Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much

Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much
4.75 (95%) 68 votes

Given their oxalate content, how much is too much spinach, chard, beet greens, chaga mushroom powder, almonds, cashews, star fruit, and instant tea?

Discuss
Republish

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The tragic case in which a green smoothie cleanse shut down the kidneys of a woman who drank two cups of spinach a day for just 10 days is complicated by the fact that she had had a gastric bypass, and was on “prolonged” antibiotics, which can both increase absorption of the oxalates in spinach. So can taking megadoses of vitamin C. This guy went into kidney failure juicing spinach and beet greens, but he was also taking 2,000mg a day of vitamin C. “Vitamin C is metabolized to oxalate” inside the body, and likely played a role in his oxalate overload. In both cases, their juicing alone was giving them more than 1,200mg of oxalate a day, which is easy with spinach —just two cups a day — but practically impossible with most other greens, like kale, requiring more than six hundred cups a day.

There is one case of apparent dietary oxalate overload-induced kidney failure uncomplicated by surgery, antibiotics, or vitamin C. A man who had lost about 80 pounds eating a diet of greens, berries, and nuts, which evidently included spinach six times a day. Tragically, his kidney function never recovered.

Remember that study purporting to show a “massive” load of dietary oxalate didn’t have much of an effect on urine levels? That study went up to 250mg of oxalates a day. That is massive if you were talking about most greens. That would be 25 cups of collard greens, 60 cups of mustard greens, 125 cups of kale, or 250 cups of bok choy at a time. But, that’s less than one-half cup of spinach.

Spinach really is an outlier.  Even though there’s small amounts of oxalates found throughout the food supply, spinach alone may account for 40% of oxalate intake in the United States. The Harvard cohorts found that men and older women who ate spinach eight or more times a month had about a 30% higher risk of developing kidney stones.

What if you cook it? Oxalates are water soluble, so, for example, blanching collard greens can reduce oxalate levels by up to a third; so those 25 cups at a time can then be 33! For low-oxalate greens, it doesn’t matter cooked or not, since they’re so low regardless.

Steaming spinach reduces oxalate levels 30%, and boiling cuts oxalate levels more than half. Boil the three high-oxalate greens — spinach, beet greens, and Swiss chard— and 60% of the oxalates are leached into the cooking water. They start out so high, though, even cooked would contain hundreds times more than low-oxalate greens like kale. For high-oxalate greens, it doesn’t matter cooked or not, since they’re so high regardless.

The bottom line is that anyone with a history of kidney stones, otherwise at high risk, or who eats cups a day should probably avoid the big three. This is especially important for those who juice or blend their greens, as oxalates appear to be absorbed more rapidly in liquid than solid form.

Another reason to give preference to low-oxalate greens is that they are less stingy with their calcium. While less than a third of the calcium in milks may be bioavailable (whether from a cow or a plant), most of the calcium in low-oxalate vegetables is absorbed. The calcium bioavailability in some greens is twice that of milk, but the oxalates in spinach, chard, and beet greens bind to the calcium, preventing the absorption.

Other high-oxalate foods that have been associated with kidney problems at high enough doses include chaga mushroom powder. Four to five teaspoons a day, and you can end up on dialysis. Four cups a day of rhubarb is also not a good idea. More than a cup a day of almonds, or cashews, and then star fruit, which I did a video on in the past. A single dose of about a cup and a quarter star fruit juice, or just 4-6 fruit….  Excessive tea consumption can be a problem, especially instant tea, which boosts urine oxalate nearly four times higher than brewed. Two cases of kidney damage have been reported, both of which were attributed to drinking a gallon of iced tea a day. Tea, like spinach, is super healthy; just don’t overdo it.

Please consider volunteering to help out on the site.

Image credit: Jo Sonn via unsplash. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The tragic case in which a green smoothie cleanse shut down the kidneys of a woman who drank two cups of spinach a day for just 10 days is complicated by the fact that she had had a gastric bypass, and was on “prolonged” antibiotics, which can both increase absorption of the oxalates in spinach. So can taking megadoses of vitamin C. This guy went into kidney failure juicing spinach and beet greens, but he was also taking 2,000mg a day of vitamin C. “Vitamin C is metabolized to oxalate” inside the body, and likely played a role in his oxalate overload. In both cases, their juicing alone was giving them more than 1,200mg of oxalate a day, which is easy with spinach —just two cups a day — but practically impossible with most other greens, like kale, requiring more than six hundred cups a day.

There is one case of apparent dietary oxalate overload-induced kidney failure uncomplicated by surgery, antibiotics, or vitamin C. A man who had lost about 80 pounds eating a diet of greens, berries, and nuts, which evidently included spinach six times a day. Tragically, his kidney function never recovered.

Remember that study purporting to show a “massive” load of dietary oxalate didn’t have much of an effect on urine levels? That study went up to 250mg of oxalates a day. That is massive if you were talking about most greens. That would be 25 cups of collard greens, 60 cups of mustard greens, 125 cups of kale, or 250 cups of bok choy at a time. But, that’s less than one-half cup of spinach.

Spinach really is an outlier.  Even though there’s small amounts of oxalates found throughout the food supply, spinach alone may account for 40% of oxalate intake in the United States. The Harvard cohorts found that men and older women who ate spinach eight or more times a month had about a 30% higher risk of developing kidney stones.

What if you cook it? Oxalates are water soluble, so, for example, blanching collard greens can reduce oxalate levels by up to a third; so those 25 cups at a time can then be 33! For low-oxalate greens, it doesn’t matter cooked or not, since they’re so low regardless.

Steaming spinach reduces oxalate levels 30%, and boiling cuts oxalate levels more than half. Boil the three high-oxalate greens — spinach, beet greens, and Swiss chard— and 60% of the oxalates are leached into the cooking water. They start out so high, though, even cooked would contain hundreds times more than low-oxalate greens like kale. For high-oxalate greens, it doesn’t matter cooked or not, since they’re so high regardless.

The bottom line is that anyone with a history of kidney stones, otherwise at high risk, or who eats cups a day should probably avoid the big three. This is especially important for those who juice or blend their greens, as oxalates appear to be absorbed more rapidly in liquid than solid form.

Another reason to give preference to low-oxalate greens is that they are less stingy with their calcium. While less than a third of the calcium in milks may be bioavailable (whether from a cow or a plant), most of the calcium in low-oxalate vegetables is absorbed. The calcium bioavailability in some greens is twice that of milk, but the oxalates in spinach, chard, and beet greens bind to the calcium, preventing the absorption.

Other high-oxalate foods that have been associated with kidney problems at high enough doses include chaga mushroom powder. Four to five teaspoons a day, and you can end up on dialysis. Four cups a day of rhubarb is also not a good idea. More than a cup a day of almonds, or cashews, and then star fruit, which I did a video on in the past. A single dose of about a cup and a quarter star fruit juice, or just 4-6 fruit….  Excessive tea consumption can be a problem, especially instant tea, which boosts urine oxalate nearly four times higher than brewed. Two cases of kidney damage have been reported, both of which were attributed to drinking a gallon of iced tea a day. Tea, like spinach, is super healthy; just don’t overdo it.

Please consider volunteering to help out on the site.

Image credit: Jo Sonn via unsplash. Image has been modified.

Motion graphics by Avocado Video

Doctor's Note

If you missed it, be sure to check out the previous video: Oxalates in Spinach and Kidney Stones: Should We Be Concerned?

To be clear, I encourage everyone to eat huge amounts of dark green leafies every day — the healthiest food on the planet — but if you follow this advice (and you should!), then just choose any of the other wonderful greens. If you eat regular boring amounts of greens (like a serving a day), then it doesn’t matter which you choose. I continue to eat spinach, beet greens, and chard all the time. It’s just that you can overdo those three, so when I’m trying to hit my pound-a-day green leafy quota, I personally do mostly kale, collards, and arugula, which also happen to have the added benefit of being cruciferocious!

Why are greens so good for us? How aren’t they?!

Some tips on how you might prep them for max benefit:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

163 responses to “Kidney Stones and Spinach, Chard, and Beet Greens: Don’t Eat Too Much

Comment Etiquette

On NutritionFacts.org, you'll find a vibrant community of nutrition enthusiasts, health professionals, and many knowledgeable users seeking to discover the healthiest diet to eat for themselves and their families. As always, our goal is to foster conversations that are insightful, engaging, and most of all, helpful – from the nutrition beginners to the experts in our community.

To do this we need your help, so here are some basic guidelines to get you started.

The Short List

To help maintain and foster a welcoming atmosphere in our comments, please refrain from rude comments, name-calling, and responding to posts that break the rules (see our full Community Guidelines for more details). We will remove any posts in violation of our rules when we see it, which will, unfortunately, include any nicer comments that may have been made in response.

Be respectful and help out our staff and volunteer health supporters by actively not replying to comments that are breaking the rules. Instead, please flag or report them by submitting a ticket to our help desk. NutritionFacts.org is made up of an incredible staff and many dedicated volunteers that work hard to ensure that the comments section runs smoothly and we spend a great deal of time reading comments from our community members.

