Sally K. Norton

Vitality Coach, Speaker & Health Consultant

  • Home
  • About
    • Interviews and Talks
  • Symptoms
  • Relief
    • Nourishment
    • Results
  • Science
    • Oxalate Basics
  • Books
    • Data Companion
  • Support
    • Upcoming Events
    • Support Groups
    • Shop / Downloads
    • Sign-up for News and Updates
    • Speaking and Presentations
  • Recipes
    • Fundamentals
    • Sauces and Condiments
    • Beverages
    • Finger Foods
    • Soups
    • Salads
    • Side Dishes
    • Meats and Seafood
    • Treats
  • Blog
    • Table of Contents
  • Contact
    • Share Your Success Story!
    • Coaching and Consulting
    • Speaking
    • Webmaster
    • Privacy Policy

December 26, 2022 by Sally K Norton

Fake Meat: Dangers and Hidden Reality

Food companies use truly scary ingredients and techniques to make today’s plant-based meat substitutes. To mimic the aromas, flavors and textures of meat, high-tech manufacturing plants need to create copycat proteins, fats, and flavoring compounds. They use genetic engineering to create the key “employees” that do this work: genetically edited e-coli, yeasts, algae, and even stem cells from animals. The job of these genetically engineered micro-employees is to digest and transform big-ag GMO crops into fake meat products for human consumption.

This manufacturing is a franken-fermentation process that generates dangerous waste end-products that need careful handling and complete incineration. They must not escape into our natural environment because the consequences are completely unknown and could be catastrophic.

Large bio-tech companies are investing huge amounts of money to make imitation foods taste like real meats. This is because humans naturally love the taste of meat, eggs, cheese, and fish. Our reliance on meats is bred into our biology. Big tech wants to save us from this “problem.”

In the face of our uncertain future, new food technology is a comfort to some—but where are we putting our faith and trust?

plant-based meat subsitutes on grocery store racks
Fake Meats in the Marketplace

Bio-Tech Brewing

The “synthetic biology” at work here is briefly explained by Alan Lewis, a VP at Natural Grocers, in a 2022 Environmental Health Symposium video, here: https://www.youtube.com/watch?v=lgXbr24JP7k (I attended this conference.)

The manufacturing process is called “gene-edited fermentation” or “precision fermentation” occurring in large bio-hazard lab facilities. The Silicon Valley food-tech entrepreneurs describe their technique as a “proprietary probiotic production process” (terminology from a Berkeley, CA-based company called “Air Protein”, cited in Guthman and Biltekoff, 2020).

Creating micro-organisms that have never been seen on Earth before is a recipe for accidental epidemics of (yet more) untreatable infectious illnesses.

Plant-Based Meats: The Basic Ingredients Come from Industrialized Ag

The base ingredients “feeding” these synthetic manufacturing systems are GMO soy, corn, mung beans, sugar beets, plus hundreds of other additives that create the target microbe metabolite (some sort of novel protein, fat, or flavor compound). The sales hype gushes over these products as a miraculous futuristic achievement and strongly implies that they require no inputs—as if bacteria can produce food out of thin air. This could not be farther from the truth.

The source materials come from GMO farming systems which:

  • concentrate the control of food production into corporate hands,
  • put small farms out of business,
  • destroy soil,
  • heavily consume fossil fuels, and
  • add many harmful contaminants to our foods, including glyphosate, 2-4-D, and other pesticides.

And to make these “veggie” farm practices even more dangerous, the newest high-tech strategies already in use on farms now include spraying novel genetic materials on plants to trigger expression of selected genes as they grow in our rural countryside. In open-air farming, there is no way to contain the drift and to keep un-intended problems from spreading into natural habits, such as newly invasive superweeds that crowd out native plants!

Herbicides such as glyphosate are heavily used in GMO ag – the backbone of the new fake meat industry. Image: Exposure risk and environmental impacts of glyphosate: Highlights on the toxicity of herbicide co-formulants
Published by Elsevier; open access article (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The Process: Changing GMO Source Material into Flavors, Fillers, and Proteins

Manufacturers fill bioreactors with a GMO-derived mash of sugars, proteins and gene edited bacteria. Those engineered bacteria are designed not only to produce a target molecule but also for antibiotic-resistance. The bacterial slurry is treated with antibiotics to eliminate the naturally occurring bacteria and select the “edited” micro-organisms to consume the “feed stock” and produce the desired target compound.

Natural vs “Franken”-Fermenting

Traditional use of natural lactic-fermentation (a safe process long in use by humans to create sauerkraut, sourdough bread, beer, and yogurt) is incorrectly referenced to make the “brewing” of GMO grains with manipulated e-coli (a novel pathogen unknown in nature) seem similar and even safe. This is a far cry from reality.

The extracts that go into consumer products likely contain genes and other remnants of the gene-edited pathogens that created them.

“Cellular Meat”

Another human-invented fermentation type is lab-grown altered stem cells from beef, chicken, and pork. Bioengineers edit the genes of animal cells to enable them to survive in the fermentation tanks and grow exponentially fast to keep costs down. They remove the normal growth-regulating genes to bypass the cells’ normal growth limits (a self-regulation process) and to make them thrive on starch and sugar. This creates unregulated anerobic growth—the definition of tumor cells. Basically, this technique creates cancer tissue to be sold as a human food. Fake meat is marketed as superior to real meat, and even claims to be “animal free.”

More Synthetic Foods on the Way, Even for Babies

There’s even a lab-engineered breast milk alternative on the way called Biomilq, which is made from cultured human breast tissue. Bioengineers use a “proprietary cell culture media and growth factors” to stimulate the genetic code that directs the cells to create human casein and lactose as additives for an existing synthetic formula.

Dirtiness of “Clean Tech”

The major products of gene-edited fermentation, however, are massive amounts of “bio-waste” that must be deactivated. The spent synthetic GMO bio-hazard materials, gene edited microbes, antibiotics, and antibiotic resistant novel organisms all need to be incinerated. Misuse or release of these waste products into the environment could cause new disease outbreaks with no way to identify or track them. Regulation is almost non-existent, despite the risks.

Risks At Every Step

Key dangers are:

  • the presumption of safety;
  • limited surveillance of release controls and cleanup processes;
  • the absence of transparency;
  • lack of independent examination of the process and products;
  • no meaningful regulation;
  • no thorough safety review requirement.

The Solution: Better-Informed Consumers

The franken-synthetic realities hide under superior-sounding code names like “plant-based” and behind unproven promises like “planet friendly.” Unless consumers refuse to buy these franken-foods, the creation of cultured meat for the masses on a massive scale can only mean massive and novel environmental problems are in store.

No Real Benefits

Marketers promote these novel technologies as good for the planet. That could not be a bolder lie. As a 2020 academic article (Guthman and Biltekoff) put it, the food-tech entrepreneurs are engaging in “intentional veiling of pernicious processes” as they make grand claims and promises to attract investment capital.

Cultured meats have no environmental benefits. Bioengineers are creating GMO organisms that have never existed on earth before and these organisms and their waste are not even compostable and are certainly not edible. They pose great risks for environmental health for all life on earth, especially human beings.

Perhaps we are all Destined to Live in the Slaughterhouse . . .

The real world-changing ambitions of the bio-tech investors are to: 1) build up a culture that trusts big-tech over mother nature and, 2) to capture wealth and gain the on-going political control that comes with it. This gives them power to de-fang any future consumer protection efforts that might impede their vision of humankind needing near-complete dependence on corporate manufacturing for survival.

Who’s Cooking Dinner? Fake meat food-tech entrepreneurs.

Real Food from Real Farms

There are environmentally beneficial ways to farm. Instead of transitioning into factory laboratories where everything that comes out of them is a biohazard, we need to switch to regenerative farming and support local farms producing real foods using sustainable practices.

We can nourish ourselves by cooperating with nature. Regenerative farming communities—when set up as self-sustaining enterprise zones run and owned cooperatively by the farmers and not technocrats—can sustainably feed all humanity. It’s mostly politics (and big money) that stands in the way.

Please support small family farms not Big-Biotech companies in your food purchasing.

And to get involved in building a brighter future, you can participate in sustainable agriculture education. There are many ways to do this. Start by attending or sponsoring farmers to attend sustainable agriculture conferences. For the business minded, make connections with local leaders working to develop producer-run rural enterprise regenerative farming zones.

