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“Green smoothie cleanse” causing acute oxalate nephropathy
- gardenfelder 3y ago>Given the increasing popularity of juice cleanses, it is important that both patients and physicians have greater awareness of the potential for acute oxalate nephropathy in susceptible individuals with risk factors such as chronic kidney disease, gastric bypass, and antibiotic use.
- Obscurity4340 3y agoThese people seem to have a profound misunderstanding about how and what cleans up toxins in the body and that there's something you can "take/drink/eat" that will somehow supercede your liver and kidneys to make them pure or something. Its bizarre. In their quest to become "less full of shit" they have become maximally full of shit
- sfn42 3y agoPeople who talk about "toxins in the body" generally don't even know what "toxins in the body" means. It's like people talking about "chemicals" in food. Newsflash, literally all matter is chemicals. Food is 100% chemicals. "But they mean artificial chemicals!" Sure. Except people don't know which ones are "artificial", nor do they know whether these artificial chemicals are more dangerous than their natural counterparts. They're just full of shit. They don't have a clue, they're just parroting shit they read on Instagram or whatever. You want to prove "chemicals" are bad? Pick one specific chemical, do some studies and conclusively prove it's harmful, then say "chemical x is bad". "Chemicals are bad" is just incorrect. Almost none of this shit is based on reality. For the things we know are bad like lead, asbestos, PFAS etc we have solid science and we act on that knowledge by writing legislation to prevent unsafe use. Popular science is like 99% total bullshit. That's why people complain that "scientists change their mind every year". Because the scientists just published some results showing a weak link between chocolate and cancer, then a bunch of bullshit articles popped up saying chocolate cures cancer and then people wonder why they still have cancer after they ate chocolate.
- Obscurity4340 3y agoWhat really drives me insane is the complete crockshittery of the US food pyramid/guide and the obsession with "lite" products. People should realize fat is really good for you as a source of nourishment and satiety and if you suck all of it away, you gotta replace it with even worse garbage to compensate.
- Bostonian 3y agoThe "cleanse" notion is batty. A functioning urinary and excretory system is all the "cleanse" one needs.
- lukev 3y agoI'm sure it makes a lot of people feel better, but almost certainly because of the cessation of whatever dietary behavior was causing them to feel bad in the first place, as opposed to eliminating some undefined "toxin."
- Asooka 3y agoAnd as we can see in this case, most of the toxins that you secrete after a "cleanse" are from the "cleanse" liquid itself! Though to play debil's[0] advocate for a second, the body can retain toxins from the environment, e.g. heavy metals, chemicals from plastics, etc. So there is some basis in the idea of trying to purge toxins, but if you find a way to do that with a smoothie from store bought vegetables, you would be up for at least some kind of prize for advancing our understanding of human biology. [0] https://en.wiktionary.org/wiki/debil https://en.wiktionary.org/wiki/debil
- ryandrake 3y agoWords like toxin, detox, cleanse, and rejuvenation are red-flag words that almost always indicate quackery[1]. It's like this generation's "crystal healing". 1: https://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance https://www.theguardian.com/lifeandstyle/2014/dec/05/detox-m...
- dorfsmay 3y agoFrom what I am reading, this is true for a lot of diets, what you stop eating during your diet often has a bigger impact that what the diet prescribe you to eat.
- Mesopropithecus 3y agoExactly. So when people take"essential oils" or whatever to "detox" - yeah sure, you may feel a difference. But that's probably because that substance you ingested wasn't healthy in the first place and what you're witnessing is your body trying to get rid of it fast.
- atarian 3y agoThis is why I tell people to go easy on the spinach when they’re making smoothies.
- zingababba 3y agoYeah, throwing a bunch of greens into a blender is not a great way to consume them. Boiling/steaming is the way to go. The vast majority of vegetables I personally eat are well cooked and mushy.
- Bluecobra 3y agoI used to make green smoothies all the time, even went as far to by an expensive Blentec blender. If you are following Weight Watchers you actually get penalized for blending/juicing vegetables, so I stopped. Normally these are zero point foods. Their justification makes a lot of sense to me: https://www.weightwatchers.com/au/blog/food/why-fruit-counts-smoothies https://www.weightwatchers.com/au/blog/food/why-fruit-counts...
- whycome 3y agoThe fiber factor probably plays a big role too. Sometimes juicers take that out. Fiber can make you feel full and it may also play a role in rate of sugar absorption.
