Doctor's Note

This can be considered a follow-up to my How to Prevent Kidney Stones With Diet video. For more on the whole acid-base thing, see Testing Your Diet with Pee & Purple Cabbage.

Anyone want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups in the graph times the score. I got -79 for my diet yesterday—beat that! :)

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  • Plantstrongdoc M.D.

    Plants rock!
    :-)

  • Nutritarian
  • http://nutritionfacts.org/ Michael Greger M.D.

    Anyone want to try to calculate their LAKE score for the day? Just multiply the number of servings you have of each of the food groups in the graph times the score. I got -79 for my diet yesterday—beat that! :)

    • BB

      Dr. Greger: I got -95 for my diet yesterday. Calculating my Lake score is a fun way to insure I am getting enough fruits and veggies. Thanks for the info. Looking forward to seeing you at the Food=Medicine Conference in Atlanta this November.

      • http://nutritionfacts.org/ Michael Greger M.D.

        Whoa–I’m impressed! Good Job!

    • guest

      Dr. Greger: Thank you so much for this video. I had kidney stones a long time ago and still remember the pain! So, this is very important information for me. My big concern has been dietary oxalates. For example, I love spinach but have been careful with it. Now I can eat spinach in larger quantities more often without fear.

    • quickdraw

      I scored -115 although I also eat a couple servings of seeds/nuts a day along one each of flax and chia and wonder where they’d score.

      • http://nutritionfacts.org/ Michael Greger M.D.

        Holy moley! Would love to see your pee test! Joe’s looking into the nut and seed question–it wasn’t included in the LAKE paper.

      • Joseph Gonzales R.D.

        I’ve asked the author who published the LAKE paper about nuts and seeds. I’ll keep you and everyone posted regarding their reply! Keep up the good work :)

        • george

          Hello Joseph: Is there any way to get access to the paper without paying? (A Trinchieri. Development of a rapid food screener to assess the potential renal acid load of diet in renal stone formers (LAKE score). Arch Ital Urol Androl. 2012 Mar;84(1):36-8.) thanks

        • George

          Hi Joseph: Thank you so much for quickly sending me the paper. I really appreciate it.

      • Joseph Gonzales R.D.

        Dr. Greger also found this study showing walnuts have a PRAL of 6.8 (keep in mind this is 100 grams of walnuts; 668 calories) and hazelnuts a PRAL score of -2.8 (again, based on 100 grams of hazelnuts, which is like 3.5 ounces and 650 calories).

        • dorange

          I suppose all the examples in the graphic refer to 100grams, too. In case of walnuts, how would be the PRAL of two or three walnuts? Or, to make things simpler, how would that translate to 25 grams of walnuts, for example? I am not good at Math at all… :-/

          • Joseph Gonzales R.D.

            25 grams of walnuts would have a PRAL of about 1.7 :-) A few walnuts even lower.

    • Alexis Anastasia Bakalakos

      Dr. Greger: I calculated my score for yesterday, and I ended up with a 95.7! I was surprised, since I thought I should not be eating so much fruit… =) I am an 18 year old in Minnesota, and I cannot wait to attend the next plant based conference! I met you at it last year, it was awesome, and you inspired me to also test my pee (super purple/blue). Happy weekend!

      • http://nutritionfacts.org/ Michael Greger M.D.

        I hope you mean -95.7 (as in negative!)

        • Alexis Anastasia Bakalakos

          Yeah I did! Whoops!! :) thanks for the awesome videos and great humour!

    • Noe

      wow sounds good!
      just one idea came to my mind, this wonderful graphic of the PH and some other images, may be, can be post with the day video too (with source sited or in a image gallery ) . so one can share also the image to do this test that you propous, or maybe people share some info of nutrition facts on pinterest etc :)
      i think that the graphics are amazing some times and i found my self copying the screen to then share by email some tables and info to friends..
      thank you! for all this work!! one day we are going to see big changes on dietary recommendation in big scales, and probably the seed for that is here :)

    • Anne

      Hubby (from kidney stone question above, 3/15/16) got -226, based on each serving of fruit being 1 unit (orange, grapefruit, banana) and servings of berries being 1c, with 8 dates = 1 serving. He eats NONE of the acid-forming foods, and he still got that nasty kidney stone! I am flummoxed — and gobsmacked!

  • Slim055 .

    How do you eat ‘more vegetarian’ when you’re already whole-food plant-based? Do you favor fruit and beans over grains? And what grains are you talking about? What is the recommended mix? CAN oxalates be too high? At 60+ urination is always an issue. 10 to 12 “cups” of water I take to mean 2.4 to 3.0 LITERS of water a day. Does that also include the rather high water content of our food? I recently reduced my liquid water intake (apart from food) to ~2.5 liters and have enjoyed a much easier time. What is the benefit of ‘beating’ your LAKE score? Your video does not really explain how to calculate it and what the @#$#@ is a ‘serving’ anyway?

    • Joseph Gonzales R.D.

      HI Slim055. If you are already vegetarian I think that will significantly reduce your chances of developing kidney stones. Dr. Greger was just having some fun with his own calculations. He is taking the amount of servings he eats of each food group (beans, grains, fruits and vegetables) and multiplying by the chart in the video. For example, one serving of veggies would equal -9.9. Let’s round to 10 for ease. If I ate 3 servings of vegetables I’m at -30. You can do that for the rest of the food groups if you’d like, but it is certainly not a requirements just to give folks an idea where they might be. Have you seen his video on How Many Glasses of Water Should We Drink a Day? It sums up your questions nicely, as well as one of my comments I posted for a site user. See if these links help. Thanks for your comments.

  • mme_sylvie

    Thank you for this video! Gypsum tofu may be the exception to the rule: http://www.medicaldaily.com/chinese-doctors-remove-420-kidney-stones-man-penchant-tofu-337228

  • ashelton

    Thank you for this informative video – have been cutting down on high oxalate foods in attempt to prevent another stone, but don’t want to cut out all those delicious dark leafys. Any idea where nuts/seeds/legumes fall along the LAKE scale?

