's a lot easier to get out, too, I'm sure, just because, like, you were up, how many floors up were you, I forget?

29. 29th floor, so this, I'm right here on the first floor. I feel like I'm in a, in a house, right?

Yeah.

So, I just, the porch is right there. So, it's wonderful, it's wonderful. He sits on the porch, he thinks he owns the neighborhood, he's like an old Italian Nana [laughter] with his old Italian Nana owner, and we sit on the porch, watching the neighborhood, what's going on, what's shaking, we have a ball.

Nice!

[laughter] I really do.

Yeah, I love it, that's great.

I'm very happy.

Yeah, so like, yeah, all the stress, like you said, like, it's stressful, but it always works out, and everything, everything comes together, and, yeah, you find your joy in it.

Jeff, here's the deal, and this is why I love talking to patients, and I'm like, "Listen, listen, Cynthia made it up,

Listen, listen, Frank, listen, listen to all of this. Change is hard. Of course, you're going to be overwhelmed with all these dietary changes.

You were just thrown five lists, you don't know what the hell to do with this, right? And now, you've got to lower water, well, what does that mean? Increase calcium, how do you do it?

You're a vegan, what you going to do now? I mean, it's very complicated when you've been thrown changes. I'm just talking about a move, forget about it when you've been sick, and now a doctor or nurse is telling you, 'You got to do this.'

Very overwhelming. So, change for us as human beings is difficult for each and every single one of us. It just is, it's overwhelming.

We're creatures of habit, right? So, our job here, Jeff, is to teach people new habits. How do we teach people new habits?

And it takes a minute, ain't going to happen overnight, and then once you get them under toe, every single patient I've ever worked with is like, "

I got it now, girl." So, you practice it, just like anything else in life.

Yeah.

All right, what have we got?

Yeah, just, it becomes–

What do you think about that? What do you think about–

Oh, yeah, it becomes part of your lifestyle. That's the thing, and then it's just, it's a new version of you, is really what it is. But, that's why, yeah, habits are just difficult because it's so ingrained, like who we are, like you mentioned, like eating oatmeal every day for 40-50 years kind of thing, and it's hard to get out of a system like that, so it all, yeah, it all takes time.

Well, our habits are easy, we don't have to think about them, and I'm always pushing my patients, I don't know, and the patients who know me, they're like, "Oh, here she goes, she's going to say that." But, I am going to say it. I don't know why or how we're not thinking about the type of food we're putting in our mouth, the amount of food we're putting in our mouth.

I don't know how we're not spending a little bit more time thinking about how we're going to nourish this machine of ours, you know, I just, I don't get that. And so, I get it at first, when I first bring this topic up, people like, "Oh, yeah, I guess I should think about that." But then, after a year, 6 months to a year, you really should, right?

Yeah.

Yeah, definitely.

So, should we dive into the question of the week?

Yes, please.

So this is from Susan Carroll.

Susan.

My name is Susan Cara, and, I'm from the Bronx, New York, and I suffer from calcium oxalate stones. And my question is for Jill, I notice on the list of foods that there are, there are there are foods on that list that I don't understand how they could be low, and, like I notice that bacon, two slices, bologna, a can of chicken noodle soup,

I would think that's full of sodium. I know it's full, you know, has a lot of sodium, so like, how is that on the low oxalate side? You know, I don't really understand, I'm getting very confused with the food lists, and that's that's one of the problems.

I'm trying so hard to get it right, and, and I was kind of confused with that, and my other question was, I also suffer from IBS, and I need to take Miralax, and I was told that if you have a kidney stone problem, I read an article,

I don't know if this is true or not, but it says that Miralax is not good to take if you have kidney stones. So, I'm really concerned about that cuz I really need that, and I'm noticing that a lot of foods with fiber are high in oxalate, so I'm like really messed up with finding like how to eat properly, I'm trying so hard, but those are my two questions, I'm hoping that, you know, that I can at least get some kind of answer so that I can at least know,

You know, how to how to eat and understand the list. So, I thank you, thank you for allowing me to ask this question. Have a great day, bye.

Oh my god, she just made my heart smile.