- crazygringo 3y agoMan, I wish that chewing and food volume would reduce my hunger. The only thing that makes me stop feeling hungry is my blood sugar going back up to a normal level. I'm truly envious if there's actually anybody out there who can eat low-calorie bulky foods and actually feel satisfied by the meal. I just feel bloated but still just as hungry as before eating.
- tomcar288 3y agoi know exactly what you mean. I can eat like 4 LBS of cucumbers in one sitting and still feel like I could eat a pizza afterwards. when you consume super low calorie foods like cucs and tomatoes, zuchinni, the body actually keeps on counting the calories with incredible accuracy and adjusts your hunger/appetite accordingly. But, I'll say, it does help a little bit and you do get a bit of discount by going with low calorie veggies, it's just not a silver bullet. at the end of the day you'll still consume less calories than you would have: just don't expect one large salad to fill you up. at the end of the day, you still need to go hungry to loose weight or keep it off.
- wirelesspotat 3y agoIn the report's keywords it mentions spinach. How much spinach is ok vs too much? Is this issue caused by consuming too much spinach or by consuming spinach in combination with specific foods found in green smoothies?
- KaiserPro 3y agotoo much raw spinach, in combination with gastric bypass and prolonged antibiotic use. The bypass probably doesn't help because you are reducing the time exposed to acid/alkali. The antibiotic also kills off any bacteria that would absorb oxalates.
- gardenfelder 3y agoI would agree with that. A lot of research does talk about both antibiotics and gastric bypass surgery. But, that's only a part of the story. My research continues to uncover ways in which oxalates can cause mayhem. Just consider ordinary kidney stones. Calcium Oxalate. Oxalate damage is not limited to that,or to kidney failure through nephropathy. There is a medium.com piece by a fellow who had calcium oxalate crystals in his hearing canal. To get his hearing back, he had to go on a low oxalate diet. There's a pubmed on such situations [1] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898392/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898392/
- gardenfelder 3y agoWith oxalate nephropathy, I have an oxalate budget of 100/day - 2 oz of dark chocolate covers that. But then, if one is concerned, citrates provide a first-line defense,e.g. 4 oz of lemmon juice, or,say, calcium or potassium citrate. That doesn't stop things, but it helps. In your microbiome, oxalobacter formigenes is the primary defense. Lose that from, say, antibiotics or IBS, and you've got problems.
- gardenfelder 3y agoLet me build on that visit https://elicit.org/ https://elicit.org/ and type in a research question like "what causes oxalate nephropathy" and look at the results (elicit is free). That happens to be where I found the paper linked at the top.
- TazeTSchnitzel 3y agoThis sounds like a Chubbyemu video premise. (It's an excellent YouTube channel that posts semi-dramatised medical educational videos, usually following a fictionalised patient presenting to ER after ingestion of some substance, with an explanation of how that substance causes problems in the body and how a medical team might try to address it.) Actually, there has been more than one video about oxalate nephropathy already, but from more obviously potentially harmful sources (https://youtube.com/watch?v=QJs431FsC_k&t=6m40s https://youtube.com/watch?v=QJs431FsC_k&t=6m40s, https://youtube.com/watch?v=UrbylXMU8Mw&t=7m45s https://youtube.com/watch?v=UrbylXMU8Mw&t=7m45s).
- chihuahua 3y agoIndeed, the video title could be "A man consumed 2 gallons of kale juice. This is what happened to his thyroid." The channel is curious in that Dr Bernard seems to hire actors to produce what looks like stock footage to illustrate the story.
- sockaddr 3y agoYeah I’ve thought that too. He seems to have very good editorial control and access to decent no-name actors. His channel is really great.
- idontwantthis 3y agoI’ve assumed they were his friends, but I have no evidence.
- TazeTSchnitzel 3y agoI've definitely seen a video where he says the actor is a YouTuber friend and links to their channel, so it'd make sense if other videos are also friends?
- tegmark 3y agoim finally doing it. there is this thing where people recommend a youtube channel and laboriously explain what its about and 99.99% of the time its a channel that is insanely famous and known by everyone, requiring no recommendation or explanation. doing this has a negative association because it indicates everyone is oblivious to the world, to the fact that what you watch on youtube is not special.
- yakshaving_jgt 3y agoGiven that this is a case report rather than a study, what confidence can a layman such as myself have that the report suggests causation? Asking in earnest; I don't want to read this and then repeat it to people if it's not really true.
- hackerlight 3y agoI would skip this case study and just research the impacts of too many oxalates.
- stevenwoo 3y agoAlmost every study on that page links a separate case of gastric bypass with later oxalate dietary issues. There are other reasons to be aware of oxalate intake but it’s like that one woman who almost overdosed on raw bok choi (iirc 1-1.5 kg per day https://www.nejm.org/doi/full/10.1056/NEJMc0911005 https://www.nejm.org/doi/full/10.1056/NEJMc0911005) a little moderation in all things.
