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Flashback Friday: How to Prevent and Treat Kidney Stones with Diet

August 14, 2019

“How to Prevent and Treat Kidney Stones with Diet” This is what the surface of a kidney
stone looks like under a microscope. Imagine that scraping
down your urinary canal. Kidney stones affect approximately
1 in 11 people in the United States, though 20 years ago
it was only 1 in 20, a dramatic increase in the
prevalence of this disease that started going up
after World War II. Our first clue as to why
was published in the 70’s. A striking relationship was
found between stone incidence and the consumption
of animal protein. But this was a population
study, though— you can’t prove
cause and effect. So next, researchers in Britain
did an interventional study, added animal protein
to their diet, like an extra can of tuna
fish to their daily diet and measured stone-forming
risk factors in their urine: how much calcium
they were peeing out, the concentration of oxalate and
uric acid in their urine before, …and after the extra tuna. Their overall probability of
forming stones increased 250% during those days they were
eating that extra fish. And that so-called high
animal protein diet? That was just enough
to bring intake up to that of the
average American. So the average American
intake of meat appears to markedly increase
risk of kidney stones. So what about
no meat? Well, even by the late 70’s we
knew that the only dietary factor consistently associated with kidney
stones was animal protein. And not just getting
your first kidney stone. The higher the intake
of animal protein, the more likely an individual
is to have multiple stones rather than just one
single stone episode. Not protein in general,
it seems, but specifically high
in animal protein. Conversely, a diet low in
animal protein may reduce the overall probability of forming
stones to become very low indeed, which may explain the
apparent low incidence of stones in
vegetarian societies, so it may be worthwhile advocating
a more vegetarian form of diet as a means
of reducing the risk. But it wasn’t until 2014 when actual
vegetarians were studied in detail. Using hospital admissions data,
they found that vegetarians were indeed at lower risk of being
hospitalized for kidney stones compared to those
that ate meat, and among meat-eaters, increasing
meat intake is associated with a higher risk of
developing kidney stones, whereas, a high intake of fresh fruit,
fiber, and magnesium may reduce the risk. We can use this information
to advise the public about prevention of
kidney stone formation. What advice
should we give in terms of which animal
protein is the worst? Despite compelling evidence that
excessive animal protein consumption enhances the risk
of stone formation, the effect of different
sources of animal protein had not been explored until this
study was published in 2014. People who form kidney stones
are commonly advised to restrict the intake of red
meat to decrease stone risk, but what about
chicken and fish? We didn’t know… until now. Salmon and cod were compared
to chicken breast meat, and burger
and steak. They found that
gram per gram fish may actually
be worse, in terms of uric
acid production. However, the overall
effects were complex. Basically, stone formers
should be counseled to limit the intake of
ALL animal proteins, and not just
a little bit. Only those who markedly decrease
their animal protein intake may expect to benefit
from dietary recommendations. Studies suggest that excessive
animal protein consumption poses a risk of kidney
stone formation, likely due to the acid load
provided by the high content of sulfur-containing amino
acids in animal protein, as I explored in my video on
preventing kidney stones with diet. But what about treating kidney stones? Most stones are calcium oxalate, formed like rock candy when the
urine becomes supersaturated, so doctors just assumed if
they’re made out of calcium we just have to tell people to
reduce their calcium intake. So that was like the dietary gospel
for kidney stone sufferers until this study was published in the
New England Journal of Medicine, pitting the two diets
against one another: low calcium versus
low animal protein and salt, and it was the restriction
of animal protein and salt that provided greater protection, cutting the risk of having another
kidney stone within five years in half. What about cutting
down on oxalates, which are concentrated
in certain vegetables? A recent study found that
there was no increased risk of stone formation with
higher vegetable intake. In fact, greater dietary intake of whole
plant foods, fruits and vegetables, were each associated with
a reduced risk independent of other known risk
factors for kidney stones, meaning one may get
additional benefits bulking up on plant foods in addition
to just restricting animal foods. The reason a reduction
in animal protein helps is not only because it reduces the
production of acids within the body, a reduction of animal protein should
also limit the excretion of urate, uric acid crystals that can act
as a seed to form calcium stones, or can create entire stones themselves. Uric acid stones are the second most
common kidney stones after calcium. There’s two ways to reduce
uric acid levels in the urine: a reduction in animal protein
ingestion, or drugs. And removing all meat can remove
93% of uric acid crystallization risk. Here’s the risk of crystals forming eating
the standard Western diet for five days, and then switching to a vegetarian diet:
leads to a 93% drop in risk within days. To minimize uric
acid crystallization, the goal is to get the urine pH
up to ideally as high as 6.8, so a number of alkalinizing
chemicals have been developed, but we can naturally
alkalize our urine up to the recommended 6.8
using purely dietary means, namely, by removing all meat, which takes someone eating
the standard Western diet up from an acid 5.95 right up to the
target of 6.8 eating a vegetarian diet. You can inexpensively test your own
diet with a little bathroom chemistry, for not all plant foods
are alkalinizing, and not all animal foods
are equally acidifying. A so-called LAKE score was developed:
a Load of Acid to Kidney score, which takes into account
both the acid load of foods and their typical serving sizes, and can be used to help people
modify their diet for the prevention of both uric acid and calcium
kidney stones and other diseases. This is what they found. The single most
acid producing food was fish, like tuna. Then pork, then poultry, then cheese, though milk and other dairy only
rates down here. Then comes beef. Now eggs are actually more acidic
than beef, more acid forming, but people tend to eat less eggs
at a sitting, so they come in here. Some grains can be
a little acid forming, such as bread, rice, but
not pasta, interestingly. Beans are significantly
alkaline-forming, but not as much as fruits, and vegetables
are the most alkaline forming of all foods. Through dietary changes alone
we may be able to dissolve uric acid stones away completely. Cure
them. Now you see it, now you don’t. No drugs, no surgery. Just telling them to drink more
water and modify their diet, such as restricting the
intake of animal protein and the kidney stone was gone. To summarize, here are the
five types of kidney stones. And the most important
things we can do diet-wise is to drink 10 to 12
cups of water a day and reduce animal
protein, reduce salt, eat more vegetables,
and more vegetarian.