In Summary, here are Some Key Points:

E-coli based ferments use bacteria manipulated to be antibiotic resistant.

Lab meats are essentially cancer cells created from animal stem cells.

Neither the gene-edited living organisms, nor the substances that they create have any track record of safety.

Consumers are eating synthetic ingredients and gene-edited animal tumor cells thinking they are “plant-based” and “animal free.”

They are also likely eating virulent pathogens.

The waste products of these lab-factories pose health risks for all people, beyond those who elect to eat these foods (a choice typically made from ignorance).

DNA – Who Do You Trust to Design Your Franken-Foods?
Image by Sangharsh Lohakare on Unsplash

About Alan Lewis (from the video link)

Alan Lewis is based in Colorado. He has served various trade organizations: Non-GMO Project board, Organic and Natural Health Association board, Real Organic Project standards board, Retail Advisory Committee of the American Grassfed Association (certification program for grassfed producers), Farm Policy Committee of the Organic Farmers Association, and various committees of the Council for Responsible Nutrition (a leading trade association for the dietary supplement and functional food industry).

In addition to Alan Lewis’ talk, this article also references:.

Wuench, J. Got Milk! BIOMILQ Is The First Company To Create Human Breast Milk In A Lab. Forbes. https://www.forbes.com/sites/juliawuench/2021/06/01/got-milk-biomilq-is-the-first-company-to-create-human-breast-milk-in-a-lab/.

Guthman, J., and Biltekoff, C. (2021). Magical disruption? Alternative protein and the promise of de-materialization. Environment and Planning E: Nature and Space 4, 1583–1600. 10.1177/2514848620963125.

June 29, 2019 by Sally K Norton

What Is the Oxalate Content of Coffee?

Oxalate Content of Coffee

One of the most common questions I get when people hear about the health dangers of oxalates is whether coffee is “low” or “high” in oxalate. It’s a good question. After all, most everyone I know depends heavily on coffee to function. This article is not about the wisdom of your caffeine addiction, however. It’s about knowing how much oxalate you’re (not) consuming. To this end, I compiled all the published analyses of the oxalate content of coffee I could find in an attempt to understand why this is a question at all.

It should not have surprised me that looking to scientific reports for answers unearthed a golden example of how bad science comes to pass for truth. We the public don’t know when terrible science is influencing our thinking or inflaming our fears about oxalate in coffee. And we are easy dupes. Our tweet-sized attention span and resistance to technical details makes us headline readers, not thinkers.

Here we enter a bit of a rabbit hole for a good cause. That cause has multiple aims: 1) to improve your confidence that coffee is indeed low in oxalate, 2) raise your awareness that academic journals publish junk science and generate misinformation and, 3) provide an object lesson in the value of taking some time to read the fine print.

Popular Summary Lists Mostly Think the Oxalate Content of Coffee is Low

Lists of high and low oxalate foods from medical centers mostly agree that coffee is low in oxalate (see Table 1. Online Patient-Education Lists from 4 North American Medical Centers). Agreement does not necessarily make them right, nor has it vanquished the ubiquitous confusion about coffee’s oxalate content. Urologists, the public, and even the researchers can’t get or give a straight or consistent answer about oxalate levels. Some medical researchers and clinicians believe that coffee is high in oxalate. I have friends in the medical field who believe it. And they use it as an excuse to resist learning about oxalate or controlling how much they consume. Any threat to the love of their life (coffee) will not be brooked.

Still, there are two solid scientific reasons to believe that coffee is very low in oxalate. The first is that all reputable testing to date has demonstrated that coffee is low in oxalate. The second is the real-world experience of low-oxalate dieters who have maintained a daily coffee habit with health benefits and without signs of oxalate-related symptoms. Other beverages, including hot chocolate, black tea, and green tea, have consistently been found to be high in oxalate and tend to trigger oxalate-related effects (the effects are variable—e.g. night-time irritable bladder).

I have a suspicion that the rumor about coffee being high oxalate originated in confusing reports on the oxalate content of instant coffee powder, which led to misinterpretation of the results. Instant coffee is indeed very high if you eat a whole cup of the undiluted powder. However, no one does that! Instead only about 2g is dissolved in a cup of hot water. The University of Pittsburgh’s patient education lists (Table 1) use a seemingly escalated number for instant coffee (greater than 10 mg per cup). Perhaps their source mistook the powdered coffee’s oxalate content for what is present in a reconstituted cup.

Table 1.

Online Lists of Oxalate Content of Foods

From North American Medical Centers (Patient Education Materials)
List SourceType
(Plain Coffees)
Oxalate ContentURL
Univ. ChicagoRegular Brewed Coffee1 mg/Cuphttps://kidneystones.uchicago.edu/how-to-eat-a-low-oxalate-diet/
Univ. ChicagoDecaffeinated2 mg/Cuphttps://kidneystones.uchicago.edu/how-to-eat-a-low-oxalate-diet/
Univ. HarvardBrewed1 mg/Cuphttps://docs.google.com/spreadsheets/d/1nbDZPxhAW4It-m2-c460w6eGr4dMSIeDiQdqg3MaRgQ/edit#gid=1354389148
Univ. Pittsburgh (2003, PK Diet PDF hosted elsewhere)Instant coffee powder"Extremely High"http://www.pkdiet.com/pdf/LowOxalateDiet.pdf
Univ. PittsburghBrewed"Moderately High"
(2-10mg/Cup)
https://www.upmc.com/-/media/upmc/patients-visitors/education/unique-pdfs/low-oxalate-diet.pdf or
http://praveenmodimd.com/wp-content/uploads/2016/01/Low-Oxalate-Diet-_-Patient-Education-Materials-_-UPMC-Pittsburgh-PA.pdf
Univ. PittsburghInstant Coffee>10 mg/Cuphttps://www.upmc.com/-/media/upmc/patients-visitors/education/unique-pdfs/low-oxalate-diet.pdf or
http://praveenmodimd.com/wp-content/uploads/2016/01/Low-Oxalate-Diet-_-Patient-Education-Materials-_-UPMC-Pittsburgh-PA.pdf
St. Joseph’s Healthcare Hamilton, ON, Canada (2016)Coffee and decaffeinated coffee“good choice”https://www.stjoes.ca/patients-visitors/patient-education/patient-education-k-o/pd-9447-oxalate-in-food.pdf

Instead of relying on shaky lists, let’s go to the primary sources to consider results reported by credible researchers regarding the oxalate content of coffee.

Published Analyses of the Oxalate Content of Coffee

Oddly, published tests of the oxalate in coffee are relatively few. Perhaps this is because virtually all historically reported tests have found both brewed and instant coffee to be “very low” in oxalate for typical serving sizes (see Table 2. Publications Reporting Oxalate Content in Coffee: Plain and Two Flavored Coffees). There are two articles listed in Table 3 that claim coffee is high in oxalate. I will examine these articles in detail below.

Given that the question appears to be resolved, perhaps that is why testing coffee seems to be uninteresting to researchers. Nobody gets published in a quality journal if they’re reporting one more example of the same old uninteresting result. Lack of interest may perpetuate confusion regarding oxalate content in coffee, as it does for so many other foods.

Table 2 lists 11 published results (from 8 sources) reporting the oxalate content of coffee. These tests analyzed various types of coffee (instant and brewed), as well as two Starbucks flavored coffees. The researchers used a variety of analytical methods.

Coffee cup with question: what is in your cup?

The rightmost column in Table 2 reports milligrams of oxalate in an eight-ounce serving (237 ml). Instant and unflavored brewed coffee have somewhere between 0.7 and 2.4 milligrams of oxalate per cup. Flavored coffees may have higher oxalate content coming from ingredients other than the coffee.  In particular, notice that a Starbucks mocha latte has 47 mg of oxalate per cup, which is high – but at least 80% of that oxalate is coming from the (chocolate) mocha.

Keep in mind that today’s mugs, like our waistlines, have gotten rather large.  Eight ounces is roughly what you get in a “short” Starbucks cup. A typical small takeout coffee is usually twelve ounces (Starbucks “tall”), a medium size is 16 ounces (Starbucks “grande”), and a large is 20 ounces (Starbucks “venti”). Scale the oxalate results accordingly. Portion size always makes a difference, but fortunately coffee is low enough that the oxalate hit even from a large-sized unflavored coffee won’t be especially dramatic.