[laughter]

Okay, and, so, it don't matter that I've done this 500 years, it doesn't matter, every time I hear that or I hear somebody's kidney stone journey, it's like I just started this job, that's how much my heart feels, truly. So, for her, Susan from the Bronx, baby,

Susan from the Bronx, so there's two questions here. We're going to touch on, I'm already thinking, how the hell is Jeff going to title this YouTube one? [laughter] Because it really is two really separate questions. We're talking about, we all need fiber, she has IBS, she needs fiber,

Okay? And because she is talking about Miralax and fiber, she probably has IBS-C, which she's more constipation. Susan's like, "Really, did you have to?" Yes, Susan, we're talking about it, because we talk about everything here, why wouldn't we?

Being constipated is terrible. When I was going through all my chemo and everything and having to deal with rectal cancer, you're either going too much or you ain't going at all. And so, being constipated is terrible, and so many

People are, because we don't get enough fiber in our diets. Now, and I'll get to her first thing, I understand what she's asking with the sodium and the oxalate. This is mostly going to be oxalate focused, okay?

And I want to really focus on fiber

And oxalate. When people are thrown that list, or they're looking at my Harvard list on my website at kidneytonediet.com. [laughter]

[laughter]

Kidneystonediet.com, free oxalate list, go get it, okay? So when people are put on a low oxalate diet, they immediately think, " well, no more fruits and vegetables for me.

No more for me." And so, what happens is, they now have lowered their fiber. We need between 25 and 35 grams of fiber a day, the average American is getting 12. That ain't enough for a healthy bowel, said the rectal cancer patient who's in remission.

But, I the thing that has always has been so ironic is I've always been a proponent of fiber, and so you're going to get that mainly from fruits and vegetables, of course, some whole-grain carbs. And so, but people really limit these three things

On a low-oxalate diet. And Susan from the Bronx, I'm here to tell you, you don't have to, you don't have to. The other thing real quick, Miralax is not going to bother kidney stones, but I'd rather you get

Your fiber from fruits and vegetables and whole grains. "Whole grains are high in oxalates, Jill, I can't have no fruit, Jill, high in oxalate. You can't have raspberries, that's it!

Kiwis, they're high, Jill." I eat them. I even eat them with the skin on, as I'm known around town to do.

So, you can have them. Here, Susan, this is going to help you.

Unless a doctor has told you otherwise, you all get 100 g, milligrams of oxalate a day. Use the Harvard list on my website at kidneystonediet.com that we give away free. Along with that food list, there, within that little book, we give the safe list.

So, because I'm so used to patients saying to me, "I ain't got nothing to eat," I took the Harvard list

And we made it into, forget about the whole Harvard list, here's just the safe list. We took away the really high things. Now, you can eat everything on this list.

"Well, Jill, still some of these things on this list, it says it's, you know, 50 something or others of oxalate in a portion size." Well,

You, that doesn't mean you can never have it, it means you have 100 mg a day to have, unless a doctor has told you otherwise, have 50 something of something, have it! That's where you're going to put a glass of non-dairy or dairy milk, okay? So, it's not like you can't have higher-oxalate products.

What about spinach? No, it's over, almost 700 mg a cup, no. Stop asking me about spinach, [laughter] you can't have it, that's it.

I don't take away much else, couple things like buckwheat groats, whatever to those, raspberries because who wants one of those, okay? Now, you could say, "Well, if you're saying I can have all these higher ones, I'll just have two raspberries and put them in a yogurt." You can do that. If that's how you want to spend your oxalate bucks,

I give you your control back. Instead of saying "no" to all these foods, you get the Harvard list,

Use it, look at the portion size and how much oxalate is in that portion size. Right now, I'm giving you a debit card, it has 100 mg of oxalate in it.

Use your Harvard list by the portion size, and start debiting your account. When you get close to 100, you're done. That means you get some choices back in your life, you get to eat food you like again, you just can't eat it every day in whatever amount you want.

That's why people get into trouble. Spinach and almonds with absolutely no calcium in their diet, that is what leads to stones very often, not for everyone, but very often, that is what is repeated over and over again. So, Susan,

From the Bronx, you can definitely increase your fiber naturally by incorporating more fruits and vegetables into your diet, you really can. An apple, 4 g of fiber right there; a pear, 4 g of fiber right there; 8 g right there for you, if you can tolerate those things, okay? So, I also

On kidneystonediet.com, because this is such a common thing, we have a list

Of lower oxalate foods with higher fiber amounts. Go to my website at kidneystonediet.com. I believe that's in the blog.