    • Joseph Gonzales R.D.

      Good question. The study did not seem to tests nuts and seeds. Beans, however, were in the report with a score of -2.0. I’ll dig around and see where nuts and seeds fall. Hopefully someone else can post a study or help us out, as well!

    • Joseph Gonzales R.D.

      Dr. Greger found this study showing walnuts have a PRAL of 6.8 (keep in mind this is 100 grams of walnuts; 668 calories) and hazelnuts a PRAL score of -2.8 (again, based on 100 grams of hazelnuts, which is like 3.5 ounces and 650 calories).

  • Phillip Lovell

    Magnesium has also been shown to inhibit crystal formation thus reducing the risk for forming kidney stones. Here’s a link to a recipe for making ‘Waller water’: http://www.afibbers.org/Wallerwater.pdf I use magnesium hydroxide powder instead of milk of magnesia.

    • tbatts666

      Watch out that stuff can give you rip roaring diarrhea.

  • Mindy

    The link to your How to Prevent Kidney Stones video does not work. Here is what I poisted in response to that vid a month ago. I hope it helps someone:

    I thought my vegan diet of 30 years betrayed me when I developed a calcium
    oxalate stone 2 years ago. With the help of Jack Norris, RD.(link below), I
    learned that vegans don’t get stones any more so than the general public.
    Further investigation with Jack revealed that my gut may be devoid of a
    particular good bacteria (oxalobacter formigenes) that most people have in their
    guts to eat up oxalates; therefore, when I ate extremely high oxalate foods such
    as spinach, quinoa, chocolate, sweet potatoes, etc., my body formed a stone. I
    was enlightened when I read a study (link below) at Wake Forest University which
    found that overuse of certain antibiotics wiped out ox form. When I was a
    teenager, I was put on tetracycline for 4 consecutive years, and tetracycline is
    one of the antibiotics cited. Unfortunately, there is currently no probiotic on
    the market that simulates ox form. although as noted in Jack’s article (link
    below), one is in process. I joined a (free) yahoo group called Trying Low
    Oxalates (link below) which tested oxalate levels in over 1600 foods. It was a
    huge adjustment for me to eat both vegan and low oxalate, and I lost 8 lbs. the
    first month (I now eat vegan-moderate oxalates). But I was determined 1) to
    remain vegan, and 2) to never get another stone. I increased my
    water/fluids intake to 2 quarts/day, which is a challenge. Lemon juice, as
    mentioned by others, is a stone-buster as is OJ (link below), but I prefer not
    to have the added sugar. Below are some excellent references that were, and
    continue to be life-savers for me, including a link to joining the Trying Low Oxalate group which will enable you to access the most up-to-date food oxalate list, and access to their facebook..

    http://www.veganhealth.org/art

    http://www.ncbi.nlm.nih.gov/pm

    http://www.lowoxalate.info/res

    http://lowoxalateinfo.com/top-

    http://cjasn.asnjournals.org/c

    • http://twitter.com/MacSmiley MacSmiley

      OxThera ‘s website is not encouraging. It’s been taking YEARS for their product to come to market, since they’re going the pharmaceutical route. Tons of stuff about securing patents, gaps in funding and delays in clinical trials. Have you had your stool tested for oxalobacter gut bugs?

    • Joseph Gonzales R.D.

      Thanks for sharing your story! I have fixed the link in the Doctor’s note I appreciate the heads-up. Sounds like antibiotics are be dangerous I am so glad you found the culprit and able to work with Jack Norris R.D. and other groups.

      Best regards,
      Joseph

  • Terry Hebert

    Uric acid also forms during sugar (fructose and sucrose) metabolism. Removing animal purines from one’s diet only eliminates their contribution to uric acid load. One must also eliminate sugar’s contribution, especially refined sugars and sugars with no nutritive and/or fiber content. In addition. uric acid production and elimination are the two-edged sword. Fortnuately, diet affects both. Increasing fiber content and/or probiotics (e.g. resistant starches) helps mitigate 30% of the burden on the kidneys for removal of toxins. Lastly, one must exercise to keep the organism moving and active. May God grant relief to all gout and kidney stone sufferers! Amen.

  • Phil

    : alkaline vs acidic what’s the surprise !?!?

    • http://twitter.com/MacSmiley MacSmiley

      Remember, that’s alkaline vs acidic urine, not blood pH.

  • walterbyrd

    I was in the hospital with a guy who had kidney stones. Every once in a while, the guy was in such agony they had to give him morphine. I hate to even think about the kind of pain that guy was in.

    • jazzfeed

      It’s kind of like having a desk shoved up your rear, a desk with sharp corners.

  • heat108

    I eat vegan diet but constantly struggle with calcium formations in my foot and knee joints. It is getting worse and worse over the last few years, and hurts a lot. Do epsom salt baths add salt to the body in a way that could be making this issue worse? I try to eat a low oxalate diet but aside from this I don’t know what else to try. I love your videos so much. Thank you!

    • Joseph Gonzales R.D.

      I checked the literature and nothing is available on epsom bath salts and kidney stones. I did however find one case study titled Bath salt intoxication causing acute kidney injury requiring hemodialysis – “We report a case of acute kidney injury associated with the use of “bath salt” pills that improved with hemodialysis.” Looks like they were ingested so perhaps not a big deal to soak in a tub. Always a great idea to check with your doctor for clarification.

      • tbatts666

        It sounds like they are either talking about gout or pseudogout

    • Julie

      Vitamin K2 is responsible for removing calcium from soft tissues like joints and arteries. Vegan sources of vitamin K2 are fermented products, especially natto. Vitamin K2 supplements are also available. http://www.lifeextension.com/Magazine/2008/3/Protecting-Bone-And-Arterial-Health-With-Vitamin-K2/Page-01

  • dorange

    I haven’t exactly developed kidney stones YET, but going vegan has not prevented me from getting “stone dust” in my urine… having an issue with this just now! :( OK, I have to drink more water… but my husband is not vegan and has never EVER had any stones/dust… and eats basically the same veggies I do. Couldn’t be something else? Reading Mindy’s post made me realize I have been eating more oxalate rich foods than I supposed I was…

    • Julot Julott

      Do you drink water rich in minerals? What about salt?