  • Reply HDvids 101 March 22, 2019 at 12:10 pm

    First to the nutrition

  • Reply Adi March 22, 2019 at 12:15 pm

    Probably some veggie or fruit or nut or bean

  • Reply StarcraftSwarm March 22, 2019 at 12:24 pm

    How about limiting dietary oxalate, limiting sodium and increasing calcium intake?

  • Reply White Vaille March 22, 2019 at 12:29 pm

    …If fish might be worse than red meats for kidney stones, do Asian and other heavily fish-reliant cultures have more cases of kidney stones?

  • Reply Reverend Al March 22, 2019 at 12:45 pm

    Caffeine intake has been shown to be associated with increased urinary calcium excretion and, as such, could potentially increase the risk of developing kidney stones.

  • Reply Eelke Aptroot March 22, 2019 at 12:49 pm

    I mentioned this information at some point to some kidney stone sufferers and they looked at me like they were passing one…

  • Reply Pickle Beaker! March 22, 2019 at 12:59 pm

    Kidney stone? looks to me like superman's secret hideout

  • Reply ceramictiletonight March 22, 2019 at 1:01 pm

    I have had kidney stones since I was in my twenties. In my case, I was a mason who mainly worked on jobsites without running water and when I did drink something, 90+% of the time I drank soda for thirst. During the day I would sweat out whatever water was in me only to replace it with soda or coffee and my urine was super concentrated (4:08 of your video)and I had debilitating uric acid stones (5:30 of this video). The last one I had was the size of a 30 caliber bullet. I have cured my problem with a product from StoneLabs and drinking water all day long. I think the product is called stonebreaker by StoneLabs.

  • Reply Si Mon 2 March 22, 2019 at 1:21 pm

    Does this apply to gout crystals and bladder stones ?

  • Reply supersilverhazeroker March 22, 2019 at 1:25 pm

    i have high urinary oxalic acid levels and it's annoying that whenever i try to google about it all i get is results about kidney stones.. i don't have kidney stones.. though i can remember i had one when i was 6 or something.

