Fact sheetDiet specifications

Published on 1 Nov 2011


Mineral / electrolyte diet - oxalate - low

This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.

Aim

To provide a diet that limits oxalate intake to approximately 100mg per day and is moderate in protein and sodium.

Characteristics

Avoids food high in oxalate. Sodium is limited by avoiding high-salt foods and not serving salt.

Indications

Recurrent calcium oxalate stones.

Nutritional adequacy

This diet may not be nutritionally adequate; supplementation of potassium, magnesium and dietary fibre may be required.

Precautions

A liberal fluid intake (at least 2.5 litres per day) is essential. Salt and pepper should not be included on meal trays.

Previously a low-calcium diet was recommended to prevent recurrent kidney stones in patients with idiopathic hypercalciuria, but more recent studies have shown that a normal calcium intake with reduced animal protein and salt is more effective. The difference appears to be due to the different effects of the two diets on oxalate excretion.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

 Allowed Not allowed
Hot main dishesAll meat, but limit to 1.5 serves per day (one serve = 100g meat, 120g fish or 2 eggs)

Meat above allowance

All soy products

Baked beans, lentils, dried peas, nuts

Salty dishes (e.g. bacon, sausages, pies, smoked fish, silverside)

Sauces, graviesGravy in small amounts (≤30mL)Soy sauce, Worcestershire sauce
Starchy vegetables / pasta / rice

Pumpkin

White rice and pasta

Potato, sweet potato

Wholemeal pasta, brown rice

Vegetables

Low-oxalate vegetables (<5mg per serve):

Asparagus, broccoli, brussels sprouts, chives, cabbage, cauliflower, cucumber, endives, lettuce, mushrooms, onions, peas, sweetcorn, turnip, zucchini

Moderate oxalate vegetables (5-10mg per serve; limit to one serve per day):

Eggplant, parsnip, red cabbage, lima beans

Beetroot, carrots, celery, capsicum, leek, green beans, okra, parsley, spinach, silverbeet, squash, tomato, tomato paste
SoupsNone-
Sandwiches

Sandwiches made with white bread only

All other fillings with permitted vegetables and mayonnaise

Ham, silverside, sardines

Vegetables not allowed (e.g. tomato, carrot)

Salads, dressings

All others, with meat, cheese or egg from allowance and permitted vegetables only

Avocado

Mayonnaise or salad dressings

Ham, silverside, sardines

Vegetables not allowed (e.g. tomato, beetroot, celery, carrot, capsicum, parsley)

Breads, cereals

White bread

Refined breakfast cereals (e.g. rolled oats, Corn Flakes®, Rice Bubbles®, Special K®)

Wholemeal and wholegrain bread

Bran, bran- based cereals and wholegrain cereals (e.g. All-Bran®, Sultana Bran®, Weet-Bix™, muesli)

SpreadsButter, margarine, other jams, honey Vegemite™, peanut butter, marmalade, apricot jam
Hot breakfast choices

Poached or boiled egg from daily allowance

Mushrooms

Baked beans, bacon, canned spaghetti, tomatoes

Fruit

Low oxalate fruit (<5mg per serve):

Avocado, cherries, grapes, lemons, lychees, melons, nectarines, pawpaw, passionfruit, peaches, plums, strawberries

Moderate oxalate (5-10mg per serve; limit to 1 serve per day):

Apples, apricots, bananas, grapefruit, oranges, pears, pineapple

Dried fruits

Figs, kiwifruit, mandarins, mangoes, rhubarb

Berry fruits other than strawberries

YoghurtLimit to one of the three dairy serves per day-
Desserts

Fresh or stewed fruit from allowance

Plain cake, meringue

Jelly

Custard, ice-cream from dairy allowance

Fruits not allowed

Fruit cake

Desserts made with chocolate, coffee or nuts

Milk and cheeseAll, but limit to three dairy food serves per day (250mL milk, 200g yoghurt, 40g cheese)

Milk or cheese above allowance

Chocolate milk

Beverages

Fruit juice (orange, apple, pineapple): limit to one serve per day

Water, cordial, soft drinks

Weak tea or coffee: limit to one cup per day

Soy milk

Cocoa, Milo®, Ovaltine®

BiscuitsPlain biscuits and crackers (e.g. Sao™, Milk Arrowroot™, Milk Coffee™)Wholemeal and chocolate biscuits
Miscellaneous

Olives

Coconut

Chocolate

Salt and pepper

References

  1. Dietitians Association of Australia. Nutrition manual. 8th ed. Canberra: DAA; 2009.
  2. American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 26 April 2010].
  3. Mahon LK, Escott-Stump S. Krause’s food and nutrition therapy. 12th ed. St Louis: Saunders Elsevier; 2008.
  4. Taylor EN, Curhan GC. Diet and fluid prescriptions for stone disease. Kidney Int 2006;70:835-9.
  5. Borghi CL, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U et al. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. New Eng J Med 2002;346:77-84.
  6. Homes RP, Kennedy M. Estimation of oxalate content of foods and daily oxalate intake. Kidney Int 2000;57:1662-7.
  7. Noonan SC, Savage GP. Oxalate content of foods and its effect on humans. Asia Pac J Clin Nutr 1999;8:64-74.
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