      • dorange

        Not “rich”, I think, just “normal” mineral water, but I drink fresh coconut water regularly, and eat fruits.

        But I guess I might have found at least one possible explanation here: Beverages and Stone Occurrence.

        “n 2013, following up on the earlier work in their cohorts, Harvard School of Public Health compared those drinking from 1 serving/day of many beverages. The occurrence of kidney stones were affected in the following ways:
        Decreased – coffee, decaffeinated coffee, tea, red wine, white wine, beer, orange juice.
        No effect – artificially sweetened cola, artificially sweetened noncola soda, liquor, apple juice, grapefruit juice, tomato juice, whole milk, skim milk, water.
        Increased – sugar-sweetened cola, sugar-sweetened noncola soda, punch.”

        I don’t drink any of these, and my husband does: coffee, decaffeinated coffee, tea, red wine, white wine, beer, orange juice…

        Salt: I use Himalayan salt to taste.

        • Julot Julott

          I avoid minerals water personally, i think they are unhealthy, i buy the water lowest in minerals, they are usually called spring water in shop~

          • dorange

            Spring water, that is, nothing more than that.

  • shailja

    My husband is a vegetarian and produces lots of kidney stone kidney. Sometimes I get very confuse……

    • Joseph Gonzales R.D.

      Is his diet high in milk and eggs? From the video it shows milk, eggs, and even grains (but not pasta) having a positive renal acid load. I suggest eating more beans, fruits and especially veggies to see if that may helps. Of course, discuss this information with his doctor and if possible I would also recommend seeing a dietitian to consider further preventative measures that include diet.

      • shailja

        Thanks, he does not eat eggs and milk only one time a day. He has been followed by a urologist for past 15 years It’s always more effective when you hear from someone else then your own RD wife, so he met with the RD ,and following the recommendations.

        • Joseph Gonzales R.D.

          Oh thanks for the clarification. I am sure he is in good hands! Best of luck and yes I agree that your own RD wife (which is awesome by the way — so glad to have you here) may not be as good regarding advice for your husband as another “RD” Isn’t family the best ;-)

          Best regards,
          Joseph

  • Matthew Smith

    Is Calcium deposition in the form of kidney stones similar to the Calcification of atherosclerosis? Perhaps if you have kidney stones you are experiencing signs of heart disease and the hardening of arteries. If so, modern medicine might suggest to take D3 and Vitamin K2. Vitamin K2 is found in natto from Japan. There is a lot of debate on which is better, vitamin K2 mark 4 or vitamin K2 mark 7. There is no reason people can’t take both and or decide for themselves. Vitamin K1, from Spinach, is also effective but maybe not as powerful. Perhaps this could be a sign of an underlying phosphorus deficiency. Phosphorus is used in every energy reaction in the body. Who gets kidney stones? Is it the elderly and heart impaired or can young people get them too?

    • Joseph Gonzales R.D.

      This 2014 cohort study concluded “The occurrence of a kidney stone is associated with a higher risk of cardiovascular events” so yes there appears to be a link. I thought K1 produced K2? I do not think K2 is a needed or essential vitamin, as Dr. Greger addresses vitamin K2 in this Q&A. Let me know if we need to update the research? Thanks for all of your awesome comments, Matthew!

      • Matthew Smith

        I am most flattered and humbly honored by your gracious complement. I am not a Vitamin K expert, but from reading the user comments at that link your users say Vitamin K1 is involved in coagulation and vitamin K2 is involved in directing bone formation. I read the discussion at that link, and they say that only a small amount of Vitamin K is converted to K2 in the very lower intestine, similar to the production of B12. Many people are deficient in Vitamin D, and there is renewed interest in using it to prevent everything from cancer to heart disease. While people do not exactly have rickets, as adults low vitamin D can lead to hardened arteries and can provide safe harbor for calcium forts which can get surrounded by tissue and become cancerous. To take large doses of Vitamin D you should also take some form of K2 to put the calcium that is replaced back in the right place. I think there are some people here interested in going on high D therapy, given that the recommendation is low and people have been deficient for so long. Is D3 non-Vegan? Dr. Greger said it comes from Sheep wool. Anyway, I think people should certainly eat enough kale. Thank you Nutritionfacts for all your prodigious efforts. I am sure your email account is filled daily with requests for second opinions from people who have already been through the medical establishment top down. Many get additional advice here!

        • guest

          There’re two types of K2: MK4 and MK7. The body can convert K1, which is present in green leafy vegetables, to MK4. MK7 occurs only in microorganisms and the only way to get it is to eat unpasteurized fermented food or to take supplements.

          • Matthew Smith

            Thank you very much. It sounds like Osteoporosis is a curable disease, at least in theory, based on the description of K2, that it places Calcium where it belongs. Perhaps with Phosphorus, K2, D3, Calcium, and a sampling of Boron Strontium and Silicon bones can be rebuilt in those with Osteoporosis.

        • guest

          Dr. McDougall claims that vitamin D supplements are toxic, harmful, and to be avoided by humans except in the rarest of situations. He says get it from the sunshine. Something different in the pills that he thinks is harmful.

          https://www.drmcdougall.com/misc/2015nl/mar/vitamind.htm

          “Worries over vitamin D, once known as “the sunshine vitamin,” have turned hundreds of millions of people into patients with worse, not better, health. The latest, and likely the final, analyses of the studies performed on treating people with vitamin D supplements has shown that this multiple billion-dollar business does not work. The authors, after thoroughly examining the results of nearly a quarter-million people from 46 major randomized trials, conclude: “Our findings suggest that vitamin D supplementation with or without calcium does not reduce skeletal or non-skeletal outcomes in unselected community-dwelling individuals by more than 15%. Future trials with similar designs are unlikely to alter these conclusions.