  • Reply Lucca Ranoya March 22, 2019 at 1:29 pm

    Great Video

  • Reply Jon Dough March 22, 2019 at 1:45 pm

    Another blockbuster.

  • Reply billy March 22, 2019 at 2:20 pm

    i'm a bit confused 🙁 dr, berg had such a video published yesterday and he said that parsley has a lot of oxalates. so you have to consume a lot of lemon juice to combat the risk of kidney stones. nothing is safe to eat. nothing except kale :))

  • Reply Doug bananaboy March 22, 2019 at 2:39 pm

    No pain no gain ! You vegans afraid of a little pain in order to indulge in eating high quality yummo animal protein

  • Reply Cynthia Wicklow March 22, 2019 at 2:43 pm

    I am so confused! I have a friend that is and has been a vegetarian for over 20 years and she has kidney stones which she has been treated for with lithotripsy 4 times in the past two years. How should she be changing her diet? and if possible what should she be asking her urologist?

  • Reply Adnan A March 22, 2019 at 2:58 pm

    I hope I never get a kidney stone

  • Reply angela nadeau March 22, 2019 at 3:07 pm

    Good info👍

  • Reply Shaun Michaels March 22, 2019 at 3:16 pm

    I am so glad I turned vegan 8 months ago 🙂

  • Reply Kitt March 22, 2019 at 3:39 pm

    I had to have emergency surgery when i was 18 because of kidney stones. I had two very large stones blocking both of my ureters and i could not pee.

    My first episode with stones started when i was only 14. I went to the ER, they told me it was a stone and it would pass. I obviously didn't know anything about kidney stones so every now and then when i would have pain, i didn't think i needed to go to the hospital since they didn't do anything for me the first time. I never knew that i didn't pass the stone. Nobody told me what to expect or that it might possibly not pass.

    Fast forward to when im 18, i had no idea that stone has been blocking my kidney for 4 years. And now the other side is blocked due to another massive stone.

    I have the surgery, and when i go back to see my dr. he tells me what a kidney stone is and that it's made of calcium. I asked him, "what does that mean? Am i not supposed to drink milk or something?" And he said, "oh no, no. It doesn't work that way. " he never gave me any kind of diet do's and don'ts. I went back for a check up six months later and had ANOTHER surgery because i was forming stones again. He said because of my bad history with stones, he recommended they be taken care of now. Having surgery six months apart is not normal at 18!

    And for YEARS i would try to Google it and figure out why i had stones. I didn't drink soda, i didn't drink coffee. It made no sense and I was WAY too young to be having those problems, especially to the degree that i had them! All i ever found was "don't eat spinach, don't eat rhubarb." Im sorry but who the heck has a problem eating too much rhubarb??? Who is that information even for?

    Thankfully, i made my way to vegetarianism for other reasons. And a few years after that i finally found something online about animal protein and uric acid (I think i was reading about gout). Finally, everything made sense! I googled animal protein and kidney stones and boom! There it was! All my answers! When i was younger i definitely ate too much meat. Chicken nuggets where my go to snack back then.

    Im happy to say, I've only passed one SMALL stone since then and that's probably because i switched back to eating chicken and fish for a short time. I rarely eat meat now and mostly eat vegetarian. Probably at least 98% vegetarian and i haven't had issues since!

  • Reply tamcon72 March 22, 2019 at 3:57 pm

    6 "carnivore" diet cultists disliked this video already. Thanks for this refresher on what the actual science tells us, NF!

  • Reply Max Mueller March 22, 2019 at 4:21 pm

    oh the vegan zombie makes anti meat propaganda again what a suprise

  • Reply Melika Mardesich March 22, 2019 at 4:31 pm

    My mom has suffered with kidney stones over the past few years. She’s been vegan for 2 years and has had 3 surgeries to remove them during this time period. We told her doctor about her diet, and he suggested against a vegan diet because nuts, dark greens, and soy contribute to the development of calcium stones.