Have a correction or suggestion for video or blog? Please contact us to let us know. Submitting a correction this way will result in a quicker fix than commenting on a thread with a suggestion or correction.

View the Full Community Guidelines

  1. That’s interesting and answers a question that I’ve had for over 60 years.

    When I was growing up, I lived in a house on a terraced street in an old part of Liverpool in the UK. Tea drinking was immensely popular and some of the older women on our street used to have a pot of tea on hand during all their waking hours. Essentially, they drank cups of tea tea all day long. I remember, when I was 5 or 6 (we moved away when I was 7), hearing some grown-ups say that drinkng lots of tea was bad for the kidneys because many of those older ladies with the all-day tea drinking habit seemed to develop kidney problems.

    As an enthusiastic tea drinker myself, I’ve always wondered about those stories but I’ve never been able to find confirmation of the belief that heavy tea drinking was linked to kidney problems. So, thanks Dr G and the NF team – you’ve solved a 60-year mystery for me. And perhaps given me reason to make sure that I don’t drink too much tea.

    1. It is nice when that happens.

      You finally found a mechanism.

      Many of my elder generation relatives would say sentences like that.

      After a year and a half of watching Dr. Greger videos, I am amazed at how much they understood.

      They never explained why and I am not sure they understood things at a sophisticated level.

      The had the “Beans, beans they are good for your heart….” song type logic to everything and would just say sentences like that.

      1. Deb, to your point… it also should be noted how much the youngsters retained from hearing/seeing their elders. Tom’s statement quoted below testifies to how careful parents should be around their children in how they both act and speak about things. That is, they should remember they are shaping their children’s memories.
        _____________________________________________________________________

        I remember, when I was 5 or 6 (we moved away when I was 7), hearing some grown-ups say that drinking lots of tea was bad for the kidneys because many of those older ladies with the all-day tea drinking habit seemed to develop kidney problems.

      2. Listen to Dr. McDougall and no worries. Potatoes, corn, beans, rice (whole grains), oats, pumpkin (winter squash). Your diet should be based on starches. Potatoes or sweet potatoes are a complete and perfect food for humans. I even remember a NF video reporting that around the turn of the twentieth century, the Polish and Russian peasants worked very hard, under very harsh conditions, and were very healthy eating a diet that consisted solely of potatoes and bread.

        1. I don’t know how true that is … but I want it to be true!! I could live on pasta and potatoes, but IDK how that would work for my diabetic husband. I’m going to check out Dr. McDougall.

          1. Well if your husband is type 2, then going on a WFPB diet will reverse his diabetes. All our plant based doctors, Dr. McDougall, Dr. Barnard, Dr. Greger, Dr. Esselstyn, Dr. Fuhrman, Dr. Klaper, Dr. Ornish, etc prescribe essentially the same thing, a WFPB diet. A number of them have written books specifically on reversing diabetes. I think you have to do it under a doctors supervision because any medications will need to be reduced. Or just go to Dr. McDougall’s ten day program.

            1. Blair, do these docs who prescribe a WFPB diet disagree in any substantial way?
              Or do they simply emphasize different elements of a plant-based diet, or have different styles?

              1. To me, they don’t differ in any substantive way. Although there are heated debates in the WFPB community. The points of contention appear to be; nut, seed, avacado consumption, vitamin D supplementation, DHA supplementation, salt. Dr. Greger seems to emphasize his daily dozen. Dr. McDougall seems to emphasize starches. Dr. Esselstyn seems to emphasize cruciferous vegetables. They’re in 99% agreement though. If you get the 99% right, you’re going to be healthy.

    2. As an enthusiastic tea drinker myself, I’ve always wondered about those stories but I’ve never been able to find confirmation of the belief that heavy tea drinking was linked to kidney problems. So, thanks Dr G and the NF team – you’ve solved a 60-year mystery for me. And perhaps given me reason to make sure that I don’t drink too much tea.
      ————————————-
      This gave me pause at first blush since I too drink “teas” throughout the day… but then I took stock and it turns out I only drink a few cups of actual tea. The other “teas” I drink usually consist of herbals or even fruit and green teas. No distinction was made, but I’m hoping those are o.k. because I really enjoy my tea/”tea” drinking.

      1. Another confounding factor in my tea/”teas” drinking is the fact I doctor each cup with oregano extract drops, clove extract drops, bergamot extract drops, and occasionally some cilantro-chlorella drops as a detoxifier.

        I’m thinking/hoping that someday we will have the means to test for additions such as mine individually and at home.

        It’s obvious the current research stream isn’t going to account for things that are out of the mainstream.

        1. Loni:
          Most Asian spices, including cloves, are high in oxalates. The biggest culprits are cardamon, turmeric, and ginger. But, since the serving size of spices are small, consuming them in sensible amounts may not increase one’s risk of getting kidney stones.

        2. Dr. G promotes whole plant foods, but an extract is only part of the food. I think we have to be careful with extracts, because they are generally considered medicinal, some more potent than others, and when taken often may have side affects that we need to understand.

          1. Dr. G promotes whole plant foods, but an extract is only part of the food. I think we have to be careful with extracts, because they are generally considered medicinal…
            ———————————————-
            Your comment is well placed… for those who unquestionably follow Dr. Greger’s teachings.

            (Crosses arms and forms a rebellious posturing scowl countenance ‘-)

            I agree totally that the extracts and other herbals are considered medicinal… didn’t some Greek philosopher or another say “Let food be thy medicine?

          2. Actually, if the only concern is kidney stones, extracts may be the better choice assuming that they’re alcohol extracts, which is usually the case, because none of the oxalate salts present in plants (ammonium, sodium, potassium, calcium, magnesium, and iron) are soluble in alcohol.

    3. I heard that too, that too much tea was not good. Always discounted it though. Those relatives who drank a lot of tea were healthier than those that didn’t. It was the side of the family who never drank tea, or ate much greens for that matter that died of kidney failure.
      My grandmother always insisted that I add milk to my tea. It would have bound the oxalates.
      But people must vary a lot on how much oxalate they can handle.
      My standard breakfast for years was a huge mixed green salad, (80-90 grams), mostly spinach with an orange. Then an almond butter sandwich with 2 cups of strong black tea (no milk). Have never had a kidney, gallbladder problem. After this info though, I’ll moderate that.
      Thanks Dr. Gregor.

      1. Yes, this video was very effective at changing the salad I eat every night.

        Because I also drink tea and eat things like cashew yogurt and eat all of the top sources.

        Probably sometimes in one sitting.

        I do also eat kale, but I have been mixing them both together and I eat a huge salad when I eat it.

        Not 16 cups of spinach, but I would say 2 cups has happened frequently.

    4. Ok this is good news. For the last 5 weeks I have been eating six to seven cups of steamed spinach through out the day to help my heart health per Dr. Esselstyne and now I will switch to kale. But the good news is my cholesterol dropped so dramatically that my doctor wanted the full scoop on what I did. My doc couldn’t believe it and even said a statin couldn’t produce the same results. Plus I feel great smiles.

    5. what did i miss here. he was talking about spinach and 2 other grees as being encouragers of kidney stones. how does that answer u’r tea mystery?

    6. Just because a very few people (The video referred to 3-5 people, that ate lots of Spinach got kidney stones does not prove anything. The Doctor is “SCARING” the public with B.S. I don’t see any scientific “PROOF” of anything and the Doctor should not spread Fake B.S. News to scare people away from eating lots of good highly nutritional natural plant-based foods. Next we are not allowed to buy RAW vegetables thank to Doctor Greger (with B.S. science) just like we are not allowed to eat highly nutrious raw peanuts – extremely dangerous. Very sad.

  2. I usually eat a 16oz bag of spinach at least weekly (all of the last four years). Never had a stone problem. I eat other greens as well. Can mix it up more.

    Need more info on Lambsquarter, it grows wild here and I eat it regularly too.

  3. Dr Greger has mentioned the calcium issue with spinach in other videos. In my case however, it has only been in the last years of eating wfpb with spinach ( a lot of it!) that my calcium levels rose to ‘perfect’ according to my doctor. I do not buy other greens, nor do I eat tofu etc. A lifetime of chasing higher calcium levels with dairy products and supplements failed to achieve the same effect.

  4. I have a couple of questions:

    1. How much is 1 cup of spinach in grams approximately? 100g? 50g?

    2. By “tea” what did they mean? Black tea (english breakfast tea)? Green tea? How much green tea is too much? Which type of tea is lowest in oxalates?

    3. The snapshot of the tea study also talked about cases of hyperoxaluria caused by almonds? How much almonds it too much? Cashews? Peanuts?

      1. Barb, How about the calcium in nut milks. I drink about 1 half gal of unsweentened organic soy mylk a week. Is this too much?

        1. Marko, I am not a doctor nor am I a nutritionist. I can’t advise you how much soy milk and calcium you should consume but maybe someone else can. Dr Greger has said that soy milk is a delicious healthy addition to our diet. 1 cup of soy milk gives us approximately 30% of our daily calcium requirements. I consume about the same amount you do.