- stevespang 3y ago[dead]
- atleastoptimal 3y agoOxalates can be balanced out with calcium, that's why cruciferous veggies don't cause as many issues as spinach.
- chrisco255 3y agoNo they can't, as this study shows. The problem is that calcium is bonding to the oxalates. Normally your body will pass them through excretion, but it appears that oxalates in high quantities should be avoided altogether, as they just seem to collect in the kidney. Skip the oxalates and just take the calcium. One is essential and the other is the opposite.
- scq 3y agoAgree about avoiding high quantities of oxalate, but the point of taking calcium is so that the binding occurs in the gut where it can be excreted, rather than the kidneys.
- swader999 3y agoAnd water, drink water and your kidney stone issues fade away fast.
- kalupa 3y ago2017?
- OJFord 3y agoReminds me of 'fruit-only-diet influencer dead at 39'. However 'healthy' an extreme diet seems, in extreme it almost certainly isn't. Yes most people should probably eat more fruit; no they should not eat exclusively fruit. (random source: https://www.telegraph.co.uk/world-news/2023/08/01/zhanna-samsonova-tiktok-instagram-vegan-diet-dies/ https://www.telegraph.co.uk/world-news/2023/08/01/zhanna-sam...)
- TylerE 3y agoThat's wild. The photos on her instagram look like something out of a '90s UNICEF commercial.
- andrelaszlo 3y agoSad story. If she caught a stomach bug and tried to cure it by "dry fasting" I guess it could get dangerous really quickly.
- reilly3000 3y agoRIP Steve Jobs. It was likely his Apple-only diet that did him in. He would go to these orchards in NorCal and disappear for weeks on end, eating only apples the whole time. He tried eating apples aggressively to cure his colon cancer and it appears to have exacerbated it.
- cellularmitosis 3y agoThe lesson from Jobs is not "don't eat too much fruit", it's "listen to your doctors when they tell you to treat your cancer".
- soultrees 3y agoI don’t think that’s a fair judgement. Sure, from the outside the decision to ignore medical advice seems crazy, but in the end it was his decision and he paid for it. Would a billion rounds of chemo have saved him? Maybe, but it’s also likely he would have ended up in the same spot anyways. We are all human, and doctors are just humans that are more well informed about the subject than others but are still human, and in the end it’s all just an experiment to see if this works better than that or that. So I think the lesson should be, if you get cancer then you should be able to finish your days, in your own way if you decide.
- bob1029 3y agoMy system is a 12oz green smoothie every other day. Forcing it into a daily, ritualistic cult is where beneficial health ventures turn to NIH articles.
- nonethewiser 3y agoWhy do you call it a system, rather than a habit or something?
- chihuahua 3y agoMaybe it's like this: 12 oz green smoothie every other day: clever system. 6 oz green smoothie every day: daily ritualistic cult; slow painful death.
- swader999 3y agoI bet the prolonged antibiotic therapy was more of a factor.
- nullc 3y agoOne of the factors in figuring out how safe a particular substance is that there may be gut bacteria, genetic, or other dietary confounders that make something fine for one person but poison for another. A spinach smoothy a day may be good for you but bad for me. A friends father recently had some issues with gout that were requiring some rather obnoxious dietary measures to tame. He found evidence in the literature about some bacteria strains that were found to be effective, found a source for the identified strains, and swears by the result.
- nikolay 3y agoI've been arguing for years with vegans who drink copious amounts for thyroid-damaging kale and kidney-stone-forming spinach juices. Many of the plants are rich in anti-nutrients and natural toxins to weed off predators. Having a normal-size salad is one thing, drinking 2 pounds of kale is something else. People should learn more abou Hormesis and why too much of the bad thing is bad and too little of it is a good thing. Every nutrient and intervention has an optimal range - below and over it turns detrimental to health. Drink too much water and you die from brain swelling; drink too little and you dry from dehydration - everything works around this example although ranges may dynamically vary from day to day. Things are not as simple as we want them to be (for our convenience).