Do you know, Jeff, do we remember? No, I think it's–

Yeah, off the hand, I'm not sure, but it should be in the blog, yeah.

Yeah, I think it's in the blog section. We have a nice, Dave, who's our other partner, we have a, we have a nice, infographic he made, beautiful, he does all the beautiful things on the website, and so look for it at kidneystonediet.com. It is an, an oxalate fiber comparison list, foods you can safely eat for lower oxalate and getting your fiber, that's a really, really great infographic, I'm very happy with that one.

What else, Jeff? Oh, she asked the salt, right, and the oxalate thing, okay. So, Susan, w- when you see the big list, specifically on my website, those big giant, the oxalate food list, is not, that is saying what's high in oxalate.

What's high in oxalate, or low in oxalate, doesn't mean it's low or high in salt. So, these are things you have to figure out by yourself, meaning, if you're going to focus on oxalate, go on the list and say, "Okay, this is, this, this product is lower in oxalate, so I can have it."

But, that don't mean it's low in salt. People will say, "What the heck? Harvard studied food and they're telling us to eat,

Like some unhealthy food, like apple pie, don't got no oxalate, so what does that mean, we can eat it?" No, that just means they studied it, and it doesn't have a lot of oxalate. People, don't quote me on that, I threw it out of my, came out of my head, [laughter] but that doesn't mean it matches other, it doesn't mean, number one, it's healthy, it just means they studied it for oxalate value, and it doesn't mean it's low in salt, it doesn't mean it fits any other component of the Kidney Stone Diet, I hope that's clear.

And so, of course, just be so, that's a separate list telling people, telling patients what the oxalate levels of certain food foods are, it has nothing to do with their sodium. So, yeah, so right, Susan from the Bronx, bologna, no oxalate, but holy Prijole, high in sodium, so that's not something you want to eat, and I, do they still make bologna?

I don't even know, and I ate a lot of bologna as a kid, bologna and mayonnaise, I used to love bologna, do they still make that?

Oh, yeah, for sure. Yeah, it's, and it's one of those classic things, but yeah, I haven't had it in so long.

I used to love it.

Me too.

Oh my god. [laughter] So, so she, so Susan from the Bronx, you're just getting confused, that's a separate thing just for oxalate.

When you, always need to look at packages for how much sodium is in something, that's how you find, find out how much sodium is in something. So, when you're first starting the Kidney Stone Diet, you're juggling a few things, but be patient,

Read or listen to our, on Spotify, listen to this YouTube channel, we give away so much free information, so that you're less overwhelmed. And on kidneystonediet.com, also, there's a free, there's a start page, kidneystonediet.com/start, and I know everyone's like, "Boy, how many times can you say your website?" But I'm saying it because it's all the free stuff there, so go there for the free stuff, okay?

Because we know it's overwhelming. So, we created just a start page, so you can get the, so you can get where you need to be at the beginning, okay?

Yeah, so I found on the site, it's called "Your High-Fiber, Low-Oxalate Grocery List." So, that's,

Oh, good, yeah.

Yeah, that's the post you want to look for that combines all of that together, like, exactly, exactly what you were saying. But, yeah, I wanted to track down exactly where it was, because we'll, we should add that to, well, we'll rearrange it, put it with the oxalate list, maybe in the resource section, too, because it is super important, super valuable, and, something that we haven't

Yes.

Really touched on, I don't think. Like, we touch on oxalate on the show all the time, but that connection between fiber and oxalate, this is, I think the first time that we've gotten there. So, yeah, thank you so much, Susan.

It's a big deal. Yeah, it's a big deal. When patients are incorporating the Kidney Stone Diet changes, there's a few things they do: they start adding calcium back, if you are able to tolerate, dairy products, you may start feeling a little constipated.

Put that with, now you ain't eating no fruits and vegetables because you're petrified of oxalate, and you do, you have a very constipated, patient on your hands. And, like I said, I never dealt with that until I went through all my cancer stuff, so uncomfortable, have a new appreciation for people who have chronic constipation.

Obviously, it's not good to not get rid of the waste in your body, but it is super uncomfortable, so uncomfortable, I can't stress that enough, so my heart goes out for patients that experience that. So, remember 25 to 35 g a day when for fiber, when we're incorporating fiber, paying attention to it more, we need to do a couple things.