      2. Actually, spinach contains about 400-900 mg oxalate/100 g (depending on variety and season), so in this case “cup” would be about 70-150 g. The number from the referenced article make it about 90 g. Your value of 30g per cup make the oxalate content in spinach about 3 times too high.

        Which is an excellent example showing why we shouldn’t be using bullshit units like “cups” for anything serious (and I would say even for recipes). A cup of spinach is mostly air, so the actual value is mostly dependent on how well you pack it, or how big or wrinkly the actual spinach leaves you have are (and this can vary A LOT). Not to mention that such calculations are completely useless if you eg. buy frozen spinach.

        1. JP, I LOVE your comment about the problems of measuring food by volume, as opposed to by weight!

          Several years ago, after I started baking bread, I bought a kitchen scale to measure the flour and water, because bread baking can be a somewhat exacting endeavor. And then I started weighing my food in cooking, because like you, I became very frustrated by “a medium size onion” or “a bunch of kale” — as these can vary by a lot! Though I also realize that cooking is much less exacting than baking.

          But my kitchen scale is small, flat, easily stored, battery operated, digital, and provides results in both ounces, pounds, or grams (and relatively inexpensive, $20 -$30). I highly recommend it to every one. That way, we can measure what our cups of spinach weigh, and more.

    1. It looks like your question was answered well by a commenter other than I’d point out that if you have a hard time catching those type of details listening, you can view the transcript and it may be easier to catch the specific answer you’re looking for. In this video, for example, here are the quotes as found on the transcript:
      “Four cups a day of rhubarb is also not a good idea. More than a cup a day of almonds, or cashews, and then star fruit, which I did a video on in the past. A single dose of about a cup and a quarter star fruit juice, or just 4-6 fruit…. Excessive tea consumption can be a problem, especially instant tea,..”
      Research on oxalates and peanuts was not explored Hope this is helpful and reassuring in that you can still eat these healthy if high oxalate foods, just don’t overdo as stressed.

  5. Feel sorry for all those who are trying to eat healthy only to find they could be hurting themselves. I am slowly learning that these so called healthy good for you food are not so healthy in quality..are we heading to needing warning labels on these foods????? Not everyone knows about this website. That being said, the more I read, the more confused I get.

    1. Lori,

      I agree with you.

      I remember watching one of the videos of someone who left veganism and spinach giving her kidney stones and causing kidney problems was what she mentioned.

      Instead of switching to Kale, she went something like Keto and called Veganism dangerous.

      These issues are so complex, but what I know is that Americans tend to have the “overdo everything” gene and the concept they could move from the SAD diet and kill themselves eating dozens of servings of spinach is one of those crazy likelihoods.

      1. Listening to it though, there were enough foods with “risk factors” which I could see people who are trying to do Whole Food Plant Based use regularly.

        The big three vegetables, plus tea all day, plus, cashew cheeze etc.

  6. “For example, as evidence that high-oxalate vegetables aren’t a problem for kidney stones (a bold claim, given the wide acceptance of foods like rhubarb and beets as risky for stone formers), Greger cites a paper that doesn’t actually look at the effects of high-oxalate vegetables — only total vegetable intake (pages 170-171).

    Along with stating “there is some concern that greater intake of some vegetables … might increase the risk of stone formation as they are known to be rich in oxalate,” the researchers suggest the inclusion of high-oxalate veggies in participants’ diets could have diluted the positive results they found for vegetables as a whole: “It is also possible that some of the [subjects’] intake is in the form of high-oxalate containing foods which may offset some of the protective association demonstrated in this study” (1Trusted Source).

    In other words, Greger selected a study that not only couldn’t support his claim, but where the researchers suggested the opposite.”

    https://www.healthline.com/nutrition/how-not-to-die-review#section1

    1. You have made this comment before. It is a deliberately misleading one.

      The researchers didn’t suggest the opposite. They wrote

      “It is also possible that some of the [subjects’] intake is in the form of high-oxalate containing foods which may offset some of the protective association demonstrated in this study”

      In other words they identified a possibility. They also clearly state that vegetable consumption is protective.

      And all you are doing is quoting the highly biased Denise Minger who is an expert in cherry picking herself and consequently a darling of the low carb crowd who for somw bizarre reason seem to hate vegans.

      Of course high oxalate vegetables aren’t a problem for kidney stones as long as they are eaten as part of vegetabe diet and you don’t overdo it. That’s what Grgere says. You and Minger are implying that he is saying that a diet where the only vegetables are high oxalate ones is not a problem. This is a complete misrepresentation of what he says. But that’s what all your comments here do isn’t it Konrad?

      1. Yes, he seems to have trouble following what is actually being said.

        I wonder if he has trouble following the logic.

        Either way, I am having trouble following his logic.

        The fact that Dr. Greger is putting this video up and he is going to disagree with this one, too, doesn’t even make sense to me.

          1. True, Lonie ‘-)

            And to YR, if you’re tuning in, to answer your question from a few weeks ago (no, I did not forget):

            I had to put my mother in a facility in Brooklyn (close to my brother) because her care went way beyond my capabilities. The hospice crew kept giving her benzodiazepines that turned her into a raging monster. The last time they gave them to her, even though I explicitly asked them not to, I threw up my hands & said I can’t do this anymore.

            While all that was going on, I was offered a really good job in MA, so I took the opportunity. It’s more responsibility & in a different industry, so the learning curve has been steep, which is exactly what I wanted. Downside is that I have less free time than I used to.

        1. I am still trying to understand what you are thinking he said?

          Are you thinking that he is saying that people don’t have to worry about foods like spinach, etc?

          I was hearing him say that just going vegan was somewhat protective and this video would be the reason to not overdo it on the foods you are talking about.

          To me, he has given boundaries to think about to decide whether we are at risk based on our genetics and our food intake.

          I am not trying to pick on you, at all.

          I genuinely believe you are sincere right now.

          I just didn’t hear him make any claims in the last video and feel like this video clarifies the topics.

          I can tell from your response that you aren’t satisfied with his warnings to not overdo foods like spinach, but I am not sure why.

          1. I merely cite the paper of Denise Minger. I think today video of Dr. Greger corrobates what I have pasted. Dr. Greger have changed mind.

            1. Okay, you see this as him changing his mind from the last video. I see it as he is elaborating on his opinion about the topic today, rather than contradicting himself. I understand that by having two videos, instead of one, it is harder to understand his full argument.

              I don’t think he changed his mind. I think he paused at a vegetable study, which didn’t differentiate between high and low oxalate vegetables, and was trying to point out that for people who don’t have risk factors, eating things like spinach aren’t as dangerous as not having any vegetables, which some people, like my brothers both only eat one or two vegetables ever and spinach is their only leafy green. These two videos together give that they should watch the quantity of spinach that they eat and my brother who had one kidney removed needs to really look at it. I probably won’t make spinach dishes at our gatherings because I don’t want him getting too much. I feel like this whole topic will be one we discuss.

              My other brother, the choice between never having a green vegetable ever in his life versus eating some spinach occasionally, eating spinach would be good for him to have because he has not yet had a kidney stone.

              I find these videos so useful. I can watch when my family members spend time on antibiotics and I can have that in the back of my mind.

              I also have been having a 1/2 cup of spinach every night in my salad with a whole bunch of kale. Learning which doses of spinach become dangerous is so important.

              Anyway, I feel like you mistook what he said in the first video, but I do understand that you think he said those things and that he is contradicting himself and it is good for you to share when you think that. Other people might learn from the bigger discussion.

              1. I respect that it takes a lot of courage to stand up against a community.

                I don’t believe Dr. Greger said what you think he said, but I do respect that you believe he did and that you are challenging him.

                If other people hear what he said the way you did, this video I believe was meant to clarify things, not to be contradictory.

                Maybe the script writers will figure out a way to communicate a little more clearly.

                They know how to do “suspense” pretty well, but this community has a lot of literalists.

              2. I don’t think he changed his ming from the last video. I think he changed his mind from the old videos and book “How Not to Die”.

    1. Hi!

      Yes, that’s right. Checks Dr. Greger’s note above: “To be clear, I encourage everyone to eat huge amounts of dark green leafies every day — the healthiest food on the planet — but if you follow this advice (and you should!), then just choose any of the other wonderful greens. If you eat regular boring amounts of greens (like a serving a day), then it doesn’t matter which you choose. I continue to eat spinach, beet greens, and chard all the time. It’s just that you can overdo those three, so when I’m trying to hit my pound-a-day green leafy quota, I personally do mostly kale, collards, and arugula, which also happen to have the added benefit of being cruciferocious!”

      There’re several interesting videos about spinach and health. Check them out here: https://nutritionfacts.org/topics/spinach/

      Hope it helps :)

  7. A few adages come to mind:

    The dose makes the poison. Which makes me wonder: why would anyone eat only one or a few vegetables, to the exclusion of all others?

    Variety is the spice of life. Maybe this should be the stuff or staff of life. Eat a varied diet, not too much of any one food. It certainly makes life more palatable. And more healthy as well.

