What gives? Is kale high or low in oxalate?!

The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting any 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.

And I'm Jill Harris, your kidney stone prevention nurse. We've done several episodes now. We're batching them, so I'm like…

Yeah, we're all getting a little– a little slap happy at this point. But we have one that– that immediately got you riled up.

Yes.

I know that because this is a big question. So, I mean, actually, instead of the preamble, should we just dive right in?

Yeah, let's just dive right in, cuz it does get me riled up. But I'm so glad the person asked. Go ahead.

Absolutely.

Hi, this is Elizabeth from Ohio, and I'm just trying to figure out kale. So, kale on your kidney stone list shows one cup of chopped kale is two milligrams. But when I look on other lists online, it shows that it's a high oxalate food.

So, I'm just trying to figure out if kale is low oxalate or high oxalate. Thank you.

The reason I get– first of all, hello Elizabeth, I'm so glad you asked this. The reason I get riled up is because patients are confused and this always annoys me. And so, this is why people think they have nothing to eat.

This is why people think, you know, they don't– they're just throwing their hands up and say "The hell with this," because every list has a different value and they don't know what to do. And then, here's me screaming and I'll say, you know, "Just use the Harvard list." "Yeah, but, Jill, a lot of people– there's not a lot of stuff on the Harvard list.

I'm eating this and they didn't study it." So, we have a video about that. What do we do when Harvard didn't study the food? You have that food once or twice a week, and I always say twice because you may have a leftover, don't throw food out.

Get your calcium needs met and you'll be fine. I say that because nobody got a kidney stone because they had one spinach salad a month or a glass of almond milk or one handful of almond– almonds a couple times a week. It's what we do every single day in any amount we want along with not getting any calcium.

Now, Elizabeth, kale, I will say use Harvard's list and stop looking at other lists because I've used the list. People who are in the kidney stone game, people who teach it, people who educate, people who are trying to prevent it, who have been doing this for a long time, we use the Harvard list because it works. So, it's not just the list itself because there are a lot of foods Harvard didn't study, it's all the other advice we give surrounding the Harvard list, okay?

Now, it says a cup of kale, "But, Jill, it doesn't say what type. Lacinato, whatever the hell, dinosaur, boo-boo kitty kale." It– it just– it just says kale. All right, so kale.

I mean, how different are each of the kales going to be in oxalate? I'm not worried about it. Why can I say that so confit– confidentially?

Because I'm looking at urine collections all day of people who eat kale. Their oxalate's low. Why?

Because they're not overeating anything. They're eating normal portions of kale. They're getting their calcium needs met, and they have low oxalate.

So, use– I tell every patient this– use one list. Throw out the other ones because you will be so confused and overwhelmed. If you study kale in one place, say, they say they're growing it in Mexico and they're growing it in California, you may have varying amounts of oxalate because there's diff– the soil has different nutrients in it, different amounts of sunlight, all kinds of things.

The researchers research it or study it a little different ways. There's many different variances as far as why the same food will have different oxalate levels. We trust the Harvard list.

We trust those researchers. I'm not saying everybody else is wrong. I think what I'm saying is, stick with one list because patients get so confused.

Know that I've used the list. We have used the Harvard list for many, many moons. It's not just that's the end all, be all.

It's don't overeat any food. Get your calcium needs met. Don't eat kale every single day in five cups amount because this is what people do.

So, enjoy your kale. I definitely eat kale. I use it as a substitute for spinach, as most of my patients do.

If you're nervous about it, if you're nervous– not you, Elizabeth, but anybody– on any food that you've seen on the Harvard list, but it's a lot higher on other lists, have that food during a 24-hour urine collection. Make sure you have it with a calcium-containing food or beverage. You will see your oxalate level will be normal.

If you are eating these foods within normal portion sizes, getting your calcium needs met, I promise you, you will see that your oxalate will be okay. It's the amount of food you were eating that is well known as very high oxalate foods along with not getting any calcium. So, Elizabeth, can you have kale on the Kidney Stone Diet?

Absolutely. Throw away the other list, use the Harvard list. Go to kidneystonediet.com and or Google oxalate food list, Jill, Kidney Stone Diet, and it'll come right up.

We also have a calculator, a little app that you can put on your phone so you can calculate the oxalate. It looks– and if you go to kidneystonediet.com, the help section, it will show you how to put it on your phone so it looks like an app. But use the Harvard list.

Only because I know it works, cuz I'm looking at follow-up urine collections all day long, so I trust it 100%.

Yeah, and I like the urine collection test. Like as you as you put it, like consuming some when you're doing the urine collection. I really like that because that also answers the question in you.

Like you're able to see, "Okay, I have direct data in terms…" Like cuz a lot of us, I know a lot of people like when someone gets sick, it's like "I want as much data, I want to know all the really like get everything on the rails, like just have it going along the path in the right way." And the urine collection is the place to start, and you're starting with concrete data for that window of time in your in your diet.

So, I think it's I always think it's just great advice to, if you're worried about something, to actually you can test it. You can actually get the information for yourself if you if you want to put in that effort.

Yeah, it's been very valuable to patients because they will give up certain foods that they really enjoy and, by the way, are is healthy for them. And so, I'll say, "Just do it on the urine collection so you can see." Nobody makes a kidney stone in a day, so try it on– "Oh, my god, Jill, I can bring that back in my diet?

It was still low my oxalate. I'm so happy." So much of the high oxalate values is not getting any calcium, because nobody gets any calcium into their diet, nobody, until they have a kidney stone or bone disease or both. Then, all of a sudden, the doctor's like, "What?

Look, mate, you haven't been having no calcium all these years?" "Well, no, nobody told me about calcium." "Well, you better." I mean, you know. So, lots of times we're not learning about something until we have an illness and now we're like, "Well, nobody talked to me." Again, people will say, "I don't watch my sodium, Jill.