  • Reply Iron Vegan March 22, 2019 at 4:33 pm

    Great information Michael – thanks!

  • Reply Nurmagobob The Gov March 22, 2019 at 4:36 pm

    Thanks for the wake up call. Need to cutback on redmeat consumption.

  • Reply elys3 March 22, 2019 at 5:26 pm

    I've been vegan for four years and gluten free for sixteen years and at least 80% of our diet (if not more) is WFPB. I still developed a kidney stone while I was pregnant with my daughter this last year. There are other risk factors like hormones as well.

  • Reply KungFuChess March 22, 2019 at 5:57 pm

    Nuts like almonds are highest in oxalates

  • Reply So Ronery March 22, 2019 at 6:11 pm

    What about calcium sulfate which I read can cause kidney/bladder stones? Which is mostly in baked bread and tofu.

  • Reply Melanie C March 22, 2019 at 6:15 pm

    I was vegan for 5 years, reintroduced meat, got recurring kidney stones for 5 years, and nobody NOBODY mentioned this to me. My urologist just told me I needed to drink less caffeine. I had lithotripsy on one side and a basket removal on the other, and had to have a stent placed following the surgery. The whole ordeal was literally the most painful experience of my life, and I’ve had two c-sections.

    Thank goodness I connected the dots on my own (finally), and went fully plant-based again. No more problems. I’m limiting super-high oxalate foods anyway , though I am not convinced, as some websites would recommend, that cutting them out ENTIRELY is necessary. I still drink some tea and eat some spinach, they’re just not staples.

  • Reply sooooooooDark March 22, 2019 at 6:39 pm


  • Reply sooooooooDark March 22, 2019 at 6:40 pm

    spinach and kale will fuck u up!

  • Reply Geulez loves Dragons March 22, 2019 at 6:58 pm

    I have been plagued w/ kidney stones since I was 21 years old. I've had 10 episodes. My last one was 5 years ago. Each time I had one, I had to have it surgically removed. Sadly another one has recently appeared. It is small and the doctor thinks I can pass it on my own, ( I hope so). But I do have a question, can apple cider vinegar help in the treatment and elimination of kidney stones? Thanks for the video, good timing.

  • Reply Jeong-hun Sin March 22, 2019 at 7:18 pm

    You mean, it does not have any effect on kidney stones to eat spinach?

  • Reply For all March 22, 2019 at 8:40 pm

    One day, I commented that alkaline food can prevent and cure renal stone. I got so harsh reply that I am an idiot and supported by many. Hopefully, they saw this video to recognise who is the real genuine idiot now.

  • Reply Johny Relax March 22, 2019 at 8:58 pm

    I have been eating meat my entire life,tho i balance it out with vegetables,i am 28 and i never had any problems,should i worry or not,is it random or are there any tells?
    ok now that i finished the vid i think i am fine since i eat a lot of fruits and vegetables and i drink huge amounts of water daily..

  • Reply Michael Tillery March 23, 2019 at 12:42 am

    I call BS on Dr Greger on this. Uric acid stones are caused by high protein diet. Calcium oxalate stones are caused by high oxalates and too little calcium. I was on a whole food plant based diet for 2 1/2 years, following Nutrition Facts protocols, and guess what? I developed, in a relatively short period, a 1 cm calcium oxalate stone. The foods I were consuming are the highest oxalate containing foods: spinach, beets, lentils, beans, nuts, etc. So, it wasn’t caused by eating a diet high in animal protein. Just the opposite. I am no longer vegan, and I avoid those high oxalate foods.

  • Reply El principe Disla March 23, 2019 at 1:16 am

    Plants have oxolate which cause kidney stones

  • Reply Jamie Dunson March 23, 2019 at 1:38 am

    Ughh, I had an egg size stone lodged in my bladder while I was pregnant at 18. Imagine babies head pushing on your bladder with that HUGE sharp stone in it and don’t forget trying to be romantic on top of all that. Worst pregnancy EVERRRRRRRRRR!!!