Table 2

Publications Reporting Oxalate Content in Coffee:

Plain and Two Flavored Coffees
YearReferenceAnalytical MethodVariety TestedData as reportedMg Per 8 ounce (237 ml) serving
1962Zarembski and Hodgkinson ((Zarembski PM, Hodgkinson A. The oxalic acid content of English diets. British Journal of Nutrition. 1962;16(01):627. doi:10.1079/BJN19620061))Colorimetric determination of ether-extracted, acid-processed sampleNescafe Instant powder 57mg/100g powder0.7
(Estimated as if prepared using 0.5 g powder per 100 ml)
1962Zarembski and Hodgkinson ((Zarembski PM, Hodgkinson A. The oxalic acid content of English diets. British Journal of Nutrition. 1962;16(01):627. doi:10.1079/BJN19620061))Colorimetric determination of ether-extracted, acid-processed sampleGround Arabica with 5% chicory; 2mg powder/100g water, infused for 5-minutes1mg/100g liquid2.4
1980Kasidas and Rose ((Kasidas GP, Rose GA. Oxalate content of some common foods: determination by an enzymatic method. J Hum Nutr. 1980;34(4):255-266))Enzyme (oxalate decarboxylase) assay modified for food analysisNescafe Instant3.2mg/ liter
prepared 0.5g powder per 100ml water
0.8
1992/1993Elmadfa et al (cited in ((Hönow R, Hesse A. Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chemistry. 2002;78(4):511-521. doi:10.1016/S0308-8146(02)00212-1)))UnknownUnknown1mg/100g brewed2.4
1995McKay et al ((McKay DW, Seviour JP, Comerford A, Vasdev S, Massey LK. Herbal Tea: An Alternative to Regular Tea for those who Form Calcium Oxalate Stones. Journal of the American Dietetic Association. 1995;95(3):360-361. doi:10.1016/S0002-8223(95)00093-3))Enzyme assayMaxwell House Drip1.6 mg per 250ml (8.4 ounces) brewed.1.5
1997Clinic Ciba-Geigy (cited in ((Hönow R, Hesse A. Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chemistry. 2002;78(4):511-521. doi:10.1016/S0308-8146(02)00212-1)))UnknownUnknown1mg/100g brewed2.4
2002Hönow and Hesse ((Hönow R, Hesse A. Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chemistry. 2002;78(4):511-521. doi:10.1016/S0308-8146(02)00212-1))High Performance Liquid Chromatography (HPLC) with Enzyme-ReactorBrewed 30g coffee per Liter0.5 – 0.7 mg/100g brewed1.4
2004Galli and Barbas ((Galli V, Barbas C. Capillary electrophoresis for the analysis of short-chain organic acids in coffee. Journal of Chromatography A. 2004;1032(1):299-304. doi:10.1016/j.chroma.2003.09.028))Capillary electrophoresisRoasted Colombian25.6mg/100g ground coffee (not brewed)1.8
est. for standard brewed equiv.: 30g per liter water
2004Galli and Barbas ((Galli V, Barbas C. Capillary electrophoresis for the analysis of short-chain organic acids in coffee. Journal of Chromatography A. 2004;1032(1):299-304. doi:10.1016/j.chroma.2003.09.028))Capillary electrophoresisLyophilised Colombian coffee17mg/100g ground coffee (not brewed)1.2
est. for standard brewed equiv.: 30g per liter water
2010Liebman / VP Foundation ((The Low Oxalate Diet Addendum Summer 2010 - Numerical Values Table. The VP Foundation Newsletter. 2010;(34) ))Capillary electrophoresis or enzymatic assay (not specified)Starbucks4.3 mg/100g10 (“short”)
2010Liebman / VP Foundation ((The Low Oxalate Diet Addendum Summer 2010 - Numerical Values Table. The VP Foundation Newsletter. 2010;(34) ))Capillary electrophoresis or enzymatic assay (not specified)Starbucks20 mg/100g47 (“short”)
Coffee urns with overlaid table of oxalate content by cup volume.

Low-Hanging Fruit: Rotten or Not!

Let’s take a close look at the two studies that report that coffee is very high in oxalate.

If you’re expecting the latest publication to offer a definitive answer, you will be misled when you find the 2012 article from Elzbieta Rusinek ((Rusinek E. Evaluation of soluble oxalates content in infusions of different kinds of tea and coffee available on the Polish market. Rocz Panstw Zakl Hig. 2012;63(1):25-30)) which reports very high numbers for the oxalate content in coffee (Table 3: Studies Claiming Coffee is High). Rusinek published in a Polish journal that appears in Pubmed (the online research database of the National Institutes of Health). The easiest article to find when you search for “coffee” and “oxalate” is Rusinek’s. When you look over Table 2, you’ll see that the studies by McKay and by Hönow and Hesse don’t use the word “coffee” in the title of their articles, nor do they have coffee as a key word, making those articles difficult to find.

In addition to being the easiest to find, the full text of the Rusinek article is also freely available to anyone with an internet connection because the journal is an “open access” publication where all articles are free to download. In stark contrast to being free and accessible, the majority of bio-medical studies are issued by publishers expecting payment from readers. if you’re not affiliated with a university (which may pay hundreds of thousands of dollars for subscriptions), you might have to pay $35 or $40 dollars to read or download a single paper, such as the Hönow and Hesse article. Such articles are described as being behind a “paywall”.

How do we explain these very different results?

The trouble with the 2012 Rusinek study is that it seems to be junk. However, that is not obvious to non-chemists.  I’ve reported Rusinek’s results, and the results from another Polish study that she was emulating methodologically, in Table 3.  Those results state that brewed coffee has 71 to 114 mg of oxalate per cup, and that instant has 110 to 361 mg of oxalate per cup.

All the other recent studies (since 1990) have found coffee to have 1.5 – 2.5mg of oxalate per cup. These two Polish studies report that coffee is nearly forty times higher than all previous studies! Even though Rusinek herself was scratching her head over the vast disparity of her results, she made no effort to determine why her results differed and she published them anyway. With mushy language, she offers readers a vague excuse for her results and their “apparent divergence”; here’s the full passage:

“It is difficult to compare the studies presenting the results of the soluble oxalates analyses in the instant and ground coffees with our results because of their apparent divergence. The result of determinations of oxalates content in teas and coffees is influenced by the various analytical methods of different sensitivity used, as well as processes related to acquisition followed by burning, grinding and mixing procedures, extraction conditions and the initial mass of the sample.”

Rusinek, E (2012) ((Rusinek E. Evaluation of soluble oxalates content in infusions of different kinds of tea and coffee available on the Polish market. Rocz Panstw Zakl Hig. 2012;63(1):25-30)), p. 29

Table 3

Studies Claiming Coffee is High In Oxalate

Hint: Do not believe them!
YearReferenceAnalytical MethodVarieties TestedData as ReportedMg Per 8 ounce (237 ml) serving
2010Sperkowska and Bazylak ((Sperkowska B, Bazylak G. Evaluation of oxalate content in brews of black teas and coffees available in Poland. Nauka Przyroda Technologie. 2010;4(3):#42. doi:10.17306/J.NPT.2010.3.42))Potassium Permanganate TitrationVarious ground available in Poland 47.94 mg/ 100g brewed; 796 mg/100g dry114 (brewed)
2010Sperkowska and Bazylak ((Sperkowska B, Bazylak G. Evaluation of oxalate content in brews of black teas and coffees available in Poland. Nauka Przyroda Technologie. 2010;4(3):#42. doi:10.17306/J.NPT.2010.3.42))Potassium Permanganate TitrationVarious instant coffees available in Poland152.19 mg/100g prepared; 2536 mg/100g dry361 (reconstituted instant)
2012Rusinek ((Rusinek E. Evaluation of soluble oxalates content in infusions of different kinds of tea and coffee available on the Polish market. Rocz Panstw Zakl Hig. 2012;63(1):25-30))Potassium Permanganate TitrationVarious ground and instant available in Poland18-40 mg /100g for brewed and 37-56 mg/100g for reconstituted instant.71 (brewed)

110 (reconstituted instant)

Exposed: Bad Methods, Laziness and Sloppiness

To understand why Rusinek’s article is bad science, the next sections of this post consider her poor choice of method, her failure to consider other methods, and errors of fact in her paper. If you don’t have patience for learning about the science, you can skip to the last section on how to make sense of oxalate data.