          Vitamin D supplements are so powerless that the benefits of supplements can only be seen at the extremes of need, such as with institutionalized elderly women (and even then the benefits are with a combination of vitamin D and calcium, not vitamin D alone). In other words, if grandma can be wheeled onto the outdoor patio several times a week, she will reduce her risk of fractures far beyond any benefits hoped for by adding pills or injections of vitamin D.”

          Dr. Mcdougall (vegan).

          • Matthew Smith

            I personally think Phosphorus, Silicon, and Boron are good for bone health. Almost half of your bone is made of phosphorus. The body uses your bones as a lending library of atoms, and none is more in demand than Phosphorus which is used by every energy reaction in your body. What supervises the remolding of bone once the scavenging is complete? Vitamin D. The drug companies have twice tried to sell it as an anti-cancer drug. It is now being studied in nearly 500 cancer studies. clinicaltrials.gov D3 and cancer. I know vitamin D isn’t a cure for osteoporosis, and I know drug companies started to sell people bis phosphorus instead of just writing prescriptions for the phosphorus supplement. Bis phosphorus has a lot of side effects. I am on high Vitamin D3 therapy. 25,000 -30,000 IU a day. It is very quickly moving around old wounds, giving me new mobility (I had lyme disease), and removing elements from the wrong place and hopefully putting them in the right place. I think the studies McDougall sites are flawed because they give an annual injection of 300,000 to 500,000 D3. This is a high dose! I thought I was on a lot of D3. Did you know that D3 can cure MS (multiple sclerosis), most lung disorders, and is a treatment for ALS? I would love to get more sun! The seemingly endless list of diseases that can be treated by D3 therapy is stimmed at Osteoporosis. With all new UV-free windows, it is likely we are going to be in for a long, long winter of people getting less D3. I actually would like to challenge Dr. McDougall. He says that people living in the Equator don’t have less disease because they eat more plants there, not because they get more sun. Well, Hispanics who move to America eat more meat, weigh more, but technically live longer here on average than they would in their native country. This is a sign to me of a growing epidemic of rickets-like D3 deficiency. They probably wouldn’t have autism or asthma in their native country either. I think our nation’s health is in crisis to new advice to stay out of the sun. Skin cancer worry has ruled out many healthy lives.

          • guest

            Good points, and thank you for offering your thoughts. It does bring some balance to the issue. Sounds like the vitamin D has been a positive for you. It seems to me that this is likely (just my opinion) the vitamin D acting as a drug, not as a “vitamin”. Maybe this hormone that you are taking (vitamin D is a hormone, plain and simple) is necessary for you – – maybe your body does not utilize the sunshine form of D. Either way, thanks for posting.

          • Johanna

            Thank you for your post. I read McDougall’s comments and am also on high D therapy. I was thinking of stopping it, although I am on a Vitamin D prescription since my level is 22, which my doctor says is too low; I am 68.

          • Matthew Smith

            They say to do K2 with high D therapy. What don’t you like about it? I enjoy the connection to my dreams, which I can better remember with the B vitamin pyroxidine (B6). D vitamins are great for heart health and long life. Dr. Greger says here all people have to supplement. I think Dr. McDougall is recommending everyone get 20-60 minutes of sun on their bodies and legs everyday. I don’t think that is realistic, but it would probably be better.

      • Fred

        “The occurrence of a kidney stone is associated with a higher risk of cardiovascular events”

        Since the K’s tend to reduce deposition of calcium and ? in blood vessels and keep it in the bones…probably does the same for kidney stones…joints, etc?

        note: I once lost 40 lbs and kept it off by following an “alkaline diet” that partially consisted of drinking only baking soda saturated water during the day…plus food. Lost the 40 lbs but had to quit due to a serious case of hemorrhoids…probably a good thing.

        .

        • Matthew Smith

          Hemorrhoids are very painful and very common. Have you considered if your case might be a silicon deficiency? You could drink stinging nettle tea, take horsetail pills, or take a silcon pill proper. An alkaline diet can help you lose weight? An Alkaline pH is very good for your body. Iodine is very alkalizing for the body. I am sorry you had to quit your successful diet.

        • Joseph Gonzales R.D.

          Hi Fred. I looked around for something for vitamin K and kidney stones but nothing stood out in the research. Maybe others can help us out here?

      • Julie

        Joseph, here’s a study suggesting that Vitamin K2 has roles that Vitamin K1 does not. http://jn.nutrition.org/content/134/11/3100.full

        • Joseph Gonzales R.D.

          Thanks for sharing. I do not think it means K1 does not have a role it just means it did not contribute to the outcomes based on this study. Do you have any more to back this? The researchers do not have a good reason for the observed outcomes. Interestingly, “Phylloquinone intake was positively associated with dietary fiber, calcium, vitamin antioxidants, flavonols, and BMI and inversely associated with smoking (all P < 0.001). Menaquinone intake was positively associated with intake of total fat and SFA, dietary calcium, BMI, and diabetes mellitus and inversely associated with intake of PUFA (all P < 0.001)." It seems K2 presented inferior dietary patterns compared with K1, so I find it odd how these findings still remained. Anyway, I really appreciate you sharing the study! Thanks, Julie.

  • Han

    Does this list of modern diseases caused by eating animal product ever end?!

  • Wade Patton

    Off topic, video hunt. I’m looking for the video Dr. G does about the near immediate effect animal protein has on arteries. I’m nearly sure I’ve seen such, but have been hunting and searching here and youtube half the day with no luck.

    The reason is that recently I was “backed into a corner” and chose to eat some fried animal protein and veggies no doubt seasoned with animal bits. I hadn’t had anything fried and a long time. Within half an hour it seemed that I could feel my arteries “tightening up”. Did I? Curious for sure!

    Thanks for any substantial leads.

    • Joseph Gonzales R.D.

      Hi Wade. Perhaps some links within this blog can help? How Does Meat Cause Inflammation? Also, here is an example of what may happen after consuming a high fat meal. See if any of these help? Thanks for all of your comments!

      • Wade Patton

        Thanks. Tried all of those leads. Must have been somewhere else. I’m almost sure it was Dr. G, but then not every video of him is found here. I distinctly recall him speaking to arterial (carotid maybe) flow restriction (with images) from either high-fat or animal protein which starts right after consumption of the meal. Maybe something to do with vascular dynamics-that the walls stiffen? Thinking that I actually felt that happen, wanted to re-watch the information. Guess it’ll wait.