No one ever talked to me about it cuz my blood pressure's normal." Now, they have a kidney stone because they're eating too much salt and it was dumping calcium into their urine. They're not peeing a lot and that calcium is finding other salts and minerals to connect with and forming stones, think phosphate and oxalate.

So, again, this is rather complicated. There's a reason why you feel so overwhelmed, my beloved stoner family, and that's because there's too much– there's just too much conflicting information on the internet. And look, when I was researching all my cancer stuff, you know, there's a lot of solid information cuz it's really well-researched, right?

And it's pretty consistent. But for kidney stones, it's also well-researched, but there's a lot of people on the internet talking about kidney stone prevention, not under the guise of it being researched, just, I don't even know, all kinds of crazy things on the internet, particularly about kidney stone prevention, and it's– it's not the best.

So, patients are like, "This list says this, this list says this, list, what should I do?" Use the Harvard list. I don't get– there's no money made, it's a free list. So, it's not I'm telling you because of what I've seen in follow-up urine collections, so get the Harvard list.

You'll be happy you did. Don't look at another list. If it's not on the Harvard list, it Harvard didn't study it, have that food in a normal portion size once or twice a week.

Get your calcium needs met. You won't have an issue with oxalate again unless you're somebody who has malabsorption issue issues. That's a different ballgame.

Or bowel disease, which falls under malabsorption issues, okay? So, some people will have medical conditions that will have them produce too much oxalate. But everybody else, it's just cuz you're eating too much of high oxalate foods with no calcium.

So, get with the Harvard list and you'll be okay, Elizabeth. You can have kale.

And that genetic component is a tiny one, right, percentage-wise? A lot of people will be like, "Oh, I'm just a stone former."

Yes, that's very true. Yes, there's enough. Like I'm dealing with the worst of the worst typically, right?

So, they do have real– they have some things and it is genetic, but yeah, most people are not– it's not a genetic issue. Just change their diet and they'll be better. That will be it.

Right. Correct, Jeff.

Yeah. And for anyone who's who's new, how many years now has it been? Is it 25 this year that you've been doing this?

This year, I think October, 25 years.

Yeah, that's wild. So, and you've been using the Harvard list.

Harvard list the whole time.

Like, and that's the big thing is the reason you can say this with such confidence is it's not one or two people you've worked with. It is literal thousands of people over decades of time that has proven time and time again that this is the path. This is what you can and should trust.

Yes. Yes. I As far as on the internet, I'm the person with the most experience, for sure.

As far as a nurse, for sure, on the internet or even the dietitians. I mean, there's some dietitians that do kidney stone prevention, but no one as long as me, for sure. Nope.

Cuz this is this is this is too relatively new as far as people really talking about it. And I'm hoping the more I scream about it and the more Dr. Coe, my mentor, and his website is kidneystone.uchicago.edu and his name is Fred Coe, C-O-E, and he is truly the granddaddy of kidney stone prevention and his site contains all the research for which I talk about here.

And not just his research, he brings all the thought leaders together and brings their papers on forth on his website, so it's all in one place, so you can see. I mean, I bring this very down home in street terms, but it– this is all drenched in research on his website. It's not for the faint of heart, his website.

But please, you should look at it. It's He's an amazing man. 86 years old, still works 7 days a week on his website.

He still does see patients, very limited, on Zoom calls, but his whole life has been kidney stone prevention and he's pretty– he's just a pretty amazing man. He loves poetry. He loves He's an amazing man.

He loves science. He's He's He's a Renaissance man, and he's still, like I said, he's he's just working his butt off at 86 years old. And I always say, "Are you– so you're just never going to retire?" He's like, "I really believe once we retire, our brains just die." That's what he believes for him because this is such an important part of his life.

And he wants to make sure that all the things on his website are free and he just That's what he's leaving for the world, all the work on kidney stone prevention, all in one place from all the scientists. And it's a very valuable site, and we should all be very grateful and privileged that he has left that or he is leaving that for us.

I am. I'm very grateful to him. Obviously, as my mentor, I consider him a family member and I love him very much.

So, I just want to shout out to his website, and it's also He also redid it all. So, it's been revamped and so organized in a in a in a more helpful way to people who are trying to find kidney stone prevention tips there. He has it for patients, for doctors, for scientists.

So, he has three audiences. Very valuable site. Go check it out: kidneystone.uchicago.edu.

Yeah. Yeah, and that's for, as you said, not the faint of heart, so for everything that is Kidney Stone Diet-related that is much more easy to consume. Yeah, you definitely are.

I am on there, too. I am on there, too, on oxalates, stuff like that, yeah. He's like, "Jill, I you'll say it better.

Come over here." So, his articles will have things like, you know, Monet paintings, mine has like the Cookie Monster. So, you have, you know, the best of the best: the street girl and the mad scientist. All in one place, yes.

Yeah. Yeah, so you can check there. You can go to kidneystonediet.com for everything specifically Jill-related with the course, prevention course, prevention group, which is on Facebook, meal plans, urine analysis, everything can be found there.

And, yeah. Thank you, Elizabeth, for the question. That was a perfect question, and you, Jill, lit up immediately.

So…

Yeah, I said, "Okay, let's do Elizabeth's," cuz there were other ones to think about. I'm like, "No, we're doing Elizabeth's."

Definitely. And if you're out there with a question, the number is 773-789-8763 or email [email protected] with a voice memo so we can play it on the air here. But I think that'll do it for today.

Thank you, everyone, for tuning in, for subscribing, and giving it a thumbs up on YouTube, which means a lot to help us reach more people. And, yeah, we appreciate each and every one of you, and we'll see you next time.

Thanks, Elizabeth!