My colleague Susan Kynast-Gales, PhD, RD, and I compiled an online database with more than 1,200 published food oxalate values (http://www.spokane.wsu.edu/research%26service/HREC/FoodOxalateOverview.asp). Foods from diverse countries are included to allow application of the database by international health professionals and scientists. Values in the aggregate database are referenced to original source. The Excel spreadsheet may be printed or downloaded.
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The American Dietetic Association Care Manual recommendation is to restrict dietary oxalate to less than 40 to 50 mg per day. Because patients do not like to consult a long list of foods or do not care to take the time needed to calculate actual intake in milligrams, the first step in dietary oxalate restriction should be to avoid foods highest in oxalate, such as spinach, rhubarb, beets (roots and leaves), black teas (not green or herbal), chocolate, some tree nuts, bran concentrates and cereals, and legumes (beans, peanuts, soybeans and some soyfoods).
All plant foods contain some oxalate, but these foods have been shown to increase urinary oxalate after eating and have high amounts of oxalate. When these foods are avoided, oxalate content of the other low and moderate oxalate foods typically eaten will often only add up to the 40-50 mg daily dietary target.
Second, patients should add calcium to each meal to bind oxalate and prevent it from being absorbed. The total calcium intake for the day should be divided between as many eating occasions as possible. Patients should include about 150 mg calcium in each meal. This is the amount found in one half cup of milk, ice cream, yogurt, or pudding, or a three-quarter ounce slice of cheese. Studies looking at the addition of calcium carbonate support the use of calcium supplements with meals for patients who cannot or will not eat dairy products.
Finally, patient-friendly food oxalate tables have been recently updated from the aggregate database and can be found on the website of the Oxalosis and Hyperoxaluria Foundation (www.ohf.org/docs/Oxalate2004.htm).