        • Plantstrongdoc M.D.

          Wade,
          Could you be thinking of “healthy fat” and not protein? In that case I think the man you are searching for is Jeff Novick – and it could be this video (I cant copy the link?) “Olive Oil is NOT Health Food but Sick Food” – you can find it on youtube. Just past 8 minutes.

          • Wade Patton

            Well, that’s close and I had seen it before but isn’t quite the one. It makes sense of the situation (and I’ve seen that chart in MG’s stuff in this quest). I didn’t have my normal baked potato, nuts, and fruit for lunch; but a “meat and three” from a “greasy spoon”. The ONLY thing I saw that was fresh was slices of white onion, which I ate a good portion of with the beans. I could have omitted the meat, but didn’t. Certainly seemed like I could feel some carotid and other artery constriction within the next couple of hours, then it passed. No telling what was in the cooked cabbage and mashed potatoes and cornbread, but they seemed to be the least horrible foods of the selection. All the other adults in the group were SAD eaters and in SAD shape with SAD medications/maladies. I no longer work with them.

    • valnaples

      How about Doc’s “Uprooting the leading causes of death”? I am quite sure there’s discussion of how flesh foods “whack our arteries”…just a suggestion! I *LOVE* that youtube of Dr. G’s…LOVE IT…and it has over 1 million views!

      • Wade Patton

        Yeah that might be it, I was rewatching it last night when I got distracted and wound up on Netflix… Have to go over it again.

  • abhinav sharma

    Drink plenty of water atleast 5 litres per day and see the changes…..

  • Joris Hines

    I’d just like to share what I’ve discovered that works better than anything I’ve seen in my 64 years of living. It’s an old remedy for gall stones and kidney stones. It’s a plant called Chanca Piedra, or “Stone Breaker”. It can be bought in capsule form at your local health food store. I also bought some on eBay, and I make tea with it. I live on a boat and I pee in a gallon jug (empty water bottle) so I don’t have to get up to go pee in the middle of the night. Well, in the first couple of weeks I started to see sediment building up in my pee bottle. It continued and now it almost looks like I’ve been peeing out sand! There’s so much calcium and uric acid it’s amazing. I’m bringing my pee bottle to the doctors at the V.A. clinic to show them. They won’t believe it. I didn’t. This stuff really works incredibly well. It is good to take throughout your life, for clear bile ducts and no stones! Another good one is Bitter Melon (has another oriental name but I can’t recall it right now). It has helped me reverse my type 2 diabetes. I quit my meds for diabetes and hypothyroidism in November of 2013 and never looked back. Now I feel younger and healthier. The Bitter Melon I think is what helped me lose the diabetes. I bought some on eBay to make tea with, and then found an oriental grocer nearby that sells the fresh melons. Looks more like a skinny gourd. But I am going to try to slice the fresh melon and dry some in my dehydrator and use it to make tea. I believe it also is helping me reach a more balanced body pH. I had a heck of a time with acidity. Now I am much more balanced, better alkaline readings, and I think the Bitter Melon is the reason. Do the math: Alkaline = bitter taste. So, anything that tastes bitter should work to making the body’s pH levels more alkaline. All very interesting stuff for anyone interested in taking charge of your own health and eliminating the pharmaceutical industries, including the drug pusher doctors.

    • dorange

      Joris, could you share how many capsules (mg?) you take a day in how much water of each?

      • Joris Hines

        Chanca Piedra capsules? I just keep it loose, since there are no side effects or warnings. It recommends (on the label) you take 2 capsules with a glass of water daily. I take the 2 capsules, but there are days I miss taking them. I allow this freedom of choice because I also drink the Chanca Piedra tea, so I feel that I’m getting it thoroughly working in me on 2 separate points of attack, in capsule and in tea form. For me it’s been a journey to get to this point in my health. I started like most folks, trusting doctors and doing very little research on my own. Then, in time, I realized that all the medical industries are linked, each connecting the patient with the next, mainly for the profit ($) and never for actual healing, and saw all the side effects and warnings as just too much. But I was close to death a few times, and just decided to take the road less traveled… the naturopathic, holistic, old school road. I’m so glad I did. I changed my diet to organic, with very little “other” foods. I drink mainly spring water, but because the pH of even spring water is acidic, I wanted to get a water ionizer… BUT, they’re very expensive. So I found this small bottle of a liquid from a company called “Mineralife” called “Alkalizer – professional grade ionic mineral concentrate”. I add 2 drops to a glass of water and my water is now alkaline. The reason I stress alkalinity for body pH is that cancer thrives in an acidic environment. Cancer loves sugar, too. So, I reasoned that if I monitor my pH daily, and manage to keep it balanced, I can avoid getting cancers. I quit all sugars (except those found naturally in organic fruit) and quit eating processed snack foods. Now I feel pretty good, because getting my pH balanced wasn’t as easy as I had expected. Now it’s where it needs to be, or darn close to it. Health is like the medical industries in that everything is connected, every part affects every other part. So for a person to win, they have to use good sense and just do lots of research. I recommend Dr. Mercola on youtube. He’s my go to guy for advice. Great guy, and he provides many, many health videos. Some of the most valuable health advice I’ve ever found, and very easy to understand. I apologize for my long-winded writing. Hope this helps.

        • dorange

          It does help – thanks for sharing!

  • The Vegetarian Site

    What is the suggested daily sodium intake range in mg (not salt in mg) for athletes and for non-athletes? It has to be higher for athletes, some of whom have reported cramping when on a low-sodium diet. At what level does sodium intake appear to increase risk of kidney stones?

  • Lukas Dejakum

    Thank you for the interesting information but I have a question regarding PRAL of beans because according to this quart: http://www.precisionnutrition.com/wordpress/wp-content/uploads/2009/05/acid-base-foods-pral.pdf
    lentils have a PRAL 3.5 and peas have 1.2 so are those the exception or do all beans have a positiv score?