Permanganate Titration is an Unreliable Method for Measuring Oxalate

Truth be told, it’s pretty likely that the discrepancy begins with the fact that Rusinek (and Sperkowska and Bazyluk, the other paper in Table 3) used an outdated analytic method called permanganate titration. This method uses a titrant, permanganate, to generate a litmus-like test of oxalate content. The persistence of a light pink color indicates that the reaction of the permanganate with the oxalate is complete. Here is Rusinek’s description: “Titration in hot temperature was conducted with 0.02 N solution of potassium permanganate until pink color appeared and remained for about 1 minute.” p.27

There are several inherent problems with permanganate titration. For one, it is very easy to over-estimate the amount of the material (oxalate in this case) that is being sought with this method. Lab instructions for performing this test explain that the overestimate happens because the permanganate ion is able to “autocatalyze” its own destruction which requires additional (excess) permanganate titrant to reach the endpoint. The oxalate content is determined by measuring how much of the titrant was consumed, so if the permanganate consumes itself the result is going to overstate the amount of oxalate.

But there are other problems with the permanganate titration method. In their 1980 study on oxalate in foods, GP Kasidas and GA Rose ((Kasidas GP, Rose GA. Oxalate content of some common foods: determination by an enzymatic method. J Hum Nutr. 1980;34(4):255-266)) point out that “…substances such as citrate could be extracted with oxalate and might have interfered with the subsequent precipitation and titration with permanganate.”2 But you can go back 20 years earlier and see that the perils of using the permanganate method were already well-known by the early 1960s. At that time UK-based leaders in the oxalate field, PM Zarembski and A Hodgkinson ((Zarembski PM, Hodgkinson A. The oxalic acid content of English diets. British Journal of Nutrition. 1962;16(01):627. doi:10.1079/BJN19620061)), concluded that alternative colorimetric procedures are less subject to processing-related issues and therefore preferred over the permanganate titration method.

Rusinek does not explain the reasons for choosing an inferior method of analysis that had been out of favor for about 50 years prior to her publication. We can safely conclude that Rusinek’s analytical methods contributed to her wildly skewed results. Given her poor choice of method and lack of comparison to more widely accepted methods, Rusinek’s results can confidently be classified as spurious.

Good Scientists Study their Methods, not just their Samples

It is interesting to compare Ruth Hönow and Albrecht Hesse’s 2002 article ((Hönow R, Hesse A. Comparison of extraction methods for the determination of soluble and total oxalate in foods by HPLC-enzyme-reactor. Food Chemistry. 2002;78(4):511-521. doi:10.1016/S0308-8146(02)00212-1)) to Rusinek’s to get a sense of what happens with better science.

In the Department of Urology at the University of Bonn (Germany), Hönow and Hesse sought to validate a new, simpler method for testing oxalate content in food. They also explicitly wanted to determine if or when artifacts of the new testing process could skew their results. And when they tested cherries, they found that for some reason their approach led to higher estimates of oxalate content than previously reported. Instead of brandishing their new findings as “truth”, they did a detailed examination of what might have led their method to “go wrong”, including testing with an alternate method. The result is honest science, and a paper that not only reports believable data obtained using a credible method, but also carefully explains the advantages, pitfalls and limitations of the method.

Errors in Citing Previous Studies

Apart from the poor choice of analytic technique and lack of critical examination of the method and the results, there is one more reason to distrust Rusinek’s report. Her results for coffee deviated massively from every previous study. But in reporting the previous studies, she made misstatements that downplay just how big the deviation is.

First, she claimed falsely that Hönow and Hesse found an oxalate concentration of “10.6 mg/100 cm3 of infusion” (p. 29). In fact, they reported 0.5 to 0.7 mg/100g (see Table 2 above). (For purposes of comparison, 100 cm3 is the same as 100 ml, which for brewed coffee weighs almost exactly 100g, so the reported oxalate content is all on the same basis.)

Rusinek invented a number (10.6mg/100 cm3) that is twenty times larger than the real number (0.5 to 0.7 mg/100g). In doing so, Rusinek implied that her results are two to four times higher than Hönow and Hesse. However it’s much worse than that. If she were honest about the numbers, Rusinek would have to admit her results are 50 times higher: 71 mg per cup versus 1.4 mg per cup.

Our sloppy researcher makes another important citation mistake as well: “[C]onducted in the Sixties Zarembski and Hodgkinson’s studies on oxalic acid in the English diets the oxalates were at the level of 57.00 mg in the infusion of instant coffee (emphasis mine) ‘Nescafe’ from the Arabica beans which was prepared from 2 g sample soaked for 5 minutes with 100 cm3 water at 40°C.” But as shown in Table 1, the article reported 57mg for the instant coffee powder and not the infusion. Moreover, Zarembski and Hodgkinson did not analyze the prepared instant coffee, only the powder. The statement regarding their preparation method is also a “miscommunication”: the sample preparation method Rusinek describes is the one that Zarembski and Hodgkinson used for brewed coffee, not instant.

In her defense, Rusinek’s mistake is easy to make. Zarembski and Hodgkinson reported brewed coffee results on the basis of milligrams per liter of brewed coffee, yet they reported instant coffee on the basis of milligrams per 100g of dry powder.  And I suspect the same mistake is probably happening in patient education materials like those in Table 1 when they decide that instant coffee is spectacularly high in oxalate: they are misinterpreting data presented as oxalate in powder or dry material as if it were the value for the prepared drink. If you’re making a cup of instant coffee from two grams of powder, and the powder has 57mg per 100g, you’re only getting 1.14mg of oxalate in that cup!

I’m not convinced that Rusinek’s sloppiness is entirely innocent. The effect of both these errors is to understate the magnitude of the discrepancy between her results and respected prior research by almost two orders of magnitude.

But Wait! Isn’t There Another Study Saying Coffee is High?

One more reference offered by Rusinek deserves comment (and inclusion next to her results in the Table 3 “Hall of Shame”). In support of her findings, Rusinek cites a 2010 article by Sperkowska and Bazylak published in another Polish journal ((Sperkowska B, Bazylak G. Evaluation of oxalate content in brews of black teas and coffees available in Poland. Nauka Przyroda Technologie. 2010;4(3):#42. doi:10.17306/J.NPT.2010.3.42)) . The study featured in that article appears methodologically identical to Rusinek’s: obtaining coffee and tea samples from local stores, brewing them up, and analyzing them with a harsh preparation process followed by permanganate titration for the measurement step.

Because the Sperkowska and Bazylak article is only available in Polish, I won’t take it on in detail. In the abstract (available in English), their tests found the amount of oxalate in instant coffee powder to be 25.36mg/g of dry mass, or 2.536 grams per 100 grams. In other words, they claim that 2.5% of the instant powder (by mass) is pure oxalate. If instant coffee really were that high, surely someone else using other methods would have noticed! And the vendors would probably make more money selling it as a cleaning product to remove stains from your coffee cup than as a food.

Why were these authors confused? Did they make mistakes? Did they lie? Did they have bad editors? Or did none of them really care what they were publishing? Regardless of how it happened, the bottom line is: low quality papers get accepted and published by seemingly respectable journals.

Other False Claims that Coffee is High in Oxalate

Another article available on Pubmed states bluntly in its title that coffee is a significant source of dietary oxalate. The reference is Gasińska and Gajewska (2007) ((A Gasińska, D Gajewska, Tea and coffee as the main sources of oxalate in diets of patients with kidney oxalate stones. Rocz Panstw Zakl Hig. 2007;58(1):61-7)) entitled “Tea and coffee as the main sources of oxalate in diets of patients with kidney oxalate stones.” (I presume it’s an odd coincidence that this study was published several years earlier in the same Polish journal as Rusinek’s later study. We’ll leave it to someone else to diagnose the curious and apparently unique compulsion for Polish researchers to publish claims that coffee is high in oxalate!)

Gasińska and Gajewska did not conduct any oxalate testing of foods eaten by kidney stone sufferers. Instead, the 2007 study surveyed kidney stone patients (using an unspecified food-frequency questionnaire and 3-day food record) about their diets, and used other published oxalate content numbers to estimate how much oxalate the patients had been eating and from what sources. They offered no real detail about how they performed this magic trick. The Food-Frequency Questionnaire (FFQ) method is rife with pitfalls. For one, FFQs are not designed to distinguish between high and low oxalate foods. For example, spinach and arugula (opposite ends of the spectrum of oxalate content) are considered the same food type; and how much did you eat last year anyway?! Let’s not go any deeper into that annoying topic!