    I try not to sweat the details. We eat veggies and fruit, beans and whole grains, and nuts and seeds (preferably in decreasing amounts as we go down the list, with the last two groups in moderation), roughly following Dr. Greger’s Daily Dozen as a guide. Eat all colors of the rainbow is another adage (rough rule of thumb) I like. Even too much exercise is deleterious to health — not that I would ever have to worry about that. I never got any runner’s high, or any other exercise high.

    This video will make me think twice about eating more than one serving of spinach, chard, or beet greens in a day.

    But I also wonder about the effect of any one type of food if it is eaten in a mixture of different kinds of foods. And if the types of food eaten have any effect on the effects of a single type of food.

    1. Dr J, Yes, it seems quite common for people to concentrate on one fruit or one vegetable, especially when they read a popular magazine article touting it’s benefits. Where a variety of fruits and vegetables have been shown to be much more healthy. Reminds me of the food synergy effect espoused by Dr T. Colin Campbell and explained in a previous NF video:

      https://nutritionfacts.org/video/food-synergy/

      Also, it reminds of a quote that I heard Dr Joel Furhman say in one of his talks: “The most important vital nutrient in an individual’s diet is the one they are not getting enough of!” In other words, one has to eat a wide variety of nutritious foods to get all the nutrients that one needs.

      1. Most of the people around me don’t like vegetables or fruit for that matter.

        That is partly how people get focused on one.

        I liked spinach growing up. My brothers did, too.

        We didn’t necessarily eat it as a side dish. We ate it in spinach bread type products.

        Anyway, my brothers won’t eat any leafy green except for spinach and this video becomes a huge contemplation and I am not sure of the logic.

        No greens versus the risks of spinach.

        One brother has gout. The other had his kidney removed.

        So both probably will choose to not eat it.

        The brother who has gout already gave it up. (Yes, he gave up the spinach, not the animal products or soda or beer.)

    2. This video will make me think twice about eating more than one serving of spinach, chard, or beet greens in a day.

      Yes, particularly if we are using it in a dish with cashew cream sauce or foods high in Vitamin C

  8. Great. I’ve been feeling so good about the smoothies I make for my grandsons, with a cup of spinach in them. I’ll switch to kale, but I’ll bet they won’t drink them. So much for that.

    1. Joetta Fort, Maybe another possibility would be to use a ratio of 3/4 kale and 1/4 spinach? That would yield a better variety of nutrients without overloading on any single nutrient.

      1. I was thinking of starting with half and half. They’re only 8 & 9 so I don’t know how much is too much. Dr. Greger doesn’t discuss kid’s nutrition much.

    2. Joetta, I find collard greens to be very mild in smoothies. I use both collards and kale, depending on what is available during a given week.

      1. Thank you for the tip – I admit I’ve never had them. I don’t even know if they have them in the grocery store, but I’m going to look!

    3. You are doing a great job, keep making the veggie smoothies! Why not vary the ingredients: eg a spinach/kiwi/cucumber one day, carrot/strawberry and apple the next, beetroot/kale/pineapple/ blueberry (my favorite)the next. Consuming too much of any one thing can be bad, even water will kill you if you drink enough of it!

      1. I’d love to do that, but they are very picky and the 9-year old can tell if I make the smallest change. But I have to keep trying, because in a normal day the smoothie is the only actual nutrition they get. I’ve got my thinking cap on – thanks for the inspiration!

    4. Confused and scared. Have kidney cancer (Renal Cell Carcinoma) and only one kidney left. Except for fish (no red or white meat), my diet is veggies and fruits and pasta and such.
      My daily smoothie is a mix of 3-4 frozen fruits, a touch of ginger, some cinnamon, water plus half a bottle of Boost or Ensure, protein powder with “super greens” and a handful or two of spinach. My daily salad usually consists of arugula but sometimes spinach is my green of choice.
      I have tried to measure the spinach but as mentioned what really is a cup of spinach? Is that baby or large leaf spinach? Compacted or simply tossed into the measuring cup?
      Oh, and I drink green tea, usually a cup or two daily.
      RCC diagnosed 10 years ago, radical surgery removed one kidney, no meds until cancer showed up in my liver, now taking oral chemo.
      I have followed and benefited from the good doctor’s threads, If I did not read today’s thread I might have gone on another 15-20 years oblivious to how dangerous my “healthy” diet is.
      What I like about spinach in the smoothie is that it does not affect the taste like other greens. Thought I was having a nice balanced drink.
      Go know…

  9. Please post a blog for each story, or a transcript for the video.

    I do not have time to sit and watch a video on my computer, so I never open or watch any of them.

    I print out your blogs/articles and read them later when waiting for someone/something.

    Please consider this option.

    Thank you

    1. It’s my understanding that almond milk actually contains very few almonds (it’s mostly water). An entire carton is less than a handful of almonds.

    2. Almond milk? Is that something we need to worry about if we drink lots of it?
      —————————————————————————————————-
      Was thinking along those same lines but with the beet root juice instead. I’m remembering that Dr Greger (or as Tom calls him, Dr Grgere ‘-) referenced beet greens so I’m thinking the beet root juice is not so high in oxylates. The same probably can be said for Almond milk.

      On the other hand, I eat a tsp full from a jar of almond butter and when that is finished I’ll eat from a jar of cashew butter (no, not a jar at a time… a jar usually lasts a week.) I’m not worried, but I do wonder how many almonds does it take to make a heaping tsp of almond butter?

      1. ” I’m remembering that Dr Greger (or as Tom calls him, Dr Grgere ‘-)”
        – – – – –

        And that’s why some of us call him Fumbles. :-)

    3. Hi C.Hall

      I’d believe that almond milk won’t be a problem regarding oxalate content. However, I’d suggest you to check how much almond milk you’re actually drinking each day and to check nutrition labels of the almond milk brand you buy. Some brands are really high in sugar and are not fortified, these are some things you need to pay attention too.

  10. I’m a little surprised that people have to be told to not eat the same thing all the time.

    Who would want to eat the same thing everyday anyway?

    1. Who would want to eat the same thing everyday anyway?
      —————————————————————————–
      sheepishly holds up hand.

      I very often go for periods of time eating pretty much the same thing every day. Could have to do with hating waste and thus I’ll eat something over time until it is eaten up. I’m not concerned because I supplement daily with concentrated dried foodstuffs that insure I am getting the nutrition I need.

      1. I can definitely relate to the hating waste aspect. I guess I’ve gotten used to buying perishables in the smallest portions available (like one single bunch of spinach, one single sweet potato, etc.) and then buying different perishables on the next week’s shopping trip. And my freezer’s always got my back if I have too many leftovers!

    2. There are a lot of stories about people being cured of a disease by eating product XYZ. If people are afraid of a disease, or have one, they may eat product XYZ till the cows come home….

    3. Who would eat the same thing? People who dislike the alternatives, that’s who. For any given food, availability, and cost varies considerably depending on where you live which also impacts what’s on the daily menu.

    4. Most of the time, people have been eating the same thing (more or less) all the time. That’s why we have those “staples.” And mostly, it would be OK. (Sometimes, not so OK. Eg. the Irish potato famine or pellagra in Italy). Buying a (truly) varied diet in small portions gets unaffordable very quickly.

  11. The mention of tea at the end of the video was interesting. I recall a recent video that mentioned some benefits of drinking green tea but that were only pronounced if one drank a significant amount (forget the number at the moment). I drink a couple of pots a day of green tea (brewed from leaves) and always assumed that was a good thing but now am wondering if this should raise any concerns re. oxalates as Dr. Greger seemed to be including tea as something that was good except when overdone.

  12. if you eat high oxalate foods you should balance that with eating whole plant foods that are high in calcium, so that the calcium binds the oxalate in
    the gut. the video does mention this in brief. boiling is not the answer since it will leach out much more than just the oxalate. i have given this link
    before, i am not sure if many people bother with it :

    https://veganhealth.org/calcium-part-3/

    calcium usually has a valence +2 and oxalate is -2, so equimolar should be more than enough.

    1. Thank you for the link ptrjnf, it’s very helpful, especially the chart. I’ll study it and see if I can find out why I have been fortunate not to have stone trouble in spite of eating lots of spinach Thanks again.

    1. mike, the oxalate content of dandelion greens is listed at 25mg. per 100gm.
      Contrast with spinach, 750mg. per 100gm.
      100gm. is 3 ounces+, a lot of greens! They don’t weigh much.

  13. What timely information. Just spent some time in the ER last week with yet another kidney stone. The dietary information I received from my urologist was vague at best. “Eat a low protein low Na+ diet and drink more water”. This clears it up and gives me better direction for the future. Thank you, Thank you, Thank you. Having a lot of kidney stones is a great motivator to eat healthy. I so value this fabulous web site.

  14. What about sweet potatoes? I eat about 200-300g daily. I have found very different values in regard to oxalate content, from 28mg for 1 cup to 240mg for 100g. But they are such a convenient starch and nutrients source…

    1. Hi, Phil! I am not sure where you are seeing these numbers. According to this study: https://www.ncbi.nlm.nih.gov/pubmed?term=(%22Ipomoea+batatas%22%5BMesh%5D)+AND+%22Oxalates%22%5BMesh%5D&cmd=DetailsSearch&log$=activity, the oxalic acid in sweet potatoes is only partially absorbed prior to reaching the large intestine, where it is likely to feed the gut bacteria, producing butyrate, the preferred food for our enterocytes, the cells lining the intestine. If you haven’t already, you might want to see this video: https://nutritionfacts.org/video/oxalates-in-spinach-and-kidney-stones-should-we-be-concerned/ I hope that helps!