    • dorange

      Good find, Lukas, thank you for sharing. Pasta is not alkaline as per this table, and it’s actually more acidic than bread. Oats have a PRAL of 10,7 and refined rice and wheat have lower PRALs than brown rice and whole wheat. Interesting.

  • JP

    Hi Dr. G, do you ever get to Southern California to give any talks?

    • Joseph Gonzales R.D.

      Yes! Here is his speaking schedule. Looks like Anaheim in October is the place to be. Thanks, JP.

  • Jocelyn

    I noticed on your Acit Load To Kidney graph you mention eggs show up further down tha graph because people tend to eat less of them. What is the placement of these foods based on, the amount of acid in each food, or the amount that is eaten?
    Thanks.

  • Wade Patton

    No I won’t calculate my LAKE score for the day because that would mean I’d have to cipher out “serving sizes” and weigh/measure my portions. Part of the beauty of the WFPB thing is not measuring, not counting. I only measure to cook and half that time that’s using my left hand as Justin Wilson used to do. I weigh myself too, but that’s quick and easy-Detecto.

    I know I blow the “normal” (pathetic) scores away.

    • valnaples

      HA ..Wade, good one! I too am sipping hibiscus tea as I type this…and I do agree with you on the total FREEDOM that comes with a Whole Food Plant Based lifestyle…no worrying about portion sizes!!! yippee! I like to brew hibiscus tea WITH green tea lately…not crazy about the flavor of green tea so combining it with the hibiscus tea helps immensely. Cheers!

  • Jay Rosenbergstienroth

    Going vegan for beginners and everyone else
    https://youtu.be/vlNiHl36gd8

  • Kathy

    What about vegans who have kidney stones? I have a small one and my vegan friend also has some. Can it be genetic? My dad (meat-eater) gets them very badly. I’ve been vegan for 9 years and vegetarian 10 years before that. I do eat minimal fruit and veg. I like rice, pasta and a small selection of vegetables.

  • Natalia

    My stones and ocsalaturia go out at three month ov vegan diet.. Natalia. Russian therapists, phytotherapeutist and function specialist.

  • Zuppkko

    Acid urin means that the body eliminates acid waste from the body, therefore it is good to have lower pH. But ofcourse with WFPB diet our bodies have less acid to eliminate.

  • Suzie Kyootie

    I’ve been eating a vegan diet for over forty years. After hurting
    my back, I went for an x-ray and saw a one-centimeter stone in my right kidney,
    and several other stones on both sides. I’m glad to hear that I don’t have to worry
    about eating oxalates in greens. My weakness is that I like to use salt and oil
    on my starches–rice, noodles, and potatoes. But as a long-term vegan, I’m
    surprised by the prevalence of stones.

  • DavidRPh

    Can someone point to the reference which describes treating oxalate stones with dietary modifications? I only noted references referring to the treatment of uric acid stones. Thank you.

  • GIJoeActionMan

    Hi guys,

    I have a very rare neuropathy of my bowels (significant nerve damage), called chronic ideopathic intestinal pseudo obstruction. I’ve had it since birth but was only diagnosed in 2009. Before that I had bouts of chronic volvulus (which I kept surviving:) due to intestinal malrotation. This is also from embryonic development. This was only diagnosed in 2007. Since I had a right hemicolectomy at the start of 2008, I have had over 50 bowel obstructions (54). I can no longer eat. I have redundant peristalsis and have erratic peristalsis in parts, and this is throughout my entire bowel, and so I have lived off a liquid diet since 2011 but it took a number of years to come to the realisation that I’d have to reduce my eating gradually to nothing to stay out of hospital, and this on top of being very ill was very, and still is, very hard. I’m 37 years old. I’m extremely fit and you wouldn’t guess to look at me I’ve been through hell and don’t eat food. However, I do have chronic fatigue, had/have hormonal issues, and have a host of related problems including autonomic nervous system disorders, and I’m on a lot of medication. The next step will be a venting tube for the amount of gas I get building up so I can get rid of wind easier, because even passing gas and liquids can be tedious, and in the future will have to have IV feeding tube.

    Of course I’m currently under multiple consultants and I’ve seen dietitians, but was wondering if anyone has any thoughts of what I’m currently ingesting. Remember, I cannot have blended food, or lumpy soup (too much bloating and crampy pains), definitely no fibre, so it has to be liquid, if you can suggest anything.

    My current ingestion daily is: up to 2Lt lactose free milk (occasionally have almond and soy milk but these are mainly made of water and don’t fill me up, not like milk does but at least it’s a little more viscous), up to 2-3Lt pure orange juice, 2-4 scoops (25g) plain protein powder, 1 scoop oat powder (but causes bloating and pain), 4 x 125ml Fortisip drinks. Vit D3 tablet, multivit and mineral tab, omega 3 tab, 5g x spirulina/chorella powder, and/or grape seed extract powder/nutri-green powder/barley grass/wheat grass powder in orange juice.

    If anyone can think of a more nutrient-dense way than this to currently stay alive, please let me know…
    Thank you.

    • Joseph Gonzales R.D.

      Wow sounds like you’ve been through an awful lot! Thanks for reposting. Those dietitians you saw can come up with more ideas that are better than mine. If you are adding protein powder to liquids the type of milk or amount of water should not matter. You may even consider adding a bit of flax oil for a bit of fat. There is a product called Liquid Hope that is used for tube feeds, but it has fiber. Others on the market I know of use inulin (a prebiotic) so that would also have fiber. Can you really have “zero” fiber? I would think the wheat grass and oat powders have a bit of fiber, especially the oat (perhaps explaining the bloat and pain). Gosh I wish I had better solutions, but I would turn to the experts who deal with bowel obstructions in hospital settings. I can ask my network of oncology dietitians for their advice if you’d like? Hang in there, GIJoe!

      Sincerely,
      Joseph

      • GIJoeActionMan

        Hehe don’t worry Joseph, I’m hanging in there! Yes, ask away, if anyone else has ideas. What does Dr Greger think about me drinking all this skimmed/semi-skimmed milk? He doesn’t like milk judging from the research in some of his videos, but as far as I’m concerned, it packs the best punch for me nutritionally and energy wise.