You can't go from eating no fiber to 35 g of fiber, you will be sick, your stomach will hurt, you'll lose loved ones [laughter] because your stomach will never be the same. You've got to slowly, I would say, "So, what does that mean, Jill, slowly adapt?" I would add, so if you're getting the average 12 g of fiber a day, how do I know if I am, Jill?

Turn the Rumbus Brown and look at your nutrition labels, it will list the fiber, okay? So, start adding how much you get up on just a regular day, maybe you only get 5 g of fiber, whatever it is. An apple don't have no nutrition label, Jill.

It's called Google, people, [laughter] it's been around for a minute, Google it, okay, has about 4 g of fiber. So, when you don't know because there's no label, first of all, it's going to be a healthier food because it's in the produce section, there's going to be a little bit of fiber in there, so that's good, but Google it and it will tell you.

And so when you're incorporating more fiber, do it, maybe I would say, look, if you're getting 12, a day, I would maybe strive the next week, go to 15, the next week after that try for 20, if you're like, "Hey, 20's doing me right now," or 15, "I need to stay here for a minute," then you stay there for a minute. Listen to your body, please, your body will tell you everything you need to know.

And when you make lifestyle changes, you get a new perspective. You'll start thinking, "Oh, my god, that's salty! Who would have ever thought I noticed something that was salty, right?" So, as you adapt and get a new perspective for the new healthier foods in normal portion sizes that you're putting in your body, you will notice changes, and most of them are very, very good, okay?

You know, I have a lot of healthy patients, happy patients, because they're making these changes. The other thing while you're incorporating fiber, is please make sure you're getting enough fluids. The only way to get these all the things that the fiber is doing, like bulk up your stool and creating more stool, all that, is to you know, you want to get rid of the stool, so you need to drink your fluids to help flush that new happy, fluffy stool out of you, okay?

So, that's important, too, you have to drink fluids when you're upping your fiber, it will help get rid of it, okay?

Yeah.

Love talking about fiber, I do.

Yeah, I think that was great. I mean, I really, I do think this is a, this is one of those areas we just didn't get to so far, so it's like, yeah, thank you so much, Susan, for, for that question, and anyone else out there who has a question of their own, that number again is 773-789-8763, and, Jill will answer your question on a future episode.

Like, we really appreciate everyone who calls in, takes the time out of their day to leave the message, and the people are taking their time out to watch, listen to the podcast, and leave a comment, and like, and subscribe. Like, it really goes a long way, especially on YouTube, for helping us reach more people, because that's the only reason we're doing this.

I mean, this is completely free, one of the many free things, like all the things on the website as well, that we just want to reach as many people as we can, and make a difference in any way that we can, along the way.

Look, we, you know, I think it's really important, Jeff thinks it's really important. I have paid services, not everybody can afford paid services, and so we recognize that. And so, since we're talking about your health, and we're talking about a chronic condition that is lacking in the medical field, we take it upon ourselves to make sure that we are giving as much as we're receiving here, and so, we want to make sure that we always give back to the audience, and so we appreciate, the comments go a long way, help each other in the comments.

Are you constipated? Have you been constipated? Can you help Susan with some tricks that you've learned?

I, I will say one more thing, if I were writing a comment, I would say "movement," really important. You want to move your bowels, you got to move your body. I'm going to make a new T-shirt out of that one: "You want to move your bowels, you got to move your body." [laughter] So, you can't be sitting around, watching Netflix, and, eating apple pie, and, not moving, you got to move, too, the body wants to move, so it can move everything within it.

All right, Jeff, I'm done.

[laughter] No, this was really good, yeah, because movement is such a key piece of it, so we can't forget that part. But, yeah, so we have some new merch on the way then, I guess, [laughter] like, I mean, it sounds fun, we do have so many ideas for different things, just little inspirational things, like the little merch we already have, like the apparel and whatnot, but, yeah, when we get around to it, there's going to be a few more things, that could be really fun, I think.

People are saying they want, "I need a, we need aprons that say, 'Just a bitt.'" [laughter] Or, or "Turn It Around Buster Brown," we got to get that.

I like it.

Yeah, for sure.

For sure. But, yeah, for everyone listening, thanks again, we appreciate you taking your time, and we will see you next week.

Bye, everybody, thank you, Susan from the Bronx!

Spyur.