  15. Don’t overdo it with tea consumption? Clearly we’ve never met. Whatever the metric, I’m sure I am overdoing it with tea consumption, but I’d like to know what a reasonable daily amount would be.

  16. Hello. I didn’t really get how much is too much when it comes to spinach. For instance, I eat about 2 oz/day in a smoothie. Is that too much? Also, does green tea also have oxalates? If so, how much green tea is too much? I drink about 8 cups/day. thanks, carly

    1. Hi, caroline! You might want to see this video, if you haven’t already: https://nutritionfacts.org/video/oxalates-in-spinach-and-kidney-stones-should-we-be-concerned/. If you have had kidney stones, or are at risk for developing them, you should probably use other greens in your smoothie, instead of spinach. Kale, collards, and arugula would be good substitutes. This is because raw spinach in a smoothie may have a higher oxalate load, due to higher absorption, than a serving of cooked spinach eaten in the usual way. Green tea does include oxalate, but less than black tea. Moderate intake would be about 6 cups a day. Some Chinese studies have shown that green tea consumption reduces risk of kidney stones. I hope that helps!

  17. Gradually, as the years go by and my body is completely free of any source of animal protein, lots of “good” things begin to happen. Starting January 12, 2012, I have not allowed inside my body not 1 gram of any kind of food containing protein originated in animal stuff, dead or alive: no eggs, cheese, milk, dairy cream, beef, pork, poultry of fish.

    I used to think that what we call here “jalapeño” hot pepper, was “bad” for my stomach; one piece of it and I would feel some sort of stomach ache. This did not use to happen with other kinds of hot chiles (hot pepper?).

    Today, I am glad to declare that very hot “jalapeño” no longer causes me any kind of stomach ache.

    I must be honest and declare that I do not overdue on any kind of vegetable, fruit, legume, nut or seed, but I DO HAVE some of all of those at least 3 or 4 times a day. I never measure how much, I just put things on my plate, which include all 3 times a day a rather small amount of black beans (refried or “refritos”). I like to eat all other things feeling the taste of those black beans.

    Sometimes I add corn tortilla; rice some other times; pasta some other times. Very little potatoes, and usually without the other starches. I have bananas and kiwi almost daily; half a banana and one full kiwi.

    Every single morning I must have some pecan nuts on the side or mixed in my organic soy drink (which claims to include vitamins B12 and D).

    I am never ever hungry. I eat because it is time to do it. If I overdo pasta or tortillas or rice, my scale shows it in less than 24 hours. Anything else keeps my scale fixed at 65 kg, which is 5 kg more than I should weigh (at least).

    BTW, broccoli is something I never eat without: 1) grinding it to bits, 2) leaving it to rest for 40-50 minutes, 3) then 3 minutes in the microwave. Also, spinach is sometimes raw in my plate, combined with the aforementioned beans, and sometimes it is cooked. Carrot is something I never eat raw: I chop it like I do with broccoli and then I microwave it for 3 minutes (100-120 grams).

    Sometimes I steam lots of greens and vegetables, using very little water, which I will pour over the vegetables before eating them.

    I always have peanuts on the side, which I add to the mouthpiece just before taking it.

    I have at least 5 or 6 cups of coffee per week; black, no sugars or creams of any kind.

    Nothing sophisticated in the food I eat. No sugar in anything: I feel it gives anything an artificial sweetness. Salt, is something I never ever add to any meal.

    I will by 70 in 6 months.

    I forgot to mention that I love to have guacamole (avocado, tomato, etc.) at least 3 times a week. When I feel like being a little mean to me, I take a piece of bread free of egg, milk, butter, etc., and I spread guacamole, peanut cream or refried black beans on it, and just as it enters my digestive system, I begin to feel that I ate “too much”: this is literally an “instant feeling”.

  18. I was just reading on another site and came across this bit of info. Started me wondering if different sources of black tea for instance, can account for over-indulging problems. Link to the rest of the information is below the following.

    In general, tea contains tannin (catechin), caffeine, and theanine (a free amino acid). Tannin is astringent and caffeine has a bitter flavor. Assam tea contains higher levels of both tannin and caffeine, so black tea produced in southern countries has a stronger flavor than Japanese black tea. On the other hand, theanine tastes of umami and sweetness but is chemically fragile under sunlight. The reason why tea fields are located in foggy mountainous areas is that the leaves are not overexposed to sunlight, which enables theanine to remain in tea leaves. In addition, the metabolism of theanine is influenced by temperature, being accelerated as the temperature rises. Therefore, theanine and tannin differ in content depending on when the tea leaves are harvested. Black tea made from leaves picked during the summer contains more tannin; thus, it is possible to make tea with a strongly astringent flavor.

    https://www.eurekalert.org/pub_releases/2019-06/ku-rot061819.php

  19. I am curious if the root of the beet juiced would offset the oxalate in the spinach. Mr. Walker’s book on juicing shows that juicing the root of beets will clean the liver. What about Brussel sprouts. these are used to lessen the oxalate in the body. Are there any studies on these foods?

    1. Hi, tmoorep! Beets are high-oxalate vegetables, and so I don’t think they would offset spinach oxalate. I am not aware of any research showing that Brussels sprouts can lessen oxalate in the body. Brassica vegetables, to which Brussels sprouts belong, are lower oxalate vegetables, in general. Eating them instead of high-oxalate vegetables could reduce dietary oxalate load. I hope that helps!

  20. I had renal colic due to over consumption of soy products. However I have found conflicting research, some which shows a beneficial effect of soy on renal function and some which links oxalates in soy to kidney stones. Can we please have a review on the effects of soy products and oxalates on kidneys?

  21. Just eat some e.g. garbanzo beans which contain calcium which will bind the oxalate in the gut and the oxalate won’t be absorbed.

    1. Berner, I am confused. If we supposedly can not access the calcium in spinach because it binds with the oxalate, then why does the oxalate still present a problem if we eat spinach? What if we had soy milk in coffee after a lunch spinach salad? Would the calcium in the soy milk tender the oxalates of the spinach harmless?

      1. Barb:
        According to the research I’ve seen, calcium from any food lowers the absorption of oxalate. I saw research that compares eating spinach with or without some sort of a dairy product – I don’t remember what it was – and spinach with the dairy product lowered the absorption. (I’m not trying to get people to eat dairy, just reporting what I saw.) Calcium deficiency is, in fact, said to be a risk factor for kidney stones. Calcium supplements, for some reason, don’t lower the oxalate absorption. They actually increase the risk of kidney stone.

        1. Thank you so much for your post George… that is indeed helpful. In fact, I think the good doctor was remiss in not being more explicit with the risk factors, and/or explaining how it works. It may also go a long ways to explaining why I have not suffered kidney stones (nor gallstones thank goodness), in spite of heavy spinach consumption. Having salads with chickpeas or broccoli etc or other calcium sources may have been my saving grace.

  22. I am a long time follower and so much of my diet has been based on these numerous videos and your first book. I have a female friend 68 years old who had bouts with bladder and breast cancer in the last seven years. I just sent her your video ” #1 vegetable to fight cancer” and included your information in the e-mail with the video that the #1 vegetable to fight kidney cancer, breast cancer, brain tumors, lung cancer, pancreatic cancer, stomach cancer and prostate cancer is…SPINACH—-so I eat lots of it daily with several other vegetables and encourage everyone I know to do the same per your video. AND NOW THIS : EAT 2 CUPs of SPINACH a DAY and RISK KIDNEY FAILURE !!!! One video leads us to believe spinach is a miraculous cancer fighting vegetable–so why not eat a generous portion almost every day …right ? NOOOOOOOOOOOOOOO…..now just a relatively small amount daily and –per this video and your last comment-YOU CAN BE ON DIALISIS —Now I have to tell everyone that the information I gave you was wrong–‘and who gave you this conflicting information John ?” the same person who told me SPINACH IS THE NUMBER ONE VEGETABLE TO FIGHT CANCER—now I have to doubt everything–because the next video may totally discount the prior. STUNNED and DISMAYED.

  23. Damn. I’ve been eating 3 – 5 almond butter sandwiches per day because Dr. Greger reported that almonds fight osteoporosis.

  24. I have read elsewhere that given sufficient water intake that kidney stones become almost impossible to form.

    Perhaps we sometimes get too laser-focused on certain issues without surveying all the salient information.

    1. Agreed Richard. I remember a urologist saying that eating oranges with bits of the white pith is helpful in preventing oxalate stones. Drinking ample water, avoiding vit c supplements, maintaining low salt intake were other points he mentioned.

  25. Where are oxalates found in almonds? In the skin, or the white part? Would soaking almonds overnight in water and rinsing them reduce oxalates? Does soaking almonds change anything in the almond like sprouting does?