Here’s the stinker: Gasińska and Gajewska stated that their number for coffee oxalate content came from the 1995 McKay et al study ((McKay DW, Seviour JP, Comerford A, Vasdev S, Massey LK. Herbal Tea: An Alternative to Regular Tea for those who Form Calcium Oxalate Stones. Journal of the American Dietetic Association. 1995;95(3):360-361. doi:10.1016/S0002-8223(95)00093-3)). Specifically, they write: “The intake of oxalate was estimated on the basis of [a] table with oxalate concentration in tea and coffee by McKay et al” (Gasińska and Gajewska, p.62). But the McKay study (see Table 2 above) showed that coffee was very low! And the problem is not just that Gasińska and Gajewska misread the data table from McKay. They apparently also didn’t read the article text, where McKay et al state bluntly “Coffee prepared by the drip method was also found to have a low oxalate content–similar to that of herbal teas” (McKay et al, p.361).

So clearly the editors and reviewers of the Gasińska and Gajewska article did a terrible job of fact-checking. (For crying out loud, people, how can you put “coffee” in the title and not check the source?) At best, their article might support the assertion that tea is a major source of dietary oxalate. But that’s not news, and their coffee claim amounts to garbage.

These problematic articles that put the word “coffee” in the title are free. They appear in a seemingly legitimate journal, and in the index on Pubmed, so they must be true, right? Almost no one takes the time to correct the record or have these studies retracted.

And that, dear internet, is how bad science takes flight and lives on and on and on.

How do you make sense of oxalate data?

A lot of the information on the internet about oxalate content for any food (not just coffee) is problematic. The USDA table, for example, is filled with errors and only offers a tiny set of foods. Mistakes get introduced into the record as a result of a combination of outdated or inaccurate testing, bad math (and misinterpretation of what is actually being reported), and poor availability of the science. Even in good research, the numbers are often not reported in units that dietitians and consumers can use directly.

Because of the variability in testing procedures and in the foods themselves, there is always some uncertainty. It would be great if there were programs in operation that would repeatedly:

Oxalate content of Starbucks lattes in different sizes.
Flavored Coffees are Not Necessarily Low in Oxalate
  • Sample lots of common foods;
  • Be specific about the botanical variety being tested and its state of freshness and ripeness;
  • Describe in detail the culinary preparation methods;
  • Test the foods multiple times for oxalate content using a variety of analytical methods;
  • Describe the methods in detail, and
  • Present the results in a format that can be used to calculate dietary intake of oxalate.

For now, we’ll just have to keep making do with what has been reported by responsible researchers: plain coffee, even instant, has under 3mg of oxalate per cup. Let’s hope that the growing interest in the benefits of low-oxalate eating will inspire better standards and more publication of results that are reliable. We should also call attention to bad data on websites (and get the bad data off the USDA list of oxalate content).

Thanks for making it all the way through this technical article. I hope it is a valuable example of how bad science is abundant and problematic.

Disclaimer

I want to point out explicitly that I am not myself a coffee-drinker, and I wouldn’t personally recommend coffee to anyone. I’m not “defending” it because I want to drink coffee, but rather because I have a strong commitment to convey complete, honest, and useful information (and call “BS” when I see it).

May 18, 2018 by Sally K Norton

Our Oxalate-Loaded Environment: No Seasons, No Awareness

I’m very excited to announce a new article in the Journal of Evolution and Health: “Lost Seasonality and Overconsumption of Plants: Risking Oxalate Toxicity” by me: Sally K. Norton. Link http://jevohealth.com/cgi/viewcontent.cgi?article=1085&context=journal (or you can download it from my site)

Please read and share this heavily referenced, peer-reviewed article. Perhaps it will help us all see how we’re eating today in a new light. The article offers an up-to-date synopsis of what we know about oxalates, based on my extensive review of the scientific literature.

The rest of this blog post revisits and expands on the key points from the article.

Oxalate Toxicity Illness

Once you realize that oxalate in foods is at the root of your suffering, you can’t help but wonder: Why am I in trouble with oxalate? Why is this happening? Hasn’t oxalate been around forever? Is there something wrong with me that made me especially vulnerable to the oxalate problem? Why me? – this is the classic victim question. Yes, you are a victim, but of what? I say you are a victim of modern progress, affluence, cultural trends, and generalized ignorance of oxalate science; hear me out. . .

Oxalate-related illness is, in general, a problem of: 1) oxalate exposure and 2) bioaccumulation inside of our bodies. This is so, regardless if the effects of this exposure and accumulation surface as arthritis, digestive problems, headaches, pain issues, skin trouble, bad sleep, or kidney stones.

The One-Two Punch

Let’s consider that modern eating patterns douse us in oxalate far too routinely. (Missed any meals recently?) When the continuous oxalate marinade (daily low to moderate doses) includes occasional pulses of extreme doses (as in a spinach smoothie or a bag of almonds), accumulation is bound to occur. This combination – constant eating of plant foods (like bread and spices) interspersed with the occasional dark chocolate bar or spinach salad – is especially good at promoting the build-up of minute oxalate deposits in the body. The speed and extent of this process may be what separates the seemingly unaffected from those of us with joint, digestive, brain and neurological issues. Beyond just the level of oxalate intake, these factors seem to be key determinants of how fast and how extensively oxalate toxicity develops:

  • oxalate absorption
    • (many dietary factors and other changing conditions will affect the amount that gets inside the body),
    • it is generally much higher then scientists used to think
  • gut health, and
  • internal inflammation.

Never a Break

Never before has it been so easy to obtain oxalate-heavy foods. At the same time, we’ve become nibblers (or grazers) who believe that six small meals daily make for a healthy and acceptable meal pattern. We never take off from eating plant foods. We used to have those breaks: things called winter, or drought, or crop failure, or high-holy fasting days. And, of course when we’re eating oxalate, we have no idea that we are doing it; no one has bothered to tell us. Hardly anyone is aware of the presence of oxalate in our beloved foods and its potential dangers. Never have we been so at risk for slow, low-grade health damage thanks to our modern food choices, constant eating, and unawareness.

Global Food System Has Erased the Seasons

Winter is gone. No longer do we subsist on ham, onions, pickles, and white biscuits from January to March. Now, fresh green spinach, fruits, and nuts of all kinds can be had any day of the year. Our modern food scene is slick and sexy (packaged with grand promises), tasty and super-convenient, affordable, and . . . risky.

You can get nearly anything you could want, seven days a week, 365 days a year. Refrigerated trucks, the interstate highway system, inter-continental shipping, and the 24-hour grocery store all work to meet the demand for affordable, constant access to any and all foods. We usually see this as a great victory of modern commerce, but the downside… well, it has made it possible to bypass and disarm the body’s own defenses against what was historically only periodic over-dosing on high oxalate plant foods. That’s my guess, anyway. There is not any good research on the amount of oxalate in our diets and how this has changed.

Getting Plenty of Neo Foods

Envision some modern basics: tea, chips, fries, and almond milk. . . Finding our way to a daily cup of tea was never this easy! No longer do you have to haul water from the river, or fire up a wood stove. Potato chips? They were mass-produced for home consumption only recently. And french fries? Routine access to fries came with the invention of cheap (and addictive) fast food in the 1950s. That helped to launch the new and steadily expanding practice of eating meals away from home,  not just on special occasions but as part normal daily life. Restaurants eagerly offer hash browns, potato chips, fries, and mashed (or baked) potatoes as the classic side. (Too cheap, popular, and profitable to resist.)

Almond and rice beverages? These new-fangled products became commercially available and widely distributed only about 10 years ago (and have been growing in popularity). And please note: These faux “milks” are marketed as a fitting substitute for calcium-rich dairy milk. They are not. Not only do they contain oxalate (which real milk does not), but they lack milk’s ability to protect against oxalate absorption offered by dairy calcium.

Normal variability in what and when we eat, and restrictions that once came with the seasons and periodic food scarcity, are all gone in modern affluent societies. Easy, routine access to tasty oxalate-ridden foods has created a new situation for our bodies. The constant bombardment of our bodies by oxalate is an escalating, and uniquely problematic source of toxic stress in 21st Century life. It’s as if it were Thanksgiving Day, every day. The harvest is in and abundance is the theme of the moment. Have whatever you like; if its “healthy”—have a lot of it, frequently.