        Trouble is, I’m sooooo limited. I really can’t have any fibre because I don’t have the bowel strength or bowel coordination to move stuff through. Even a small amount causes trouble (i.e., 25g oat powder). I only have small amounts of wheat grass powder.

        As an e.g., 12 months ago I volunteered to participate in my bowel professor’s research trial which is a first of its kind for people with my problem in the world. The first week I drank 1-2 Lt of non-digestible sugar (it was the exact consistency of water) and was scanned in live time with a special MRI machine. I was injected with neostigmine (which they’ve started injecting this into me during bowel obstructions to cut down on the masses of morphine, etc., I have over a 30 hour period of an obstruction). Anyway, the next week, the same (1-2 Lt of this non-digestible drink), but this time injected with placebo saline (unbeknown to me, blind trial). About 5 hours later, I couldn’t pass the liquid and got a horrendous bowel obstruction. The aim was to observe my bowel peristalsis live, not to give me a bowel obstruction. But that’s the kind of severity I’m dealing with. Even a little fibre causes sub-occlusions.

        I like the idea of flax oil. I can add some drops to my juice/protein powder. I’ll look into that. Does anyone think I should change my whey protein to mix it up with some soy protein, or does that not really matter?

        Thanks!
        Joe

        • Joseph Gonzales R.D.

          Interesting trial let’s hope you are through with that and no more bowel obstructions in the future! You are under the right impression regarding milk. If you check out our videos the research does not support drinking lots of milk, if any. Do what you feel is best you know your body better than us! Regarding whey it’s your call. I have a lot of information on whey, here. Soy protein isolate and concentrate (pills and powders) may not be the best choice, as like dairy protein it can stimulate IGF-I production. If looking for a protein powder there are so many on the market. I may suggest pea, rice, hemp, or potato protein (whatever one has the least fiber — or a blend). You could also change it up and have whey one day, then rice, then pea, or a combo. Obviously find one you tolerate and enjoy. If anything else crosses my mind I’ll be the first to let you know. Good luck!

          • GIJoeActionMan

            That’s great, thanks so much Joseph. Yes, I can consume more than ‘zero’ fibre, but once I start going past, say, 5g I start getting bowel pain, colikey, cramps, stabbing pains, then find it hard to poo. So even lumpy tomato soup is a waste of my time unfortunately. There’s nothing wrong with my stomach, which is a natural blender, and so most people think I can blend food, but even blending foods, once it’s into the gut and out of the stomach, it gets stuck, so that’s a no-no also.

            I’m going to check out those links now. That’s brilliant. Thank you so much for your help, I do appreciate it a lot.
            Joseph.

  • Youcef

    Is there a plant-based way of creating a high acid load? (i.e. like meat and fish)

  • joe

    I feel Dr Greger has an agenda and wouldn’t present studies that show the opposite. What about those vegans that eat spinach, nuts and beans and also get stones?!?! If the doctor got a stone would he share it here? Probably not!

  • mariah

    I have a condition called vulvodynia which I have successfully controlled with a low oxalate diet (and a few supplements, most importantly calcium citrate) for almost 20 years. I was an ovo-lacto vegetarian both before and after developing this condition, and am now a recent convert to a vegan diet thanks to T. Colin Campbell’s _The China Study_, and your excellent website, nutritionfacts.org. My biggest challenge is finding a way to eat a sufficient quantity of leafy greens and whole grains without getting into trouble with my overall oxalate load, which can cause a flare up of very painful symptoms. Our bread and pasta tend to be made with white flour, for example, because whole grains are generally more oxalate-dense. I would appreciate any suggestions you might have on how to best balance good nutrition with a low oxalate diet. Many thanks

  • anthony porta

    Does this apply for gallstones as well?

  • Alex

    “cutting down on oxalates, which are concentrated in certain vegetables?
    A recent study found there was no increased risk of stone formation
    with higher vegetable intake.”

    This (dis)connection is not explicitly stated. Sure, beans, veg and fruit are alkalizing. Sure, calcium intake has little impact on stone formation. But the relation between “oxalates and stones” was not directly addressed. Begging the same old question:

    Should we limit spinach intake or not?!?

  • Alex

    I have noticed that many low-fat sources of fat-soluble vitamins (A, E, K), iron and calcium tend to have high oxalate concentrations. I assume there’s a straight-forward logical correlation there, as if oxalate binds to chemicals in much the way fat does. Any connection?

  • Anne T

    Help please! I have been on thyroid medication for 53 years. 50 years ago my thyroid was mostly removed because it had been irradiated. I have now developed kidney stones and need also a low oxalate diet. Because some of the foods on the low O list are not good with synthroid I need to know if I can eat these veggies as long as they are not eaten in close time with synthroid. Also where can I find dietary advice and help getting started? wow! Thanks Anne T.

  • Anne T

    Forgot to say I am type 2 diabetic on metformin and bydureon.

  • Youcef

    Just out of curiosity, if someone wanted to acidify the body intentionally (for a short period of time, about a month), using a striclty vegan diet, what specific foods would that involve? Why?
    Question on Quora:
    https://www.quora.com/How-do-I-acidify-the-human-body-as-much-as-a-standard-Western-intake-of-animals-products-would-only-on-a-diet-free-of-all-animal-products#

  • sportsoul

    I had two kidney stones this year, one in May 2015 and one in August 2015. These are the first in my 44 years of life. I was not aware I had and passed a stone in May. I just thought I was very ill and perhaps it was side effect of a lot of ibuprofen I’d been taking for herniated cervical disk. I was also concerned that my change to vegan diet in February 2013 contributed to this. I requested my doctor screen my blood for any triggers. We found I had low vitamin D, and I’ve since taken supplements. I am now trying to be consistent with multivitamin as a preventative in case my diet does not provide sufficient levels of nutrients. Although I eat vegan, I tend to eat anything I find out is vegan, including a lot of processed items like potato chips which I had not eaten in my previous nonvegan but non processed food oriented diet. So I teetered between plant based and whole food diet, and room for improvement. Because I deprive myself of eating pleasure of many items, I allow myself to enjoy beer anytime I want and this may have an effect. Perhaps a dehydrating effect.