  26. Oh, man! This is super disappointing. Spinach has been my favorite green since I was a little thing & I drink unsweetened iced green tea like water…and, I was born with kidney issues.

  27. Since we all know how spinach changes state when frozen, cooked etc.: how much is “a cup” in grams in your calculations? I have a cup or two of spinach several times a week in a smoothie… but this is in the form of “frozen chunks” of spinach – easily 200g per smoothie. So that may be fine, or (if you mean a cup of raw unprocessed spinach which weighs next to nothing, this may actually be way over! :/

    1. Hi Marcel Maschmeyer – Thanks for your question! In general, a serving of 2 cups of raw greens is equal to 1 cup of cooked greens. So the 1-2 cups of frozen spinach you use in your smoothie is about equal to 2-4 cups of raw spinach. The graph in the video showing that less than 1/2 cup of spinach has 250 mg of oxalates is referring to raw (uncooked) spinach. Also keep in mind that since oxalates are water soluble, more than half of the oxalate content is removed when you cook greens (which is also the case with frozen greens that is blanched prior to freezing).

      I hope this helps!
      -Janelle RD (Registered Dietitian & NutritionFacts.org Health Support Volunteer)

  28. One of the main determining factors to oxalate based kidney stones is the amount of a bacteria, Oxalobacter formigenes one has in their GI tract. Certain antibiotics, like the fluoroquinolones, reduce Oxalobacter numbers and reduce our ability to reduce oxalates. When the other Proteobacteria levels increase, like E coli, Salmonella, H pylori, etc, they take up available surface area on the villi of the GI tract and reduce Oxalobacter numbers. Reducing one’s intake of nitrogen rich foods, like animal protein, reduces the other Proteobacteria numbers and can allow for more Oxalobacter growth. Eating a plant based diet increases antibacterial substances in our GI tract and reduces E coli, Salmonella, H pylori, etc and allows for more Oxalobacter growth. This also helps manage oxalate levels by reducing the acid load in the kidneys. Acid in the kidneys is buffered by calcium phosphate which comes mostly from the bones. A higher acid load allows the calcium to precipitate out and form with available oxalates to form calcium oxalate stones. Eating a plant based diet reduces acid load while increasing Oxalobacter levels. Both of these factors help reduce calcium oxalate kidney stones.

  29. What about powdered greens like wheat grass,barley grass,nettle powder….how do their oxalate content compare?
    (I don’t think the USDA nutritional database analyses oxalate content,they do analyze a huge amount of other foods & nutrients …)
    Thanks!

    1. Hi wondering – Thanks for your question! Although I am not sure on the exact oxalate content of powdered greens to give you a number (and yes, the USDA nutritional database does not analyze oxalate content unfortunately), it is likely going to be significantly higher than raw greens. This is because powdered greens are made by pulverizing large amounts of dried greens into a fine powder. If you are following a low-oxalate diet for kidney stones, it is a good idea to avoid any powdered versions of spinach, Swiss Chard, collards, or beet greens.

      I hope this helps!
      -Janelle RD (Registered Dietitian & NutritionFacts.org Health Support Volunteer)

  30. Dr Greger, iv been trying to add beans to my diet, yet I keep getting a servere headache after I eat them which is really upsetting as I love the taste.
    However it said beans can be high in a substance called Tyramine which can trigger migraines in certain individuals.
    I’m already aware I’m sensitive to high histamine foods.
    So maybe there’s a connection between Tyramine and Histamine which is why I can’t tolerate them.
    Are there many studies on this sensitivity?

    1. I’m not familiar with this in particular, maybe others are, but please keep in mind that all beans are different. You might want to experiment with lentils and garbanzos and see if you get the same result. If not, just avoid the variety of bean that makes you not feel well.

    2. Ree, the evidence on the connection between Tyramine and histamine is certainly not extensive and although I searched the Medline data base for research studies about tyramine and sensitivity the review articles I found either stated there was no evidence for this (Not saying it does not exist, just that no evidence is available to clarify connection. The latest review focusing on this topic (admittedly dated- 2005) https://www.ncbi.nlm.nih.gov/pubmed/16093574
      Mastocytosis and adverse reactions to biogenic amines and histamine-releasing foods: what is the evidence? concluded:
      “Despite the widespread belief that biogenic amines and histamine-releasing foods may cause allergy-like, non-IgE-mediated symptoms in certain patients, the role of diets restricted in biogenic amines and histamine-releasing foods in the treatment of mastosytosis remains hypothetical but worthy of further investigation.”
      Reputable agencies have recognized a potential connection and you may want to check out both of these sources for recommendations:
      https://headaches.org/wp-content/uploads/2018/02/237149311-Low-Tyramine-Headache-Diet-from-the-National-Headache-Foundation.pdf which gives these specific recommendations for beans: “Allowed Vegetables: …Chinese pea pods, navy beans, soy beans… Avoid: Snow peas, fava or broad beans…

      https://my.clevelandclinic.org/health/articles/9648-headaches-and-food Headaches and Food
      “These foods have been identified as triggers by some headache sufferers:
      • Most beans including lima, Italian, pole, broad, fava, navy, pinto, snow peas, garbanzo, lentils, and dried beans and peas”
      The Cleveland Clinic recommendations are much more restrictive which point to the individual differences of headache sufferers responses and that suggests that before you abandon all beans, you may want to experiment, making sure any beans you try are especially fresh (research indicated beans that have been stored for a long time can be cause more symptoms) and that you try in small amounts, avoiding the fava and broad beans especially, and trying only small amounts. You may find one or two kinds of beans that do not cause you symptoms and while that limits your diet, it would be worth finding out about so at least you can enjoy the benefits of those specific beans. I hope this is helpful.

      Allowed Vegetables: Chinese pea pods, navy beans, soy beans Avoid: Snow peas, fava or broad beans

  31. What about the extraordinarily high level of oxalates in turmeric, which contains 2100mg per half teaspoon? Dr. Gregor is a proponent of turmeric consumption for a variety of beneficial effects.

    Also, since oxalates bind with calcium, does it adversely affect bone health?

  32. I have blended up 180 grams (4 cups) of spinach in my smoothie and done this for years without incident. I use soymilk in the smoothie with calcium in it, I am guessing that this had a effect on the oxalate load. From the article I it seems I am at high risk for kidney stones.

  33. Please do what you just did for vegetables with seeds NF. Thanks.

    What is considered a low fat diet? Is two ounces of nuts and seeds per day OK? On chronometer, if I eat an assortment of nuts and seeds of about two ounces a day along with everything else I eat at the moment (three servings of grains, two servings of beans, four fruit, five veg, tuber, mushrooms every second day) I can get enough efas, vitamins and minerals). It would lead to about 20% of calories from fat. Currently I try to limit nuts and seeds to one ounce per day.

  34. Do we have information about the oxalate content of BABY spinach/chard vs. mature spinach/chard? Baby spinach and baby chard are major components of my diet. I may want to moderate that a bit. Baby kale also – apparently not an issue.

    1. Hi Skowarsky, thanks for your question. Dr Greger has explained the benefit of baby spinach in this below video.
      https://nutritionfacts.org/2017/11/14/how-to-maximize-nutrient-absorption/

      As regards to Oxalate in this study they indicate that, Soluble oxalates, when consumed, have the ability to bind to calcium in the spinach and any calcium in foods consumed with the spinach, reducing the absorption of soluble oxalate.
      https://www.ncbi.nlm.nih.gov/pubmed/12810415

  35. I have watched the video several times and read the transcript. I have to say I am very confused and hoping the Dr. G posts some clarifying information soon. I have been following Dr. Esselstyn’s diet (with it recommendations for eating spinach 5-6 times per day) and am now concerned about Dr. G’s warnings. From the comments it sounds as if I am not alone in asking for more information on this topic.

  36. A few points Dr. Greger missed in his video.

    1. It is not a cut and dry case that Ascorbic acid ingestion (1-2g daily) will lead to Oxalic acid formation.
    [source: No contribution of ascorbic acid to renal calcium oxalate stones; PMID: 9429689]

    Initially Linus Pauling, now Andrew Saul propose consuming several grams of Ascorbic acid daily when one has a cold. This doesn’t necessarily result in oxalate deposits/kidney stones.

    2. Citrate is a naturally-occurring inhibitor of urinary crystallization.
    [source: https://doi.org/10.1089/end.2007.0304 ]

    Try consuming some Lemon or Lime juice with that Spinach?

    1. Louis,

      You’re on the mark with your findings regarding the use of ascorbic acid and oxalate formation in most patients. The key determinant seem to be if you have a:” defect in AA or oxalate metabolism”. I did a bit of searching and even found in IV high dose ascorbate use, it’s rare to see any elevations. https://www.ncbi.nlm.nih.gov/pubmed/19154961.

      And yes the citrate approach is well documented, hence your good suggestion on the lemon or lime with one’s spinach.

      Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  37. When I eat steamed/boiled spinach or chard, at the end of the cooking (or during the cooking) I add either baking soda or calcium carbonate powder. I believe there is a chemical reaction that takes place which binds the oxalates with either of these powders. It seems to be making a difference as I no longer have that oxalate sensation on my teeth (kind of a gritty feeling). There is research to support the use of calcium carbonate, calcium citrate and other forms of calcium but I can’t seem to find anything on backing soda. Can you speak to the use of adding something as simple as these to reduce the oxalate content in the food?

