LOK Podcast Episode 1 | Oxalate Content and Absorption - Michael Liebman, PhD

INTRODUCTION TO EPISODE #1

When I first was told I needed to go on a low oxalate diet, it was after I had my first kidney stone analyzed. The doctor told me my stones were made from calcium oxalate, and that I should start a low oxalate diet as soon as I could.

They then proceeded to hand me a couple-page printout that looked like it hadn't been updated in 20 years. It had a little bit of information about oxalates and a list of maybe 10 or 15 foods that I should avoid. So I went home, stopped eating spinach, peanut butter and chocolate and thought I was good to go.

Soon after, I learned that things are a lot more complicated than they seemed, and that the internet doesn't make it easy for people looking for reliable information.

In Episode 1 of the Low Oxalate Kitchen Podcast, Dr. Michael Liebman I attempt to help clear the waters for people just starting out on a low oxalate diet. We also give a bit more detail for the people who have been trying to figure this out for some time and are at the point that they want take a deeper dive.

We talk about the factors that affect the oxalate content of foods, and also the factors that affect how much oxalate is actually getting absorbed into the body once its ingested.

SHOW NOTES

[03:40] What are oxalates and oxalic acid, where are they found?
[05:14] Factors affecting oxalate content of foods
[06:25] Importance of serving size and cooking methods
[10:50] Soluble vs insoluble oxalates
[12:54] Impact of maturity/ripeness of foods
[14:40] Grains/breads/soil conditions
[17:26] Factors affecting absorption
[18:35] How is absorbed oxalate measured?
[22:31] Dietary and supplemental calcium and it's effect on oxalate absorption
[26:26] Oxalate absorption compared to other vitamins and minerals
[28:20] Including cheese and other low oxalate sources of calcium in the diet
[30:23] Probiotics, oxalobacter formigenes and oxalate degrading bacteria
[39:15] Questions from Low Oxalate Kitchen Facebook Group
[42:26] General nutrition guidelines while on a Low Oxalate Diet
[47:50] Spreading out oxalate consumption vs. all in one meal
[48:51] Endogenous oxalate production, primary hyperoxlauria, and Vitamin C

A NOTE ON PROBIOTICS AND VSL#3

In this episode, we talked briefly about if there were any probiotics currently on the market that might be useful in helping to break down ingested oxalates, and Dr. Liebman mentioned VSL#3.

The current formulation of that probiotic is similar to the original that was used in Dr. Liebman’s studies. But as of 2016, the original inventor of that formulation has moved on to a new company called Visbiome and taken the patent for it with him to this new company.

If you are interested in getting a probiotic VSL#3 may still be a good choice, but if you want the formulation that was used in the studies by Dr. Liebman and his colleagues, that is currently available as Visbiome.

Both of these should be available over the counter, but maybe only at certain pharmacies. They are a bit pricey, but it’s because they are such high quality and are meant for pretty serious health conditions.

They should be kept refrigerated so if you don't see them outside the pharmacy, ask if they are keeping them behind the pharmacy counter in a refrigerator. Even though they are kept back there sometimes, you still shouldn’t need a prescription.

If you can’t find them or just want to order online, there are links below to each. You can also check out this article that talks about the difference between VSL#3 and Visbiome and what happened there if you want more information.

LINKS

Michael Liebman - University of Wyoming Faculty Page
Low Oxalate Vegetable List
Article - Best Practices for Integrating Cheese into A Low Oxalate Diet
Trying Low Oxalates Facebook Group
OxThera Oxabact Clinical Trial
VP Foundation
VSL#3 Probiotics
Visbiome Probiotics

Tang M., Larson-Meyer D. E., Liebman M. (2008) Effect of cinnamon and turmeric on urinary oxalate excretion, plasma lipids, and plasma glucose in healthy subjects. American Journal of Clinical Nutrition. 87(5):1262–1267

ARTICLES ON STEAMING FOODS AND OXALATE CONTENT

Chai, W, Liebman, M. (2005), Effect of different cooking methods on vegetable oxalate content. J Agric Food Chem. 53, 3027–3030.

J. Armesto, et al., (2019) Effects of different cooking methods on the antioxidant capacity and flavonoid, organic acid and mineral contents of Galega Kale (Brassica oleracea var. acephala cv. Galega)". International Journal of Food Sciences and Nutrition, 70(2), 136-149.

Oulai, P. D., Zoue, L. T., Niamke, S. L. (2015). Evaluation of Nutritive and Antioxidant Properties of Blanched Leafy Vegetables Consumed in Northern Côte d’Ivoire. Polish Journal of Food and Nutrition Sciences, 65(1), 31-38. https://doi.org/10.1515/pjfns-2015-0003