Because many vegetarians and vegans eat a high-oxalate diet, I have been interested to see if a prospective study might find a higher risk of kidney stones.

A recently released report from EPIC-Oxford measured the risk of being hospitalized for a kidney stone over the course of five years for people in various diet groups (1). Vegetarians (including vegans) had a 31% lower risk (.69, .48–0.98) as compared to high meat-eaters.

The other diet groups were:

Moderate meat-eaters, 50–99 g of meat per day – 0.80 (.57–1.11)
Low meat-eaters, < 50 g of meat per day – 0.52 (.35–0.80)
Fish-eaters – .73 (.48–1.11)

Oxalate intake was not measured.

I have updated Oxalate at VeganHealth.org with this info.

The authors also found a correlation between zinc intake and kidney stones. However, this finding barely reached statistical significance and the rate of kidney stones were very low in this population (.6% over five years). Kidney stones were not a common enough side effect in the recent Cochrane Database Analysis of clinical trials on zinc to be mentioned in their report.

Considering all of this, I am not worried that a modest zinc supplement will lead to a kidney stone.

References

1. Turney BW, Appleby PN, Reynard JM, Noble JG, Key TJ, Allen NE. Diet and risk of kidney stones in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). Eur J Epidemiol. 2014 Apr 22. [Epub ahead of print] | link

I just read a very helpful article on kidney stones that I thought I’d pass on. (Thanks, Jeff!) It was written in 2002 but to my knowledge it is still valid. It also had some information on calcium supplements and kidney stones suggesting that calcium supplements taken with meals could reduce the risk of kidney stone formation whereas taken without meals could increase the risk (in genetically predisposed people).

I modified my calcium recommendations to reflect this, and also added a page on kidney stones to VeganHealth.org and am reproducing here:

The article, Diet and Kidney Stones, by James J. Kenney, PhD, RD, FACN is an excellent resource for treating kidney stones with diet.

A quick summary is that people with calcium-oxalate stones, the most common type, should avoid high-oxalate foods (listed in the chart in the article), limit sodium to less than 1,500 mg per day, do not take vitamin C supplements, limit animal protein, and only take calcium supplements with meals.

You should also drink plenty of fluid, according to The Mayo Clinic:

Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid – mostly water – to produce clear or nearly clear urine.

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Question:

I am 19 years old and I get chronic kidney stones. I have had over 30 or so (I lost count). I have been vegetarian for over a year and vegan for four or so months. I cannot eat high oxalate foods which is confusing because they are the healthy foods I am supposed to eat while being vegan! I drink three liters of water a day and barely eat any foods high in sodium. Once I became vegan I got more stones (having to pass them). It went from every two months to once a month to every two weeks. I really want to stay vegan because I know how much healthier it is but I cannot deal with all of this pain. Any information you can give me would be greatly appreciated. I have gone to a urologist but she hasn’t given me any helpful information and right now I am just so frustrated I want to give up. So please help!

Answer:

Assuming your stones are oxalate stones, I would say that doing two things could help:

1. As it sounds like you’re doing, avoid the high-oxalate vegetables ‒ spinach, swiss chard, and beet greens. Kale, broccoli, collard greens, mustard greens, turnip greens, and bok choy should all be safe. According to the Mayo Clinic, you should also limit or avoid rhubarb, beets, okra, sweet potatoes, nuts, tea, chocolate and soy products. Yikes – that’s no fun. But maybe if you cut them all out, you could then slowly add back in small amounts of nuts and soy products and see if they are safe for you.

2. Consider a calcium supplement with meals. Calcium can bind oxalates and cause them to be excreted in your feces, but you should ask your doctor about this before doing it. Here is some more info on this:

mayoclinic.com/health/kidney-stones/ds00282/dsection=prevention

Follow-up:

I am mainly concerned that with all these restrictions I will not be able to receive all the essential nutrients I will need. I eat mostly nuts and beans to receive protein and those are some things I can’t eat.

Answer:

Have you seen ohf.org/docs/Oxalate2008.pdf

It lists beans as being moderately high in oxalates. I would think that you could eat small amounts of beans without it being a problem.

Unfortunately, it looks like quinoa (a non-legume, non-nut source of vegan protein) is high in oxalates:

whfoods.com/genpage.php?dbid=142&tname=foodspice