Saturday, May 18, 2013

Low Oxalate Diet

What is oxalate?
Oxalate (charged form of oxalic acid)is a chemical commonly found in many types of plants. Oxalate can often bind with calcium and then crystallize, which can cause irritation and pain to in your tissues, which leads to increased inflammation. Oxalates composed of any mineral other than calcium are water soluble and therefore excreted by the body without problem.


Where do oxalates come from?
Our bodies always contain oxalates, and our cells routinely convert other substances into oxalates. For example, vitamin C is one of the substances that our cells routinely convert into oxalates. In addition to the oxalates that are made inside of our body, oxalates can arrive at our body from the outside, from certain foods that contain them.

Oxalate and its acid form oxalic acid are organic acids that are primarily from three sources: the diet, from fungus such as Aspergillus and Penicillium and possibly Candida , and also from human metabolism.

Oxalates are present in a lot of plants and fruit that we eat and in virtually all seeds and nuts.  These oxalates are metabolized by the flora or just leave the body with the stool when the gut is an healthy state. So they are not absorbed by the body. The problem starts when these oxalates are getting absorbed and this happens usually when the gut is leaky (when the tight junctions between the cells which line the gut open up and let molecules pass through between the cells). High levels are absorbed and then enter in urine, bloodstream and tissues(especially damaged tissues). In cells oxalates can lead to oxidative damage,depletion of glutathione, immune system’s inflammatory cycle and pain.

Leaves of plant almost always contain higher oxalate levels than the roots, stems and stalks.

Aim for 25-45g Oxalate daily intake
The Autism Oxalate Project was begun in early 2005 by Susan Owens. A brand new diet is being extensively used to treat children with autism and other disorders. Oxalate and its chemically similar form oxalic acid are widely used in industry. A researcher named Susan Owens discovered that the use of a diet low in oxalates markedly reduced symptoms in children with autism and PDD. For example, a mother with a son with autism reported that he became more focused and calm, that he played better, that he walked better, and had a reduction in leg and feet pain after being on a low oxalate diet. Prior to the low oxalate diet, her child could hardly walk up the stairs. After the diet, he walked up the stairs very easily. Many hundreds of children with autism throughout the world are now being placed on this diet with good results.
Ref: Greatplains lab
Oxalates and Autism
Oxalates in the urine are much higher in individuals with autism than in normal children (Figure 1). As a matter of fact, 36% of the children on the autistic spectrum had values higher than 90 mmol/mol creatinine, the value consistent with a diagnosis of genetic hyperoxalurias while none of the normal children had values this high. 84% of the children on the autistic spectrum had oxalate values outside the normal range (mean ± 2 sd). None of the ± 2 sd). 
None of the children on the autistic spectrum had elevations of the other organic acids associated with genetic diseases of oxalate metabolism, indicating that oxalates are high due to external sources.
As shown in the table, both mean and median values for urine oxalates are substantially higher in autism compared to the normal population. As a matter of fact the mean oxalate value of 90.1 mmol/mol creatinine is equal to the lower cutoff value for the genetic hyperoxalurias. The median value in autism is six times the normal median value and the mean value in autism is five times the normal mean value.
Benefits reported by Susan Owens
  • Improvements in gross and fine motor skills
  • Improvements in expressive speech
  • Better counting ability
  • Better receptive and expressive language
  • Increased imitation skills
  • Increased sociability
  • Speaking in longer sentences
  • Decreased rigidity
  • Better sleep
  • Reduced self-abusive behavior
  • Increased imaginary play
  • Improved cognition
  • Loss of bed wetting
  • Loss of frequent urination
  • Improved handwriting
  • Improved fine motor skills
  • Improvement in anemia
and many more...
Oxalates Metabolism by Susan Owens
Eating food high in oxalates is not the only way to get high oxalates systemically. Our bodies make oxalates on their own, especially when certain enzymes aren't balanced in their activity. Normally, once oxalates are in the gut, they may encounter particular species of bacteria which will digest them and turn them into something else that isn't so irritating. This system of microbial digestion may be why the body seems to purposefully route excess oxalate from the rest of the body to the gut. Unfortunately, the very microbes we need to do this digesting of oxalates for us are subject to being killed by antibiotics in common use. Even if there was no exposure to antibiotics, these microbes might not have colonized yet in very young children, for it does not tend to be in breastmilk, but must be picked up from the environment.
Lactobacillus acidophilus is an oxalate-eating species, but when oxalates are in excess, lactobacillus can be killed off. It will be interesting to learn whether this may explain why certain people have great difficulty colonizing lactobacillus acidophilus. Fortunately, a probiotic formulation of a bacteria called oxalobacter formigenes that helps digest oxalates even better than lactobacillus is under development for patients with hyperoxaluria and related conditions.

There is a positive side to oxalates because they help us manage calcium, but the management of oxalates themselves will fall down when cells are low in glutathione and also in oxidative stress. Oxalates add to that oxidative stress.
Plants use oxalates to protect themselves from infection or from being eaten, as these crystals can tear up the mouths of the bugs that eat them, but we haven't learned nearly enough about the positive side of oxalates in humans. We know a lot of negatives about oxalates, but we are just starting to learn what chemistry will change when both the sulfur and oxalate chemistry are disrupted at the same time.


Symptoms of high oxalates:
  • Pain: urinary pain, joint pain, achiness
  • Inflammation
  • Ongoing dysbiosis
  • Sandy Stools
  • Low minerals Status
  • Laboratory confirmation on UMA or MAP
High Oxalates(greater than 10 mg per serving) Moderate((2 to 10 mg per serving) Low Oxalates((0 to 2 mg per serving)
Beer
Beets
Blackberries
Black and red raspberries
Blueberries
Celery
Chard
Chocolate
Cocoa
Coffee powder (Nescafe)
Collards
Concord grapes
Crackers made from soy flour
Currants
Dandelion greens
Eggplant
Escarole
Fruit cake
Fruit salad (canned)
Green bell pepper
Grits (white corn)
Juices containing berries
Kale
Leeks
Lemon and lime peel
Nuts (especially peanuts and pecans)
Okra
Ovaltine
Parsley
Pokeweed
Rhubarb
Rutabagas
Spinach
Strawberries
Summer squash
Sweet potatoes
Tea
Tofu
Tomato soup
Wheat germ
 Apple
Apricots
Asparagus
Bottled beer (12 oz [360 ml] limit/day)
Broccoli
Carrots
Chicken noodle soup (dried)
Coffee (8 oz [240 ml])
Cola beverage (12 oz [360 ml] limit per day)
Corn
Cornbread
Cucumber
Lettuce
Lima beans
Marmalade
Oranges
Orange juice (4 oz 120 ml])
Parsnips
Peaches
Pears
Peas (canned)
Pepper (greater than 1 tsp [2 grams] per day)
Pineapple
Plums
Prunes
Sardines
Soy products (most)
Sponge cake
Tomatoes
Tomato juice (4 oz [120 ml])
Turnip
Watercress
Apple juice
Avocado
Bacon
Bananas
Beef (lean)
Bing cherries
Brussels sprouts
Cabbage
Cauliflower
Cheese
Eggs
Grapefruit
Green grapes
Jellies
Lamb (lean)
Lemonade or limeaid without peel)
Melons
Milk
Mushrooms
Pork (lean)
Poultry
Preserves
Nectarines
Noodles
Oatmeal
Oils
Onions
Peas (fresh)
Plums
Radishes
Rice
Salad dressing
Seafood
Spaghetti
White bread
Wine
Yogurt