    Based on what is presented I have a low risk, but something is in play. It may be excess minerals from the multivitamins or too much processed foods. I’m perplexed but I will keep on with hydration.

  • Traveller

    Great video/info! Is there any way to estimate what type it is based on what it looks like?

    I have stones, no idea how many, and recently passed one. I was able to save it to learn what type it is, but I am traveling and was advised to wait until I am back in the USA to have it analyzed.

    (I already barely eat red meat, don’t eat chicken 3x a week, love veggies and fish and fruits. Stopped salt at 15, don’t eat chips etc, stopped soda at 15 and don’t consume energy drinks. I seem not to be a candidate for getting stones. Gall stones age 21, gall bladder was removed age 30 though. I suspect my stones are from UTI that went on for over 6 months but maybe that was really stones, not infection.)

  • Traveller

    Does cheese and cottage cheese count as animal protein or are we just talking about red meat. Also, how is chicken? I assume it is animal protein but is it better than red meat?

  • Rodrigo Cardoso

    Legendado em Português / Subtitled in Portuguese: http://nf.focoempatico.net/como-tratar-pedra-nos-rins-com-dieta/

  • cwwitter

    I read in a nutrition book of a man who ate largely of eggs and spinach and developed calcium oxalate stones. It stated that spinach was high in oxalic acid along with several leafy vegetables such as poke, lamb’s quarter, and others. It said that the body cannot break down the oxalate and uses calcium to remove it from the body.

  • Sherry Groff

    Hi, my husband became Vegan Jan 1st as a test to see if he could get off his blood pressure medicine after 90 days. Last week he passed his first kidney stone and another 2 this week. He is convinced that the change in diet has caused these kidney stones. We’ve watched your video’s but he is still convinced that the only dietary change has been the elimination of animal products. Have you ever heard of this before? I’m thinking that the dietary change has caused him to eliminate the kidney stones that were stored in his kidneys.

  • otto9n9otto

    I eat a strict plant-based diet. I am presently walking around with a (calcium-based) kidney stone. My urologist knows this. I have found that consuming turmeric, even 1/4 tsp., causes me kidney stone pain. After stopping turmeric consumption, kidney stone pain started to decrease, then was gone a week later. I have long consumed turmeric so I wonder if that caused this kidney stone.

  • amy

    you didn’t really get at how to treat calcium stones which are most stones. any guidance there?

  • Heather3

    Greger is an Angel

  • Anne

    My husband (age 58) has been eating a whole foods, plant-based diet for over 3 years. He is mostly a raw vegan. He got his first kidney stone — 4mm in size, and there’s a 2mm hanging around in there, too!!!!!!! We can hardly believe it! He is clearly doing everything he is supposed to do to NOT get kidney stones. A typical day for him is, thus: Breakfast: 10oz berries + 5 bananas; Snack #1: 2 oranges; Long Walk; Snack #2: a grapefruit; Lunch: Salad of 3.5 oz greens (varies), 3 bananas, 10oz berries, 1 carrot, 1 celery stick, 9g. flax, chia or hemp seeds; Snack #3: 8 dates; Dinner: Same as lunch, but usually with 10oz mangoes instead of berries and walnuts or pecans instead of seeds. Snack #4: 4-6 cashews and some homemade raw kale chips. Usually, he will have a few bites of my spicy bean & veg dishes. The high oxalate foods he eats are dates (daily), a grapefruit (daily) and spinach (3x/week or so, depending on what’s available), but it says dietary oxalate isn’t supposed to be a factor. He hasn’t had a physical in a couple years, but there was no blood in his urine last time, so I would think the stones were newer than that physical; otherwise, I would think they were from meat-eating days and just being passed now. Does anyone have any thoughts? Thanks!!!!!

  • shailja

    How can I see the answers of the questions which are asked here???

  • kristinainman

    I saw a post here that taking magnesium can help. I have always been so allergic to it. I know I need it but can’t handle it. I can’t even take a bath with epson salts. No one has ever explained to me why this is. I’m also allergic to any b vitamins. I keep telling the doctors at UCSD in San Diego, CA that they should study me. I know that I’m a rare case and would like to help. Any ideas on where I can help would be appreciated too. I can’t eat brown rice, can’t take ANY B vitamins or eat wheat bread without feeling totally drugged. My head hangs forward and the back of my neck swells. I feel like I can’t hold my head up and like I’m on a vicodine. I feel sleepy and toxic. My aunt also has the same strange reaction to B vitamins. I would love to know why. I also have opposite reactions too. If they give me codine, it makes me hyper instead of sleepy. Coffee used to put my to sleep instead of waking me up. I’m very sensitive too. I’m allergic to penicilin, sulphas and prednisone (excuse my bad spelling). Any feedback would really be appreciated.

  • David J

    I’m still wondering if one can get too much oxalate from eating lots of high-oxalate vegetables, which I do, e.g. smoothies with several cups of spinach and beets along with celery, carrots and whatever. Spinach and beets are very high in oxalic acid, celery somewhat, as I recall,

  • Marianna Botte

    Dr. Greger & Joseph, hello! I am a 19 year old Nutrition & Dietetics student, who is just starting towards her Bachelor’s :) Thank you for inspiring me so much! My question is regarding oxalates. All I’ve ever heard is that green leafy vegetables, or any foods (even chocolate!) that are high in oxalates should be avoided… but honestly how much is really TOO much? From this video it seems that the high oxalate foods I’ve mentioned are not even the leading contributing factors to kidney stones! But should I still be counteracting my intake with more calcium rich foods? Im summation, these are my two questions:

    1. How much of high-oxalate foods such as spinach is really too much in terms of creating downsides like kidney stones?
    2. If they do have a contributing factor, what measures can I take to balance out those oxalates? (More calcium, etc…)
    Thank you!
    Marianna