Oxalate Content of Foods
Women who experience vulvar pain due to CPP and vulvodynia may benefit from a low oxalate diet. Oxalate is a chemical substance found in foods of plant origin. (See Table 4 for listing of foods with low, moderate and high oxalate content.) These women have been shown to have higher levels of calcium oxalate in their urine that peaks in relation to intensity of pain along with symptoms of urinary urgency, frequency, muscle and joint pain, and rectal itching and burning. Foods containing little or no oxalate include meat, fish, eggs, and dairy products and foods with high oxalate levels are nuts; citrus fruits; wheat products; tea; cocoa products; spices such as ginger, pepper, and cinnamon; soy and peanut products; and tomatoes. Several women who tried a low-oxalate diet as their first course of action experienced significant pain reduction, however, a low-oxalate diet alone is not always sufficient to reduce symptoms. It usually is necessary to combine the diet with additional treatment in order to achieve optimal recovery.
by Diane K. Newman, RNC,
MSN, CRNP, FAAN
| Food | Little or No Oxalate <2 Oxalate/Serving; Eat as desired |
Moderate Oxalate: 2-10 Oxalate/Serving; Limit: 2 (1/2 Cups) Servings per day |
Rich Oxalate: > 1 Oxalate/Serving; Avoid completely |
| Fruits | Avocado Berries Cherries Grapefruit Grapes, (Thompson seedless) Mangoes Melons Cantaloupes Casaba Honeydew Melon Watermelon Nectarines Peaches, Plums, green or golden eye |
Apple Apricots Black currants Cherries, red Orange, edible portion Peaches, Alberta Pears Pineapple Plums, Damson Prunes, Italian |
Blackberries Blueberries Concord grapes Red currants Dewberries Fruit cocktail Gooseberries Lemon peel Lime peel Orange peel Raspberries Rhubarb Strawberries Tangerines |
| Vegetables | Avocado Brussels sprouts Cauliflower Cabbage Mushrooms Onions Peas, green Potatoes (Irish) Radishes |
Asparagus |
Beans - Green, Wax, Dried Beets Tops, Roots, Greens Celery Chard, Swiss Chive Collards Dandelion greens Eggplant Escarole Kale Leeks Mustard Greens Okra Parsley Peppers, Green Pokeweed Potatoes, sweet Rutabagas Spinach Summer squash Watercress |
| Meat Group | Sardines | Baked beans Peanut butter Soybean curd - (Tofu) |
|
| Milk | Buttermilk Low-fat milk Low-fat yogurt with allowed fruits Skim milk |
||
| Fats and Oils | Bacon Mayonnaise Salad dressing Vegetable oils |
Nuts: Peanuts Pecans |
|
| Miscellaneous | Jelly or Preserves (made with allowed fruits) Lemons Salt, pepper (1tsp/day) Soups with allowed Ingredients |
Chicken noodle soup dehydrated | Chocolate, cocoa Pepper (in excess of 1 tsp/day) Vegetable soup Tomato soup |
| Bread/Starch | Cornflakes Macaroni Noodle Oatmeal Rice Spaghetti White bread |
Cornbread |
Fruit cake Grits, white cor Soybean crackers Wheat Germ |
| Beverage/Juices | Apple juice Coca-cola (12 oz) (limit/ day) Distilled Alcohol Grapefruit juice Lemonade or Limeade without peel Wine, red, rose Pepsi-Cola (12 oz) (limit/ day) Pineapple juice Tap water (preferred for extra calcium) |
Coffee, any kind (9 oz. serving) Cranberry juice (4 oz.) Grape juice (4 oz.) Orange juice (4 oz.) Tomato juice (4 oz.) Nescafe power |
Beer Juices containing berries not allowed Ovaltine and other mixed beverage mixes Tea, cocoa |
Adapted from Newman, DK. (2000) "Pelvic Disorders in Women: Chronic Pelvic Pain and Vulvodynia". OstomyWound Management: December 46(12): 48-54.
References
Baker, PK. (1993) Musculoskeletal Origins of Chronic Pelvic Pain. Contemporary Management of Chronic Pelvic Pain, 20(4) December:719-742.05-227.
Duleba, A.J., Keltz, M.D., Olive, D.L. (1996) Evaluation and Management of Chronic Pelvic Pain. Journal American Association Gynecologic Laparoscopists, February 1996, 3 (2), 205-227.
Glazer,H.I.,Rodke,G.,Swencionis,C., Hertz,R.,Young,A.W.(2000) "Treatment of Vulvar Vestibulitis Syndrome with Electromyographic Biofeedback of Pelvic Floor Musculature". Journal of Reproductive Medicine, 40(4),11 pp.
Metts, J.F. (1999) Vulvodynia and Vulvar Vestibulitis: Challenges in Diagnosis and Management. American Family Physician, 59(6),1547-1556.
Newman, DK. (2000) "Pelvic Disorders in Women: Chronic Pelvic Pain and Vulvodynia". OstomyWound Management: December 46(12): 48-54.
Paavonen, J. (1995) "Vulvodynia - a complex syndrome of vulvar pain". Acta Obstet Gynecol Scand. 74,243-247.
Steege,J.F. (1997) Office Assessment of Chronic Pelvic Pain. Clinical Obstetrics and Gynecology, Vol.40(3),554-563.
Steege,J.F.,Metzger,D.A.,Levy, B.S. (1998) Chronic Pelvic Pain: An Integrated Approach. W.B.Saunders,Philadelphia, PA.
Yount,J.J., Solomons, C.C.,Willems, J.J., St. Amand, R.P. (1997) "Effective Nonsurgical Treatments for Vulvar Pain". Women's Health Digest, 3(2),88-93.
February 2003