The Real Scoop on Oxalates: Separating Fact from Fiction in the Plant-Based vs. Carnivore Debate

About 10 years ago I recall noticing some lower right back pain, a slight ache. Over night it intensified to the point that I knew something was wrong. For days I sat with a heating pad on my back, pounding huge amounts of water. 

I had a kidney stone. 

If you’ve ever experienced a kidney stone, you know it can be one of the most excruciating experiences—often likened to giving birth. The pain from kidney stones is just one of the reasons that oxalates have entered the public discussion, especially among those curious about plant-rich diets and health.

Our Diabetes Reversal Diet contains high amounts of plant-based whole foods. Proponents of a carnivore or keto diet that is animal-based often say that plants should be avoided due to oxalate levels. Let's find out what the science says. 

In this article we'll explore what oxalates are, the questions you might have about them, and how they impact your body and health choices.

What Are Oxalates?

Oxalates are natural compounds found in many plant foods, as well as produced by the body. They can bind to minerals like calcium, forming compounds like calcium oxalate, which sometimes lead to kidney stones or other issues in people who are sensitive to oxalates or consume them in high amounts.

But here's the catch: not everyone is sensitive to oxalates, and most people consume oxalates without ever experiencing problems.

Can Oxalates Affect Your Health?

Yes, but it depends on a few factors. The most well-known issue related to oxalates is their potential role in forming kidney stones, particularly calcium oxalate stones, which make up about 80% of kidney stones. However, it’s crucial to remember that genetics, hydration status, and calcium intake all play significant roles in kidney stone formation.

For most healthy people, eating oxalate-rich foods like spinach, nuts, or rhubarb is not a problem when part of a balanced diet.

Symptoms of High Oxalate Levels

If you're prone to kidney stones or oxalate-related issues, you might experience symptoms such as:

• Severe pain in the lower back or abdomen (common with kidney stones)
• Urinary discomfort or changes
• Joint pain or inflammation (in rare cases of oxalate sensitivity)

Oxalate-Rich Foods and Serving Sizes

Some foods are particularly high in oxalates. Here are a few examples:

• Spinach: One cup of cooked spinach contains 750 mg of oxalates.
• Rhubarb: One cup of rhubarb contains about 500 mg of oxalates.
• Almonds and nuts: A quarter cup of almonds has around 120 mg of oxalates.
• Swiss chard: High in oxalates, with around 500-600 mg per serving.
• Sweet potatoes and dark chocolate also have moderate oxalate content.

How Much Is Too Much?

For those who are concerned about oxalates due to a history of kidney stones or oxalate sensitivity, a low-oxalate diet typically suggests keeping oxalate intake under 50-100 mg per day. For reference, one cup of cooked spinach far exceeds that amount.

However, for most people, consuming moderate amounts of oxalate-containing foods is generally safe, particularly when balanced with adequate hydration and calcium. Most people can safely consume an average of 200-300 mg of oxalate per day.

Are You Oxalate-Sensitive?

Not everyone is sensitive to oxalates, and most people can consume high-oxalate foods without issue. However, if you have a history of kidney stones, have gut malabsorption issues (like from IBD or gastric bypass surgery), or notice joint or urinary discomfort, it might be worth exploring your oxalate intake. 

Do Oxalates Cause Mineral Deficiencies?

One concern about oxalates is that they bind to minerals like calcium, magnesium, and iron, which can reduce the absorption of these nutrients. But before you worry, know that this doesn't mean you'll automatically become deficient by consuming oxalates.

A varied whole-foods plant-based diet provides plenty of minerals and, when balanced, can compensate for the mineral-binding effects of oxalates. Plus, pairing foods high in vitamin C (like bell peppers or citrus fruits), vinegar, or citrus juice with iron-rich plant foods enhances iron absorption.

Balancing Oxalates and Nutrition: Plant Foods That Offset Negative Effects

• Consume calcium-rich foods like leafy greens (other than spinach), beans, sesame seeds, and tofu. Calcium binds to oxalates in the gut, making them less likely to form kidney stones.
• Stay hydrated to help flush out oxalates out through the urine.
• Incorporate probiotics or fermented foods, which can help break down oxalates in the gut. Bacteria such as Oxalobacter formigenes crush oxalates, reducing their absorption and risk of stone formation.