Modern Concepts of Health Foods

Modern dietary approaches have placed great emphasis on the health benefits of vegetables, nuts, chocolate, and spices, despite their being high in oxalate. There is a great deal of encouragement, pressure even, to eat greens, nuts, fruits, and other “whole” plant foods. We constantly hear that the sure path to complete health is the “plant based” diet. If it doesn’t work, you are just not trying hard enough… so just keep selecting antioxidant-rich “health foods”.

In this culture, how would anyone ever begin to suspect something amiss with this moral and fail-safe approach to eating? They don’t, not until they have exhausted every other possible explanation for why they hurt or can’t think well or get restless sleep… but I digress.

Accumulation of Oxalate

Any tissue of the body can end up with oxalate deposits, not just the kidneys and other parts of the urinary system. But how and why? This question has been posed, but rarely studied, at least since 1940 when a London coroner found oxalate crystals at the site of a brain aneurysm in a 61-year old woman.1 The prevailing theory in medical science is that the entire drainage system had to be broken down (persistent kidney failure) for oxalate to collect in non-renal tissues. Yet the exceptions to this rule are many—littered across the various fields of research.

Pathologists report finding oxalate deposits in eyes, arteries, hearts, skin, wherever—despite functional, healthy kidneys. We find this in cases of acute oxalate poisoning among patients who have tried to commit suicide with oxalic acid washing powders or ethylene glycol anti-freeze (ethylene glycol is a metabolic precursor that becomes oxalate in the body), and in cases of genetic disorders that cause excessive internal production of oxalate. But we also find these deposits in the chronically ill, in previously injured tissues, and in perfectly healthy people.

Stuck in Catch Mode

The scientific evidence suggests that the body is good at a game of “catch and release”. This is a process in which healthy cells take on minute oxalate crystals with the intention of this being a temporary accommodation. When the coast is clear and conditions right, cells recruit immune cells to help them dismantle and release the sequestered oxalate and send it off for excretion. Our diets, however, are pitching oxalate steadily (and at quite a clip). The effect is that the catch and release cycle gets stuck in “catch” mode. Cells holding oxalate attract more oxalate crystals which then become ever-present because oxalate is ever-present in so many of our favored foods. Injured cells or cell fragments passively get saddled with crystals that not only persist but grow, for years and decades.

We don’t see the inevitable but invisible nano-deposits and non-crystalline traces in cells throughout the body. The trained pathologist can see the much larger micro-crystals (when the tissue are fresh and properly handled, and when using the appropriate stain and polarized light). But the hunt for these troublesome contaminants isn’t done in typical tissue biopsy and tissues are usually not fresh. (The central concern being the detection of cancerous cells.) The body, however, is aware of oxalate. It is designed to unload these toxic traces, if it can only get the opportunity.

Let the Toxin Go

The cells await the conditions necessary for dismantling and releasing crystals. It would seem that tissues may need several days of very low-level oxalate intake to start the slow process of dismantling, dissolving, and unloading these nano-deposits. (In one study, looking at rat kidneys, this process was underway in just a matter of days. In another study, complete dissolution of a crystal took five or more weeks to complete).

The way we eat, the “release” conditions don’t come very often or for very long. The next time someone tells you “you’re full of it” they might be right!  And they might be full of it themselves!

References

1. Glynn, L.E. (1940). Crystalline bodies in the tunica media of a middle cerebral artery. J. Pathol. Bacteriol. 51, 445–446.

November 7, 2017 by Sally K Norton

Will today’s natural foods fix our health problems?

Paleo bread made from high-oxalate ingredients

Today’s health crisis. Have you noticed it? Obesity, insulin resistance, diabetes, kidney disease, cancer, infertility, behavioral and mood problems, poor sleep, and PAIN. Do you know anyone with any of these problems? Yes, you do, even if you are not aware of it. And, the suffering is happening at younger and younger ages. Our kids are in trouble, we’re all in trouble.

It is expensive to be sick. Both time and money are sucked out of our lives, not to mention the fun. And what about the bigger picture all around us? Perhaps you’ve noticed that poor health is threatening social and economic stability, world-wide.

Eating Better?

So, what are we doing about it? Eating better? Going “natural”? Yes, we are indeed eating more veggies and less meat, less fat too. We’re swearing off gluten and A bag of cheese-like "healthy food" substance made from almonds.milk, going for alternative low-carb or gluten-free breads, alternative “milk”, and fake cheese. Is this going to save us? I say no. Hear about one reason why this approach is not a great solution: in this video about oxalate toxicity from natural foods.

My Ancestral Health Symposium Presentation

In September, I had an opportunity to offer an address to the Ancestral Health Society. This presentation argues that many of today’s health foods are having the opposite of the intended effect. Rather than making us healthier, the superfood food craze could, like the holy war against saturated fat, be launching another public health calamity, as expensive and unpleasant as the current diabetes and obesity explosion.

Here are some highlights from this talk:

Bags of chocolate covered almonds on a supermarket produce shelf.

Chocolate is now “produce” at Walmart

  • Low-level toxicity and nutrient deficiencies make us sick.
  • One of the most potent toxins that people regularly ingest in the contemporary diet is oxalate.
  • Oxalate causes nutrient depletion AND toxicity in the body.
  • Oxalate, when purified, can rapidly kill a person.
  • It was even the poison of interest in the very first experimental toxicology study published in 1823 in England, because it caused several accidental deaths in the early1800s.
  • Many of the plant foods we like to think are good for us have enough oxalate to harm our health in much more subtle ways.
  • These natural foods might even cause mechanical abrasion to your digestive tract do to the “needle effect”.
  • Oxalate can collect in your tissues.
  • The availability of high oxalate foods we see today is unprecedented.
  • Today we are eating oxalate in amounts that cause us to begin accumulating oxalate in our arteries, bones, thyroid, breasts, and kidneys.
  • When you eat “normal” levels of oxalate, you “maintain” and grow the oxalate deposits that have already started in your body.
  • Medical and nutrition authorities have virtually no awareness of the threat of biological toxicity posed by over-exposure to oxalate and its precursors. They are not paying attention to the increase in our use of high oxalate foods.
  • Going low destabilizes oxalate in the body, and helps it move out.
  • Going low can prevent and even reverse a lot of common complaints, as proven by thousands of reports from real people in the real world (members of the VP Foundation, Participants in the Trying Low Oxalates online groups, my own clients and followers, and many others).

Action Items for You

  • Please watch the video, it is only 39 minutes and is packed with helpful images and information that will make you want to share it and watch it a second time.
  • Please give it a thumbs up.
  • Share with those you love.
  • Let me know what you think.

… and

  • Skip the swiss chard and almonds.

The fewer toxins in your body the better, even the natural ones!

“From a practical point of view, it would be better to avoid oxalate-rich foods than to take measures to neutralize the effect of oxalic acid, especially when other sources of green vegetables are available.”

—Hoover and Karunairatnam (1945).
Oxalate content of some leafy green vegetables and its relation to oxaluria and calcium utilization.
The Biochemical Journal 39, 237.

July 2, 2016 by Sally K Norton

Vitamin D Lamp: This little light of mine, finding time to let it shine.

Healthy Sun Solution with a Sun Lamp

Here in this video you can see my “electronic sun”. This easy-to-use vitamin D lamp has specialized UVB emitting bulbs intended to emulate natural sun. For most of us, brief sessions with such a lamp may improve our vitamin D status and general health. Making time in your busy life can be a challenge, however. Check out my own solution in the video to see how I fit this practice into my own schedule.

Read on to learn more about vitamin D and the advantages of the lamp.

Vitamin D

Deficiency of vitamin D is not only terrible for bone health, it increases your risk of almost any disease and lowers your life expectancy. Low D levels are epidemic these days. It is common in every age group, and especially common among dark-skinned people. This is because the natural way to “get” vitamin D is to make it with your own skin, when the sun shines.  The sun’s ultraviolet B (UVB) rays interact with cholesterol (7-DHC) in the skin to make precursors that your body can convert to vitamin D.  Skin pigment blocks UV penetration, protecting skin from UV damage, but limiting vitamin D production. Other factors that limit D production in skin include aging and sunscreen use.  The strength of the sun is also a factor, varying by time of day and season, and lower at higher latitudes.