    1. When I eat steamed/boiled spinach or chard, at the end of the cooking (or during the cooking) I add either baking soda or calcium carbonate powder.
      ——————————————————————————————————————————–
      This reminds me that my mother used to add the same to tomato soup… and usually some milk as well. Just assuming it had something to do with the pH of the tomato soup.

      1. Thanks Dr. Kadish. Your cited article above uses sodium bicarbonate as a supplement, not added directly to the cook water or to the vegetable, so the action is taking place within the body. In the first article, sodium bicarbonate is used with water for soaking taro corm chips and the results, to my untrained eye, appear to make a profound impact on the oxalate load. I assume that after soaking, the sodium bicarbonate water is rinsed away. When I add it to the cooking spinach or chard, I rinse several times.

        http://www.ifrj.upm.edu.my/21%20(04)%202014/44%20IFRJ%2021%20(04)%202014%20Kumoro%20368.pdf

        This article discusses the use of different forms of calcium… carbonate, citrate, etc. on spinach juice and calcium carbonate is not nearly effective as calcium citrate https://researcharchive.lincoln.ac.nz/bitstream/handle/10182/7859/2016BongVanhanenSavage.pdf?sequence=1&isAllowed=y

        Can you find any articles that show the effects of cooking with either calcium carb/citrate and sodium bicarbonate, or anything else?

        Thanks!

        1. Susan,

          After spending some time searching I’ve come up short on a direct answer to your question…..

          Perhaps a science experiment with a local university or college is in order ? Good easy project for an undergrad in the food or nutrition sciences program.

          Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com

  38. This article and prior NF articles discuss Vitamin C supplementation and the subsequent increased risk of developing kidney stones and other kidney issues. I am curious if anyone has thoughts on consumption of Amla powder (very high in Vitamin C and also discussed here on NutritionFacts.org) and increased risk of kidney stones? Previously, I have read articles talking about the potential benefits of amla powder for kidney health; for example, first article when I Google –> https://amlagreen.com/blogs/news/the-healing-amla-side-effects-on-kidney-health

    Should we not take amla powder and/or be concerned about oxalate? Is the real concern the ascorbic acid version of vitamin C vs food-based vitamin C? Thank you!

    1. While there might seem to be a connection between increased kidney stones and kidney issues due to the fact that Amla powder is high in Vitamin C and we know that Vitamin C supplementation may cause increased kidney stones, we need to remember there’s a huge jump from high dose supplementation and use of a minimally processed fruit (dried and heated but without other additives) used at doses that are not excessive. Read this article if you want some thoughts on just why continuing using your amla powder seems wise: https://www.ncbi.nlm.nih.gov/pubmed/21317655 Medical and Dietary Therapy for Kidney Stone Prevention. Hope that puts things in perspective.

  39. I think it’s important in a situation like this to understand absolute risk, and not just relative risk (or change in risk). I have several times read of a study indicating that something doubled risk of a health condition, only to read the details and find out that risk went from 1 in 5,000 to 1 in 2,500. So while the increase in risk was real, the absolute risk was still negligible. (This kind of increase in risk is important from a public health standpoint, but less so from an individual standpoint.)

    I’d be interested to know what the absolute risk is of kidney issues as a result of consuming spinach, chard, beet greens and tea, as opposed to the increase in risk. My guess is that the absolute risk is negligible, and more than offset by the other health benefits of these items. This seems to be supported by the fact, cited in Dr. Gregor’s other video on this subject, that genetic predisposition is a much stronger predictor of kidney stone/disease risk than what you eat.

    Thanks!

  40. Is there a way to see if you are getting too much oxalates?

    For two years I have been trying to be as healthy as possible. But now I fear it might be doing me harm.

    I make a breakfast smoothie everyday with the following in it:

    100g of pineapple, watermelon, blueberries, strawberries, banana
    50g kale (cooked)
    100g organic oats
    1 tablespoon flax ground seeds
    teaspoon of cinnamon, cocoa powder, amla powder
    80g of ground hemp seed protein powder

    I also drink a lot of black tea, eat a lot beans, dates, cashews, peanut butter – you know all the things that this site and videos say is healthy. Add to all the vitamin C I get from fruits and veg and I am left thinking my kidneys are now being pummeled.

    I am worried that collectively I am shutting down my kidneys – worse my partner has a similar diet since we both started at the same time.

    What is a safe oxalate level? Arew there any tests? Are there any warning signs of kidney damage?

    I’d greatly appreciate some advice, because frankyl I am disheartened to watch one video or read one chapter of the How Not to Die book and see all the benefits of e.g. Turmeric Powder and then find out – oh its super high oxalates – enjoy your dialysis!

    Seems to be everything vegan is high oxalate. HELP!

  41. While it can be discouraging to consider how hard you are trying to eat healthfully and then learn there are some limits to indulging in a FEW healthy foods remember the amounts Dr. Greger mentioned, except for spinach were generally massive and what you put in your smoothie hardly qualifies. Because yu asked about measuring oxalates, I will cite this information from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid…oxalate…article which advises that there is ” a urine test to see whether you have a high level of the chemical oxalate in your urine. Oxalate is a natural end product of metabolism in the body. It should leave your body through your urine. If your oxalate levels are too high, the extra oxalate can combine with calcium to form kidney stones.” However that test is not necessarily recommended for assymptomatic individuals. In fact limiting oxalates in general may not be necessary (except in those exceptional cases Dr. Greger cited) Review this for more reassurance: “However, we recommend limiting dietary oxalate only if the patient has hyperoxaluria, because many of the oxalate-rich foods are considered “heart-healthy.” Together, spinach, potatoes, and nuts account for 44% of oxalate intake for the average American. The simplest way to minimize oxalate intake is to monitor consumption of these foods” Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265710/ Don’t over react and enjoy those health-promoting foods.

  42. Hi everyone.
    I’m feeling a little frustrated.
    Kale is hard to find and expensive in my country.
    Spinach was a great way to get my greens but looking for an alternative I decided to turn to purslane or grape leaves. However now I read on the internet that purslane has even more oxolate content than spinach.
    Any suggestions for good summer greens for someone who can’t get kale?
    All the best

    1. I am not sure which greens you would have access to, but some great options would be collard greens, bok choy, arugala, mustard greens, watercress, and lettuces. I would go through the produce section at your nearest grocery store and see what’s available.

      I hope this helps,
      Matt, Health Support

  43. Hello everybody
    My name Is Dganit, I am new here and in Dr. greger’s incredible site. Thank you Dr. Greger, You are one of the people who makes this earth a better place.
    I try to imagine someone eating 2 cups of spinach a day- that looks a lot to me! I use spinach in my vegetable balls I make for my family, I guess I use about 1-2 cups for the whole mixture (around 20-30 vegetable- balls) and we eat it once in a few weeks.
    I want to share my story and hopefuly get inspiration and support since I am realy in a very bad period, sick and confused, quite desperate / hopeless.
    so, here it goes : I am 46, a mother of 4 lovely girls. In my eduction I am a biologist but I don’t practice it. Yet, I get my knowledge mostly out of scientific journals. I can’t help it but reading even though I don’t understand all of it and luck the biochemical knowledge). As most (or all?) people in this planet, my life is full with stress, which I do my best to reduce and as you can imagine, some periods are more stressful than others. I have a background of biology study and to day I work as an applied behavior analyst, hence, I am familiar with read in professional journals.
    My health background: I am obese (BMI 36). I had a partial lumpectomy – that is removing about a third of my breast due to pre cancerous cells that was 6 years ago. The LAST thing I wanted was to return to surgery room, yet, 4 years ago I had to have a back surgery due to Herniated disc that caused me to loose partial feeling in my foot and lose control of closures. I passed it all with success and went back to live my life, I even started to exercise and lost weight and eat “healthy”. About 2.5 years ago my family doctor told me I have diabetes, I had pregnancy diabetes with my 3rd girl, and got diabetes when she was 10.
    I decided to treat my self with a healthy nutrition and now, after getting to know Dr. greger, I THINK THAT WAS MY DOWNFALL.
    my doctor told me to reduce my carbohysrates into zero!! he didn’t mean for me to continue it for ever… but I did not understand it. I googled and looked at low carb diets and learned about Ketosis and about palleo diet. Then I must say I did my best to research in the right places, I went to the “European Journal of Clinical Nutrition (EJCN)” checked and read quiet a bit of articles and was convinced I was on the right way. I changes my diet to an almost zero carb AND high fat diet- Yes, I did a mixture of ketonic diet and paleo diet (now that I write and read it I just can’t believe I actually did it, and I can’t stop crying).
    Three month later- I was feeling exellant!! I lost wight and most importantly, my A1c dropped from 7.5 to 4.8!!! I HAVE BITTEN DIABETES!!
    I continued with my diet and also did sport, it felt great. I think I managed to do it for almost a year . I lost a total of 33 pounds and my Diabetes was gone !! Then, I started to become less strict and careful with my diet, adding a chocolate here and there and bread and so on… before I knew it I gained my weight back and my A1c rose back. But still I was happy with my self (suppression is my best friend).
    Roll forward 2 years and we are in February 2019. I got a very strange rash on my legs, arm and belly. As suppression is one of my best friends I did nothing until April 2019 , my girls just argued with me and forced me to go and see a doctor. I went to my doctor and he send me to E.R… I was hospitalized and was told the rash is actually purpura and I have a children disease called “Henoch schonlein”. I had lots of tests and apparently I have a lot of protein in my urine (proteinuria) in my 11 days of hospitalization I was checked regularly and my protein levels were always around 3.2 gr/day. Since they were not sure if I had Henoch schonlein and also usually it does not come with a high proteinuria, I had a kidney biopsy and the findings are I have IgAN ( IgA nephropathy).
    This is where I got back to health and nephrology journals to investigate a bit about IgAN and kidney diseases.
    Here are some insights from my investigation:
    • IgAN is an auto immune system disease in which Immune system proteins, known as immunoglobulin (Ig) from type A form a layer on a specific area of the Kidney.
    I was curious why does this happen? and went to re learn about immune system and Ig. Surprisingly I have found a partial answer to my question: in order to create IgA the body needs among other things 2 amino acids: serine and threonine. Our body can produce serine, but need threonine in order to do so. Our body can noy produce threonine and we must consume it. It is found in download order mostly in beef (which I don’t eat), chicken ( I rarely eat) , fish (again, rarely), eggs, diary and Legumes. In cases of deficit in threonine, the IgA molecules might have a slightly different structure. Some people with threonine deficiency develop IgAN. My guess is the luck of threonine and the “tiny” change in IgA1 molecule increase the affinity of the IgA to the glomeruli , causing deposits and inflammation.
    Sooooo – is it possible I don’t have sufficient amino acid (threonine) in my body? Id so, I I consume it will I hill my self?
    I know body builders consume amino acids and started to read about protein and kidney.
    As I did my investigation I reached a very sad understanding- there is no doctor that can answer all my questions. And as I did turn diabetes ones I started looking for doctors who believes in the body’s ability to heal itself given the sufficient and correct tools.
    I was horrified when I somehow reached one of Dr greger’s videos and started to learn more about keton bodies, paleo diet and the connection to kidney stress.
    DID I BROUGHT IT ALL UPONON MY SELF????

