Upon first meeting, many of my patients have already given up all nuts and seeds for fear of the high oxalate content. However, there are only a few nuts you should give up to lower urine oxalate.
The problem with nuts and seeds is that we tend to overeat them, which, coupled with not getting calcium in your diet, can increase your risk for kidney stones. It’s important to remember that calcium plays a crucial role in this equation.
Eat nuts and seeds within portion limits. You’ll often find these nuts and seeds in my meal plan service recipes (I count all the oxalate for each recipe), and you’ll see that you don’t have to give up all of your favorites; they are still part of a balanced diet.
Here is your safe seeds and nuts list.
The * denotes an updated studied food from Harvard.
- Coconut Meat, Dried (Desiccated), Sweetened, Shredded: 1 tbsp / 0.1mg oxalate*
- Coconut Meat, Raw: 1/8 cup 0.1*
- Flaxseed, Ground: 1tbsp / 0.2mg oxalate*
- Peanut Butter, Salted, Smooth: 1tbsp / 19.2mg oxalate*
- Pecans, Oil Roasted, Unsalted: 1oz / 15.7mg oxalate*
- Pistachios, Dry Roasted, Unsalted: 1oz / 9mg oxalate*
- Pumpkin & Squash Seeds, Whole Roasted, Unsalted: 1/4 cup / 4.3mg oxalate*
- Pumpkin & Squash Seeds, Kernels, Dried: 1/4 cup / 7.7mg oxalate*
- Sesame Butter, Tahini, From Roasted & Toasted Kernels: 1tbsp / 16.2mg oxalate*
- Sunflower Seed Kernels, Oil Roasted, w/o Salt: 1/4 cup / 8mg oxalate*
- Sunflower Seed, Dried, Kernels: 1/4 cup / 2.9mg oxalate*
- Walnuts: 1oz / 11.7mg oxalate*
Which Nuts Should You Limit?
Some nuts are high in oxalates, which can contribute to kidney stone formation. When oxalates bind with calcium in your urine, they can form crystals; over time, they can grow into stones. Cashews and almonds, for example, are among the highest in oxalates, so it’s best to avoid them if you’re prone to stones.
But that doesn’t mean all nuts are off-limits! You can still enjoy lower-oxalate nuts like peanuts, walnuts, pecans, macadamia, and pistachios.
How Much Is a Portion?
These nuts provide a great source of healthy fats, protein, and nutrients without the high oxalate load. The trick is to keep portions small, about a handful (1 ounce) daily. That way, you get the benefits of nuts without overloading on oxalates. Many get kidney stones because they eat handfuls of higher oxalate nuts without meeting daily calcium needs.
If you can’t control your nut portions (let’s be honest; it’s hard to stick to one handful of nuts), avoid them altogether. I use them in my baking only. I would have a more challenging time controlling these crunchy comestibles, so I only use them if added to my recipes. Your kitchen, your rules!
Pair Nuts With Calcium
Getting enough calcium daily is crucial to lowering your kidney stone risk, especially if you eat foods containing oxalates like nuts. Calcium binds with oxalates in the gut, preventing them from being absorbed into your bloodstream and eventually excreted in urine, where they can contribute to stone formation.
Aim for the recommended daily calcium intake, whether through dairy products like milk, yogurt, and lower-sodium cheese, or calcium-fortified foods like plant milk and orange juice. So go ahead, savor that small handful of pistachios or peanuts! Just be sure to pair them with a calcium-rich food or beverage.
And to clarify, 1 ounce is equal to 2 tablespoons.
So you see, you CAN eat nuts and seeds on the Kidney Stone Diet. Enjoy them in portion size and meet your calcium needs. I can’t stress the calcium part enough.
Your friend and advocate,
Jill
P.S. Most of you can safely eat 100 mg of oxalate a day, which is who this list is written for. Some of you who have had bariatric surgery or bowel surgery (that has left you with malabsorption issues) may have been told to keep your oxalate to 50 mg a day. If this is you, nuts will be harder to keep in your diet. If you have questions about this, please talk to your doctor.
If you’re lactose intolerant or don’t want to use dairy products, read my article, 16 Non-Dairy Calcium Sources for Kidney Stone Formers.
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