Download our free Gut Health Guide to learn more about foods you need to build a robust gut biome (including Oxalobacter formigenes) that will support your health and mitigate disease.

How Does a Carnivore Diet Come into Play?

Proponents of a carnivore diet argue that eliminating plant foods, and thus oxalates, can reduce inflammation and improve health. However, it's important to consider:

• Gut Health and Fiber: Plant-based fibers support beneficial gut bacteria, and eliminating fiber from the diet can negatively impact gut microbiome health and overall digestion (Sonnenburg & Sonnenburg, 2019).
• Uric Acid and Gout: High meat consumption is linked to increased uric acid levels, which can precipitate gout (a type of intensely painful arthritis) in susceptible individuals.
• Nutrient Deficiencies: A carnivore diet can lack essential nutrients like vitamin C, antioxidants, and fiber—all crucial for overall health and reducing inflammation.

While eating carnivore and eliminating carbs and plants form your diet can lower blood sugar in the short term, there is no science showing long-term health benefits.  In fact, there are decades of science showing that it increases the risk of diabetes, heart disease, stroke, cancer and other chronic disease that shorten life expectancy. 

The science of a smart, plant-rich diet shows the opposite: reversal of the root causes of diabetes, disease risk reduction, and healthy longevity. In fact, the healthiest and longest-lived people on the planet eat mostly plants. Some of the world's top athletes eat a plant-based diet, including Olympic athletes, body builders, football stars, and ultra-marathon runners. 

Oxalates and Inflammation: What Does the Science Say?

While a carnivore diet might show short-term benefits for some people, it can also contribute to long-term inflammation and chronic disease risk due to its high saturated fat content and lack of anti-inflammatory plant compounds. Studies have shown that processed meats and red meats increase inflammation markers like C-reactive protein (CRP) (Ley et al., 2014).

Moreover, plant-based foods rich in polyphenols (such as berries and tea) have been shown to reduce inflammation, support beneficial gut bacteria, and improve metabolic health (Esposito et al., 2014).

The Role of Oxalates and Gut Health

Gut bacteria play a crucial role in oxalate metabolism. If your gut microbiome is balanced and diverse, it’s more capable of breaking down oxalates, reducing the likelihood of kidney stone formation. A diet rich in probiotic foods like sauerkraut, kimchi, or tempeh, and prebiotics like oats and garlic, supports a healthy gut flora that can better manage oxalate levels.

The Benefits of a Well-Balanced Plant-Based Diet

Instead of avoiding oxalate-rich foods altogether, focusing on a balanced plant-based diet with adequate calcium, hydration, and diverse fibers can offer health benefits without the risks associated with excess oxalate. Additionally, plant-based diets are associated with lower risks of chronic diseases like heart disease, type 2 diabetes, and certain cancers (Wang et al., 2014).

In Summary: Should You Worry About Oxalates?

For most people, oxalates in plant foods are not a major concern. By consuming a balanced diet, staying hydrated, and including calcium-rich foods, you can minimize any negative effects of oxalates. The benefits of eating a variety of nutrient-dense, fiber-rich plant foods far outweigh the potential downsides of oxalates for the majority of people.

Ultimately, if you are struggling with health issues like kidney stones or specific oxalate sensitivity, working with a healthcare professional can help you identify the best dietary approach for your needs. For everyone else, embracing a plant-focused, whole-food diet with moderation in oxalate-rich foods is the best way to support overall health.

References for Further Reading

1. Cani PD et al. (2007). "Metabolic endotoxemia initiates obesity and insulin resistance." Diabetes.
2. Deopurkar R et al. (2010). "Differential effects of cream, glucose, and orange juice on inflammation, endotoxin, and the expression of toll-like receptor–4 and suppressor of cytokine signaling–3." Am J Clin Nutr.
3. Sonnenburg & Sonnenburg (2019). "The Good Gut: Taking Control of Your Weight, Your Mood, and Your Long-term Health."
4. Ley SH et al. (2014). "Associations between red meat intake and biomarkers of inflammation and glucose metabolism in women." Am J Clin Nutr.
5. Esposito et al. (2014). "Dietary patterns and cardiovascular risk factors." Current Atherosclerosis Reports.
6. Wang et al. (2014). "Vegetarian diets and the incidence of cancer in a low-risk population." Cancer Epidemiology Biomarkers & Prevention.