Department of Urology, New York University and New York Harbor VA Healthcare System, New York, New York.
Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama.
J Ren Nutr. 2022 May;32(3):363-365. doi: 10.1053/j.jrn.2021.03.011. Epub 2021 May 25.
Patients with kidney stones are counseled to eat a diet low in animal protein, sodium, and oxalate and rich in fruits and vegetables, with a modest amount of calcium, usually from dairy products. Restriction of sodium, potassium, and oxalate may also be recommended in patients with chronic kidney disease. Recently, plant-based diets have gained popularity owing to health, environmental, and animal welfare considerations. Our objective was to compare concentrations of ingredients important for kidney stones and chronic kidney disease in popular brands of milk alternatives.
Sodium, calcium, and potassium contents were obtained from nutrition labels. The oxalate content was measured by ion chromatography coupled with mass spectrometry.
The calcium content is highest in macadamia followed by soy, almond, rice, and dairy milk; it is lowest in cashew, hazelnut, and coconut milk. Almond milk has the highest oxalate concentration, followed by cashew, hazelnut, and soy. Coconut and flax milk have undetectable oxalate levels; coconut milk also has comparatively low sodium, calcium, and potassium, while flax milk has the most sodium. Overall, oat milk has the most similar parameters to dairy milk (moderate calcium, potassium and sodium with low oxalate). Rice, macadamia, and soy milk also have similar parameters to dairy milk.
As consumption of plant-based dairy substitutes increases, it is important for healthcare providers and patients with renal conditions to be aware of their nutritional composition. Oat, macadamia, rice, and soy milk compare favorably in terms of kidney stone risk factors with dairy milk, whereas almond and cashew milk have more potential stone risk factors. Coconut milk may be a favorable dairy substitute for patients with chronic kidney disease based on low potassium, sodium, and oxalate. Further study is warranted to determine the effect of plant-based milk alternatives on urine chemistry.
肾结石患者被建议食用低动物蛋白、钠和草酸盐、富含水果和蔬菜的饮食，同时摄入适量的钙，通常来自乳制品。对于慢性肾脏病患者，也可能建议限制钠、钾和草酸盐的摄入。由于健康、环境和动物福利等方面的考虑，近年来植物性饮食越来越受欢迎。我们的目的是比较流行的牛奶替代品品牌中对肾结石和慢性肾脏病有重要影响的成分浓度。
从营养标签中获取钠、钙和钾的含量，通过离子色谱-质谱联用测量草酸盐的含量。
杏仁奶的钙含量最高，其次是大豆、杏仁、大米和牛奶；腰果、榛子和椰奶的钙含量最低。杏仁奶的草酸盐浓度最高，其次是腰果、榛子和大豆。椰奶和亚麻奶的草酸盐含量无法检测到；椰奶的钠、钙和钾含量也相对较低，而亚麻奶的钠含量最高。总的来说，燕麦奶与牛奶的参数最相似（钙、钾和钠适中，草酸盐含量低）。大米、夏威夷果和大豆奶与牛奶的参数也相似。
随着植物性奶制品消费的增加，医疗保健提供者和有肾脏问题的患者了解其营养成分非常重要。与牛奶相比，燕麦、夏威夷果、大米和大豆奶在肾结石风险因素方面具有优势，而杏仁和腰果奶则具有更多的潜在结石风险因素。由于低钾、低钠和低草酸盐，椰奶可能是慢性肾脏病患者的一种有益的奶制品替代品。需要进一步研究以确定植物性奶制品替代物对尿液化学的影响。