  • Reply G Vas March 23, 2019 at 3:01 am

    Awesome info.
    Thank you for sharring this👍

  • Reply James Humphrey March 23, 2019 at 4:00 am

    tough to be a human being will be uploading my consciousness to the internet soon

  • Reply James Humphrey March 23, 2019 at 4:01 am

    mannnn i just ate a can of tuna fish!

  • Reply James Humphrey March 23, 2019 at 4:03 am

    gut the body and figure a way to get correct nutrient to the brain and body artificially

  • Reply James Humphrey March 23, 2019 at 4:08 am

    simple solution – grow more trees!

  • Reply Zoee Stolz March 23, 2019 at 7:40 am

    Can you please make a video about the weight loss treatment „Keto Pure and apple cider vinegar „ ? It is all over the internet and I am constantly seeing contrary opinions on it.

  • Reply Kelsang March 23, 2019 at 7:47 am

    Great info as always… please could you do a video on this latest Celery Juice craze? 🙏🏻

  • Reply Susan K March 23, 2019 at 8:56 am

    Dr., your ethos and presentation of nutrition based disease prophylaxis is extremely welcomed. So much alternative information out there is akin to pseudoscience, "Bro Science", supplementation quackery (i.e., colloidal silver and "leaky gut" nonsense), heck "Flat Earth" science too, why not. It's refreshing to see your evidence-based-knowledge about dietary habits and its impact on health and longevity. Many of us are avid subscribers, and I'm sure we all share your own personal goal of health preservation and life extension in kind. Thank you. BTW: Perhaps a video on gallstones, food types and weight loss associated risk factors?

  • Reply Daniel Manahan March 23, 2019 at 9:47 am

    Vegan for 14 years after Vegetarian for 25 years prior to that. I have had two episodes of stones. this most recent, I have two. one is a 5.3mm and the other a 1 mm stone and they are stuck. they won't pass.
    I drink plenty of water

    this makes no sense why.

  • Reply Plant Maven March 23, 2019 at 10:17 am

    Kidney stones gone. Ouch.

  • Reply Shari T March 23, 2019 at 1:43 pm

    Thanks for doing the research and [re]posting! Avoiding excruciating pain…yet 1 more reason to eat only plants!!

  • Reply Lloyd Hlavac March 24, 2019 at 4:01 am

    I had a kidney stone several years ago. Ungodly painful! After researching it, and the causes, I figured it was caused by all the high oxalate foods I was eating at the time, like spinach, beet greens, Swiss chard, peanuts, and 100% cacao. Changed some of the food for lower oxalate ones, plus also started drinking lemon water and supplementing with both potassium and magnesium citrates. Also drinking a lot more water to flush things out. Haven't had a problem since. Whew!

  • Reply Andrew Peace March 24, 2019 at 9:17 am

    But vegeterians eat a fish, don't they?

  • Reply Donna Reeves March 24, 2019 at 4:23 pm

    If you've had kidney stones…You are more likely to develop Gout (Uric Acid) Fresh Lemon Water (I drink 1x week) Breaks Up the stones and keeps things in check. Cutting down on Meats…can only help your body. Alcohol is the biggest factor…Raises your Uric Acid.

  • Reply Matti F March 24, 2019 at 5:47 pm

    Why didn’t you include the info from your update on high oxalate greens? If you’re going to repost videos you should at least make sure the information presented is current.

    Links to video & newsletter in question:

  • Reply cookie's & coconut cream March 24, 2019 at 6:57 pm

    Can you talk about restless leg syndrome. It's something I've had for around 20yrs and it's gotten worse over the yrs.

  • Reply Sophia Eleftheria March 26, 2019 at 1:17 am


  • Reply Veronica Lacrosse March 27, 2019 at 5:02 pm

    This is beautiful Doctor! Great work! 👏

  • Reply Guillaume Bourgault March 27, 2019 at 9:39 pm

    I have been vegan for 8 years. I'm 38 years old. I had 2 kidney stones in the past 3 years. about 50% of what I eat is whole food and I drink the recommended amount of water. What more can I do?

  • Reply Stingy Mcstingypantsface March 29, 2019 at 9:39 am

    Untiiiiiiiil now. This is the favourite part of your videos.

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