If you are new to the low oxalate diet, you may find it to be very different from other diets. For example, gluten-free diets, which are often advocated for celiac patients, advocate removing gluten from the diet entirely. The difference with oxalates is that it is simply impossible to remove them from the diet entirely. They are present in almost every food, at least to some small extent, and so eliminating them completely isn’t an option.
Instead, a low oxalate diet is sometimes referred to as a “threshold” diet, where you want to keep your intake of oxalates below a certain level each day. Some liken this to counting calories or carbs; I think it’s considerably more complex than that, but still possible. I call it more complex, simply because there is no line item on a Nutrition Facts label telling you how many oxalates are in a food item. In order to have a clue about the oxalate content of the food, you will need to join the Trying Low Oxalates Yahoo Group, and download the latest oxalate spreadsheet there. (You can use this link to go straight to the Files section of the Yahoo group once your membership is approved.)
One of the things you’ll learn when you get hold of that spreadsheet is that almost every processed food is high in oxalates. This has caused many people great frustration. You don’t have to be a master chef in order to follow a low oxalate diet, but you will likely have to either learn how to prepare more (or all) of your own food, or eat a much simpler diet. Personally, I’m no great kitchen experimenter most of the time, though I occasionally have a burst of culinary brilliance. Most days, though, I’m too pressed for time to be futzing around in the kitchen, so I eat very simply. Four ounces of steak and three ounces of cauliflower, for example. I’ll season with relatively low oxalate items like butter, bacon, salt, and just a couple of grinds of pepper (black peppercorns are pretty high ox). Sometimes I’ll saute some onions and add them, in small quantities, to everything I eat for a few days – they go well in omelettes, on steaks, and with pretty much every other vegetable I eat.
But that is merely an illustration of this diet at its most basic. I personally also follow a low carb way of eating for other health reasons, so folks who allow themselves to eat higher carb items like fruit and rice have considerably wider options than I do. I do hope to someday heal my gut to the point where I can add in small amounts of carby foods, but I have learned the hard way that health must be rebuilt one step at a time.
So as I said, this is a threshold diet, with the threshold being measured in milligrams of oxalates. A low oxalate diet would contain between 40 and 60 miligrams of oxalates per day (assuming a 2,000 calorie intake). It is suggested that you adjust your oxalate intake for your calorie level, which would entail multiplying your caloric intake by 33 and 50; this would yield your lower and upper recommended values for oxalate intake. I want to stress right now, however, that if you have been eating high oxalate (which you undoubtedly are, unless you’ve specifically been trying to limit oxalate intake) that you should NOT attempt to drop to this level too quickly.
Let me re-state that for emphasis: DO NOT lower your oxalate intake overnight. Many have tried, and all have bemoaned the consequences (myself included). A much better way to start the diet is to begin removing the highest-oxalate foods from your diet at the rate of one or two per week. Then proceed onto the high oxalate items, and finally the medium items. This not only gives your body time to adapt, but also helps you mentally and emotionally deal with the changes to your diet. For example, if you’re used to just grabbing a handful of (high-oxalate) almonds any time you need a snack, you could try replacing these with roasted pumpkin seeds your first week. Then move on to replacing the spinach in your salad the next week with arugula or romaine. And so on.
This slower approach can not only help you by easing you into the changes required; it also allows you to avoid throwing out half your pantry! If you’re like most of us, probably 80-90% of the food you have in there is medium-high ox. If you’re coming to this diet from another highly specialized diet like the Specific Carbohydrate Diet or a gluten-free way of eating, those percentages may be even higher. Vegetarians are also among those who tend to eat very high oxalate without realizing it. I know when I was testing out vegetarian and vegan ways of eating, I would eat some amazingly high-ox nut loaves and soy products in an effort to raise my protein intake.
There are many, many more steps to doing the low oxalate diet correctly, but these are the very basics. Once you start the low oxalate journey, I highly recommend keeping a detailed food diary of everything you eat, as well. This will help you see your progress in black and white, and eventually allow you to associate symptoms with certain foods. Since we will likely never have a complete list of oxalate values for foods (though the TLO Yahoo Group does offer an opportunity to have any food tested), this could also enable you to learn about the oxalate content of your favorite foods which have not been tested. For example, you could trial small amounts of foods with unknown oxalate values, and see if they affect you in the same way a high, medium, or low oxalate food normally does. While this is obviously not as accurate as laboratory testing, it is a much better method than eating foods blindly, and hoping for the best. One caution, though; I’d never try to use this method to indulge wantonly in any food. As one of our members learned the hard way, dumping and infractions (infractions being when you get too much oxalate in your diet) can look terribly similar, and mistaking one for the other can really set you back in your detoxing of oxalates!