Sunlight – We Need It.

Correcting vitamin D deficiency is an important aspect of health and healing. Vitamin D deficiency is associated with insulin disorders, autoimmune disorders, cancer, and even risk of infectious disease. Many experts recommend routine oral supplementation.  But there is some evidence of short-comings and side effects to this approach that we still do not understand well.

For those with inefficient vitamin D absorption, oral supplements do not correct the deficiency. For others who do absorb oral vitamin D, there are still drawbacks. Some suspect that daily consumption of D3 may encourage excessive absorption of calcium from the intestinal tract or movement of calcium out of the bones, which can create other problems.  To minimize these issues, it seems better to take D periodically in large doses, not in daily small doses.  But not everyone can tolerate pills and supplements at all:  such people especially need to generate vitamin D naturally from UVB rays (sunshine or sunlamp).

Practical Sun Exposure with a Lamp

Given the limitations of oral supplements, making the most of your skin’s ability to produce vitamin D is a good idea. But modern life makes it impractical to get regular sun exposure, even in the summer months. And UV radiation is insufficient in the northern U.S. during the winter months, November through February.  Many other variables influence how much UV light your body needs to make adequate vitamin D.

For pale skinned folks five minutes a few days a week might be enough. The darker your skin the longer the exposure needed. You can’t necessarily force your skin to make a lot of vitamin D from UVB, however. There are biological limits. So keep in mind that more time in the sun or under the lamp may not be better for you. Remember to have you doctor measure your vitamin D levels with blood testing.

August 24, 2015 by Sally K Norton

Radio Program: Gut Health, Inflammation, and Oxalate in Foods

Check this out. I was recently interviewed about Oxalates and Health by Sunny Gardener on Lightly On The Ground Radio on 97.3 WRIR, in Richmond VA. This show aired on Aug. 12, 2015.

Sunny and I discussed the back bone of all disease: inflammation.  We cover the connection between changes in the bacteria in our colons and increased susceptibility to inflammation.  We touched on oxalates in foods as a possible contributor to gut health deterioration and inflammatory illnesses.

https://sallyknorton.com/wp-content/uploads/2015/08/2015-08-12-skn-on-lightlyontheground.mp3

 

Thank you to WRIR’s Lightly On The Ground, produced in Richmond VA.

August 20, 2015 by Sally K Norton

Taking Vitamin C? Try a Salad Instead.

If you are taking 500 mg or more vitamin C daily, there is something you need to know. Vitamin C (in excess) can become a toxin that can lead to kidney stones, arthritis, other pain conditions, and perhaps, compromised brain function.  For decades we have been told that vitamin C is good for us and may help prevent colds. But too much of a good thing can make trouble. (Research has not been able to confirm the theory that vitamin C supplements help to prevent colds unless you routinely engage in physically demanding work or endurance sports.) [Read more…]

May 16, 2015 by Sally K Norton

Catastrophic Complication of Weight-Loss Surgery: Kidney Failure

Figure 1 Nagaraju (2013). Large intraluminal translucent crystals of calcium oxalate, tubular epithelial degeneration (foamy cytoplasm, pyknosis, karyorrhexis, indistinct cell borders, dilated lumina), lymphocytic infiltration in the interstitium (H and E, ×400)

Figure 1 Nagaraju (2013). Large intraluminal translucent crystals of calcium oxalate, tubular epithelial degeneration (foamy cytoplasm, pyknosis, karyorrhexis, indistinct cell borders, dilated lumina), lymphocytic infiltration in the interstitium (H and E, ×400)

A case of kidney failure after bariatric surgery is stopped with low-oxalate diet.

Canadian nephrologists reported a case of life-threatening kidney damage caused by kidney deposits of oxalate crystals.1 The doctors performed a kidney biopsy on their patient, a 54-year old man, 20 months after duodenal switch weight-loss surgery. His blood creatinine levels had tripled over the previous nine months. The biopsy found oxalate crystals causing tubular damage and atrophy, fibrosis, and inflammation. They also noted hardening of the blood-filtering glomerular capillaries.

The patient was treated with a low-oxalate diet, calcium citrate (1,000 mg 3 times a day with meals), high water consumption, and the drug cholestyramine to help reduce oxalate absorption. This stabilized his blood creatinine levels and his urine oxalate dropped by a third from 99 to 63mg per day. Normal urine oxalate is under 40-45 mg/day. The authors’ want practicing clinicians to be aware of the increased risk of excessive absorption of oxalates from food following weight-loss surgery (“secondary enteric hyperoxaluria”) which can lead to kidney stones and life-threatening renal failure due to oxalate-induced kidney damage.

This case illustrates: 1) changes to gut function can alter oxalate absorption; 2) oxalates in foods can cause tissue damage; and 3) this process may be arrested by limiting oxalate absorption with a low-oxalate diet and supportive therapies.

Interestingly, this patient’s urine oxalate levels, although lower, remained elevated (63mg/day) despite effective diet therapy. Consistent with reports from cases of genetic oxalosis, this may indicate that the patient’s tissues are shedding existing oxalate deposits in the kidney and elsewhere in the body. The clearing of oxalate deposits may contribute to urinary oxalate, perhaps for years. It is likely that shrinking tissue oxalate deposits leave in their wake persistent renal scarring and tissue damage elsewhere.

Oxalate deposits can develop over time after either Roux-en-Y gastric bypass surgery (RYGB) or duodenal switch surgery. These surgeries can trigger an increase in the absorption of dietary oxalates (perhaps due to bile salts in the colon and fat malabsorption in the small intestine). This potential complication -the possibility of increased oxalate absorption leading to high urine oxalates and, eventually, kidney failure – is not typically discussed at the time of consent to surgery.2 Nor are these patients typically told that they can minimize the risk by modifying their diet to avoid oxalates in foods. Discharge and follow-up counseling and education should include instructions for the low-oxalate diet. The gastric banding procedure is not likely to cause this problem.2

Oxalate deposits in the body develop gradually and often without symptoms.3 Although rarely prescribed by clinicians, a low oxalate diet can help avert the risk of too much oxalate and may be especially important for people with intestinal and digestive problems, including, but not limited to weight-loss surgery.4 Other surgical procedures (intestinal resection, ileostomy, bladder diversion surgery) and GI conditions such as irritable bowel syndrome (IBS), celiac disease, Crohn’s disease, small intestinal bacterial overgrowth (SIBO), pancreatic insufficiency, or poor fat digestion (steatorrhea) can also contribute to excessive absorption of oxalates in the digestive tract.

The renal damage caused by oxalates may not be reversible so it is important to start the low oxalate diet as early as possible. Anyone who is increasing their water intake or taking calcium citrate to reduce absorption of oxalates needs to be aware that timing is important. Water with meals can increase oxalate absorption, so drink fluids between meals. Also, calcium citrate tablets need time to dissolve, so take them about 20 minutes before meals to maximize the oxalate sequestration effects.

Key Point: Dietary oxalates can cause kidney failure after bariatric surgery. The progression of the disease can be halted by the low-oxalate diet, if implemented correctly and early enough.

For my low-oxalate grocery shopping list click here.

References

  1. Nagaraju SP, Gupta A, McCormick B. Oxalate nephropathy: An important cause of renal failure after bariatric surgery. Indian J Nephrol. 2013;23(4):316-318. doi:10.4103/0971-4065.114493.
  2. SenthilKumaran S, David SS, Menezes RG, Thirumalaikolundusubramanian P. Concern, counseling and consent for bariatric surgery. Indian J Nephrol. 2014;24(4):263-264. doi:10.4103/0971-4065.133045.
  3. Marengo S, Zeise B, Wilson C, MacLennan G, Romani AP. The trigger-maintenance model of persistent mild to moderate hyperoxaluria induces oxalate accumulation in non-renal tissues. Urolithiasis. 2013;41(6):455-466. doi:10.1007/s00240-013-0584-5.
  4. Lieske JC, Tremaine WJ, De Simone C, et al. Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium-oxalate supersaturation. Kidney Int. 2010;78(11):1178-1185. doi:10.1038/ki.2010.310.