    These last 5-7 days I eat fruits (I don’t restrain my amount), whole bread, try to avoid diary , I don’t know exactly what to eat and feel I’m trying to navigate my way through darkness. I bought Dr. greger’s book but haven’t read it yet, I feel I’m about to explode at this point so I have decided to write, hopefully to get support and advices. I thought about consulting Dr. Klaper but in his site it is said that he is full and can’t guaranty he will be able to consult me.
    I learned a lot during the last few days but still feel I am in avery long a nd dark tunnel. I will appreciate all and any kind of help.
    Thank you all,
    I wish you good health of the body and soul
    Dganit

    1. Hello Dganit,

      I’m very sorry to hear about your health struggles. I understand what it’s like to get mixed messages about which diet is the healthiest and trying out all the different options. Fortunately, you have found Dr. Greger’s work here at Nutritionfacts.org and it will help you sort through the misinformation!
      It seems that one major concern of yours is diabetes. I’m sure after sifting through Nutritionfacts, you have found plenty of videos on the topic of diabetes and how saturated fat is the major culprit. A whole foods, plant-based diet may be the best tool you have to fight the disease.
      Also, while I am not aware of the research on amino acids and IgA nephropathy, we definitely know that plant-based proteins, such as legumes, are a far better option for kidney health than animal-based protein. This is another reason to adopt a plant-based diet.
      No guarantees can be made about your condition and whether a plant-based diet will reverse it, but we can make a solid guess that it’ll at the very least improve symptoms. The great thing about a WFPB diet is that the side effects tend to be good side effects (eg. weight loss, lower cholesterol, etc.) so why not give it a shot?

      I hope this helps, and please don’t hesitate to reach out and ask more questions. I have also linked a website where you can search for plant-based doctors near your city, which may be a very good idea for you at this time.

      Matt, Health Support

      https://www.plantbaseddoctors.org/
      http://plantbaseddocs.com/

      1. Thank you so much Matt for your kind and proffesional response.
        The thing is there is no information, as far as I could find, about nutrition and IgAN, so as you said it :there is no evidence based for success. I am very confused. Also I don’t understsnd how can it be that I will eat fruits and whole food with carbs (e.g whole pasta) and reduce my fasting sugar values.
        I left a message at Dr. Klaper but he is full. I also looked at the link you provided. I found two doctors in Israel but I don’t know anything about them. Couldn’t find much excepet for what they advertise in their sites.

  44. Hi thank you so much for your contribution to public health.
    I am confused about eating soy beans. I like to cook soy beans like any other bean. In other words, I use the soy bean seed much like any other dried bean cooking it with onions like any other dried bean meal (like the way you would cook chili).
    I am confused about what the oxalate value of a cup of cooked soy beans (without the green outer layer of edamame) would be.
    Do we have any dear friends out there who know? The research I find is contradictary and confusing. It seems to address processed soy products mainly….
    Respectfully

    1. Hi Lale Ann Gokyigit – According to this list of oxalate content of foods by Harvard Health (https://regepi.bwh.harvard.edu/health/Oxalate/files/Oxalate%20Content%20of%20Foods.xls) 1 cup of soybeans has 7 mg of oxalate and is considered to have a moderate amount. Unless you have a history of or are found to be at an increased risk for developing kidney stones, or you are eating massive amounts of high oxalate foods and without adequate calcium intake, you should not need to worry about limiting soybeans in your diet.

      I hope this answers your question!
      -Janelle RD (Registered Dietitian & NutritionFacts.org Health Support Volunteer)

  45. Unless I am misunderstanding some facts, maybe Dr. Greger should have added his recommended Amla powder to the list of Oxalate foods to avoid. (My references are listed in parenthesis at the end of each statement and links listed at the end).
    Dr. Greger warned us that other high-oxalate foods that have been associated with kidney problems at high enough doses include a single dose of about a cup and a quarter of star fruit juice, or just 4-6 fruit (1). In his video on star fruit he said, star fruit, which you can often find in the tropical produce section at large supermarkets is harmful enough to shut down our kidneys. Acute oxalate nephropathy, caused by the extraordinarily high oxalate content (2).
    Dr. Greger said he takes a tsp of Amla powder in his smoothies for breakfast (3).
    An article I found on the internet stated that very high levels of total oxalates were measured in 2 imported fruits, Indian gooseberry (Phyllanthus emblica L.) and carambola (Averrhoa carambola L., star fruit), at 7566.5, and 436.1 mg/100 g FW, respectively, and their soluble oxalates were also the highest measured of all the fruits (4). That showed that Indian goose berries had over 17 times as much oxalates as star fruit and since it applied to whole fruit I don’t know if the powdered forms were worse, much worse, or better, I also read that in another report that the reported oxalate content of foods varies by a very wide margin (5), so I don’t know how that would affect any result/conclusion/advice/danger. I leave the whole analysis up to the experts like Dr. Greger and his staff, but I do think the whole subject of the safety of Amla powder should be addressed unless I am misunderstanding something.

    References:
    1. https://youtu.be/Eg5ksHXQavk
    2. https://youtu.be/19jF5eNi2tk
    3. https://youtu.be/N0QbVYoKe5g
    4. https://www.sciencedirect.com/science/article/pii/S0889157513000732
    5. https://www.ncbi.nlm.nih.gov/pubmed/25168533
    Oxalate content of food: a tangled web.
    CONCLUSION:
    Wide variations exist in the reported oxalate content of foods across several Web-based sources and smartphone applications, several of which are substantial and can have a sizable impact on the construction of a low oxalate diet. As dietary counseling has proven benefits, patients and caregivers should be aware of the heterogeneity that exists in the reported oxalate content of foods.

  46. Hi Dr. Greger,

    What avbout the oxalates in cocoa? I use undutched low fat cocao and love to make nice creams and often use up to 3 Tablespoons. You have several videos on cocoa but you never mentioned the high oxalate content. Should I be careful with the cocoa as well?

    Thanks

  47. Ok so what about feijoa indian gooseberries, carambola, rhubarb and goji berries? I read a thesis by Dr. Nguyen Vu Hong Ha that listed those as extremely high in oxalates. The question started with how much oxalate is in Alma, the highest source of antioxidants on the planet, as you pointed out, and I found it has an extremely high level of oxalate, which seems to be a common theme between the other fruits I listed above. I’d like to increase my antioxidant intake by using amla like you reccomended in your How Not to Die book, but I’m conflicted because it’s so high in oxalates. I already have calcium oxalate kidney stones, but I drink well over 64oz of water daily to help flush them out, along with taking calcium citrate supplements and eating a whole food plant based diet. Do you have any comments?

Leave a Reply

Your email address will not be published. Required fields are marked *

Pin It on Pinterest

Share This