Further Reading about Bariatric Surgery and Oxalates

  1. Agrawal V, Liu XJ, Campfield T, Romanelli J, Enrique Silva J, Braden GL. Calcium oxalate supersaturation increases early after Roux-en-Y gastric bypass. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10(1):88-94. doi:10.1016/j.soard.2013.03.014.
  2. Ahmed MH, Byrne CD. Bariatric surgery and renal function: a precarious balance between benefit and harm. Nephrol Dial Transplant. 2010;25(10):3142-3147. doi:10.1093/ndt/gfq347.
  3. Asplin JR. Hyperoxaluria and Bariatric Surgery. In: AIP Conference Proceedings. Vol 900. AIP Publishing; 2007:82-87. doi:10.1063/1.2723563.
  4. Froeder L, Arasaki CH, Malheiros CA, Baxmann AC, Heilberg IP. Response to Dietary Oxalate after Bariatric Surgery. Clin J Am Soc Nephrol CJASN. 2012;7(12):2033-2040. doi:10.2215/CJN.02560312.
  5. Kumar R, Lieske JC, Collazo-Clavell ML, et al. Fat Malabsorption and Increased Intestinal Oxalate Absorption are Common after Rouxen-Y Gastric Bypass Surgery. Surgery. 2011;149(5):654-661. doi:10.1016/j.surg.2010.11.015.
  6. Lieske JC, Mehta RA, Milliner DS, Rule AD, Bergstralh EJ, Sarr MG. Kidney stones are common after bariatric surgery. Kidney Int. October 2014. doi:10.1038/ki.2014.352.
  7. Nasr SH, D’Agati VD, Said SM, et al. Oxalate Nephropathy Complicating Roux-en-Y Gastric Bypass: An Underrecognized Cause of Irreversible Renal Failure. Clin J Am Soc Nephrol CJASN. 2008;3(6):1676-1683. doi:10.2215/CJN.02940608.
  8. Patel BN, Passman CM, Fernandez A, et al. Prevalence of Hyperoxaluria After Bariatric Surgery. J Urol. 2009;181(1):161-166. doi:10.1016/j.juro.2008.09.028.
  9. Ritz E. Bariatric surgery and the kidney – Much benefit, but also potential harm. Clin Kidney J Clin Kidney J. 2013;6(4):368-372.
  10. Whitson JM, Stackhouse GB, Stoller ML. Hyperoxaluria after modern bariatric surgery: case series and literature review. Int Urol Nephrol. 2010;42(2):369-374. doi:10.1007/s11255-009-9602-5.

January 12, 2015 by Sally K Norton

I missed a key footnote in college about oxalates in food

Sweet potatoes, walnuts, and kiwi are no longer my friends. Apparently, they never were. I just never got the memo.

My nutrition education hadn’t warned me that a variety of vegetables, nuts, and fruits could cause health problems due to their oxalate content. Instead, my college textbooks suggested that toxic oxalate is confined to a short list of five foods. My old Basic Food text states: “… oxalic acid, which occurs in spinach, chard, beet greens, and rhubarb, is toxic” (p.17)1. Another textbook, Normal and Therapeutic Nutrition, added coco to this same list, bringing the total up to five foods with oxalic acid (p. 134)2. Later in the therapeutic section of Normal and Therapeutic Nutrition, the authors added 15 more foods to the list in the one and only paragraph devoted to dietary restriction of oxalate (p. 675). The oxalate-restricted diet is described in under 60 words.

Truth be told, lab methods for measuring oxalate in foods did not become reliable until about 1980. Today in 2015, the nutrition profession still lacks complete or accurate reference for the oxalate content of foods and supplements. And, we have not fully described or tested the hypothetical oxalate-restricted diet, because we lack sufficient data and other tools needed to do so. Such a diet can only be created by an opt-in method of building a diet with foods that have been accurately tested for oxalate content. Given the ubiquitous nature of oxalate in foods, the old notion of avoiding the top 20 high-oxalate foods is illogical and mathematically unsound. Yet, this is exactly the standard of practice today. In the rare instance when the oxalate-restricted diet is prescribed, the patient is handed an inaccurate list of the highest oxalate containing foods and told to limit these foods to occasional, moderate portions.

The chief message contained in my college text books about oxalic acid in foods is this: Oxalic acid reduces the amount of calcium that can be absorbed from very high oxalate foods to nearly zero, although the food composition reference tables list spinach and other greens as containing calcium, in significant amounts. From a nutritional standpoint these foods lack calcium because it is bound to oxalic acid and cannot be used by the body. These two textbooks disagree about the resulting loss of calcium availability as a result of adding chocolate (oxalic acid) to milk. When I was in school designing menus to meet nutritional requirements laid out by the FDA, we were not graded down for including, and counting, un-available calcium (in known high oxalate foods) in our meal plans. Oxalate was considered a non-issue back then, and still is today. In fact, high-oxalate foods are widely and loudly promoted as healthy foods.

My college textbooks also reassured me that oxalic acid “does not cause illness in the amounts that are normally consumed”. In today’s world proclaiming the healthy virtues of veganism, raw foods, and vegetable juicing, this dismissive and untested assertion sounds irresponsible. There is a growing body of evidence that oxalates can accumulate in tissues, not just the kidneys, which can lead to a variety of connective tissue and other problems in susceptible individuals. My Basic Foods book promoted the idea of increasing consumption of fruits and vegetables without a thought to the possibility that people could get into trouble with excessive amounts of naturally occurring oxalate in their foods. It didn’t occur to them that I had (while in college) a garden patch of Swiss chard which I ate in large portions every day for 2 months. At the time I was using crutches and 3600mg of ibuprofen to curb the constant foot pain that persisted after having surgery on both of my feet three years earlier in 1986. Today, I am pretty sure about the reason my feet were not healing properly – the toxic oxalic acid in my vegetarian diet and already in my body was interfering with healing.

So the seed was never planted in my head while in college, that over-doing Swiss chard and other high-oxalate foods could be trouble. It turns out that it can bring one’s productive life to a halt, as it did mine – several times.

References

  1. June C. Gates. Basic Foods. (Holt, Rinehart and Winston, 1981).
  2. Corinne H. Robinson & Marilyn R. Lawler. Normal and Therapeutic Nutrition. (Macmillan Publishing Co. Inc., 1982).

December 19, 2014 by Sally K Norton

Sugar

Sugar, Sugar Everywhere
Tis the season for hooking you on sugar.
Getter hyper-jazzed on sugar is optional.

Christmas is a holiday about new beginnings and the magic and wonder of ordinary life. Intentionally placed at the winter solstice, Christmas, like the solstice marks the end of the ever shortening days. Finally, the days are getting longer again. Still it is the dark time, and a time to cheer each other. So, off we go retail treasure-hunting and stuffing ourselves with sugar. We are easy prey for merchants of all stripes who coat the checkout with sugar in its many forms seductively dressed in both nostalgia and novelty. Peppermint bark, and other “sugarplums” so everywhere, so obtainable, promise to fulfill longings you didn’t know you had. 

Do you resist? Are you successfully avoiding candy, cookies, and the like? If so, does it leave you feeling left out?

Want a simple treat without damaging your health in the process?
Try ultra humble and easy baked apples (see post with recipe)

Tip: good food tastes best when you are hungry. Brain-numbing sugars, on the other hand, excite the senses even when you are full and over-fed. This turns “food” into an addictive substance from which you have no natural defenses. You need a plan for maintaining your sanity, waist-line, and good sense.

Search on SallyKNorton.com

Shopping Cart

Number of items in cart: 0

  • Your cart is empty.
  • Total: $0.00
  • Checkout
Click to sign up for email list
Click to sign up for email list

Upcoming Events

  • MeatStock 2015: Oxalate Toxicity Talk

    May 18, 2025 @ 11:00 am - 11:40 am
    US Eastern Time
    See more details

  • Group Meeting and Presentation

    May 22, 2025 @ 2:00 pm - 4:00 pm
    US Eastern Time
    See more details

  • Group Meeting and Presentation

    June 5, 2025 @ 1:00 pm - 3:00 pm
    US Eastern Time
    See more details

Connect

  • Home
  • About
  • Table of Contents
  • Shop
  • Recipes
  • Support
  • Blog
  • Contact

Visit Sally’s Other Sites

  • YouTube
  • LinkedIn
  • Facebook
  • X
  • Instagram

Copyright © 2025 — Sally K. Norton • All rights reserved.

 

Loading Comments...