- tomcar288 3y agoFact check: Kale only has 20mg of oxalates per 100g which means 2 lbs has about 180mg of oxalates. https://e-cnr.org/ViewImage.php?Type=TH&aid=487614&id=T9&afn=9994_CNR_4_3_137&fn=cnr-4-137-i009_9994CNR https://e-cnr.org/ViewImage.php?Type=TH&aid=487614&id=T9&afn... 180mg of oxalates isn't that much. Most people consume 200 to 300 mg of oxalates per day: https://www.webmd.com/diet/foods-high-in-oxalates https://www.webmd.com/diet/foods-high-in-oxalates and with regards to water. I believe, it's when you sip on water all day that the danger of brain swelling occurs because your body looses the ability to gauge how much water is in it's system and doesn't quite know how much to excrete. too much of anything isn't good. it's time to start embracing less. it's okay to drink a bit too much water at once because your body can excrete it without problems.
- tomcar288 3y agoThe article says this may only be an issue for those: "susceptible individuals with risk factors such as chronic kidney disease, gastric bypass, and antibiotic use."
- bastawhiz 3y agoI'm gonna go ahead and say that if something is bad enough to kill someone who is somewhat weakened, that doesn't make it fine for folks who aren't weakened. This is an extreme diet and even if it doesn't kill you, it's ridiculous to think it will do you no harm. If you're at risk of death from taking antibiotics because you only eat fruit, the problem isn't the antibiotics.
- tomcar288 3y agoonly eating fruit is not an extreme diet at all, especially if you're consuming the right number of calories. what makes you think it's extreme?
- hnfong 3y agoSugar especially fructose in high amounts isn't great for the body. Modern fruit has been genetically engineered (via selective breeding or other means) to be much more sweet than their wild counterparts, and hence contains much more sugar. Surviving on wild fruit is probably not really that pleasant since most of them don't really taste that great. PS: generally fruit have little protein, so you might also want to find some extra sources of protein too.
- at_a_remove 3y agoI've seen a version of this in person. Used to go to this restaurant after my Saturday morning movie, just to have lunch. This wee gal working there on that shift, usually, noted that I would pull my ticket stub out (along with other things I was planning on pitching) and began to regularly ask me what I thought of whatever movie I had seen. One Saturday I came in and was instantly struck with a kind of floating anxiety, that something was wrong. Well, it smelled like someone who was very, very ill. I see her and her color is all off: pale but for two spots of color. Her respiration is fast, shallow, and her rib cage looks lifted. As in there is a lot of pain on one or both sides above the hips. When I get to the counter, I ask if she's alright trying to play cool about it (inside I am freaking out a bit). She says she's going home in a few hours. And what can I do? I can't finish my lunch, I'm so keyed up because everything is telling me that this is a very sick person. As I leave, I am trying to be casual but again ask if she has someone to come pick her up. She says she'll be fine. She's not there for the next four or five weeks. When she returns, she tells me that she collapsed a couple of hours later and spent a week in the hospital with septicemia from her kidney infection from some obstruction. Apparently kidney stuff runs in her family when they get older. But she's young. I look at her nails, something in the corners. I use my nose again. Because this is kind of a healthy place. Again, trying to be casual, "Hey, do you like spinach?" She proceeds to tell me how she loves spinach and just "grazes" on it constantly at work. "Handfuls," according to her. Because this place throws uncooked spinach leaves on everything. I scribble down on the back of a receipt a note for her to bring to her doctor during followup, because my guess is she just grazed herself into some oxalate stones. Been very wary of spinach since.
- 23kfuhfsdf 3y agoWhat were the nail orners indicative of? How were you able to identify spinach consumption from smell and nails? Was it because there were bits of spinach in her nails and it smelled like raw spinach?
- at_a_remove 3y agoThey had a greenish tinge along the, I don't know the technical term for it, the line between the nail proper and the bed. But she smelled, uh, "leafy?" I have a particularly keen sense of smell and, well ... like fresh green leaves, in a vegetable kind of way. But it was enough for me to make the connection.
- stevebmark 3y agoThis is the most important part > Predisposing factors included a remote history of gastric bypass and recent prolonged antibiotic therapy I knew as soon as I saw it, and the keyword confirms it: a fluoroquinolone, moxifloxacin was used. FQs like cipro and levaquin are well documented to cause permanent full body damage through all sorts of mechanisms. Including acute kidney injury https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708027/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708027/ And the effects are worse for older populations. The diet was likely unrelated to the kidney injury.
- andrewl 3y agoIt could have been the diet, the fluoroquinolone, or both. YC News has a good bit of discussion on the damage fluoroquinolones can do, and it’s worth reading.
- Etrnl_President 3y agoJust add citric acid to buffer that oxalate, you'll pee it right out. Don't overdo any one thing, no matter how healthy. As Paracelsus said; Dosage makes the poison.
- adamtemple 3y agoSerious green eaters know that oxolates are there to make eaters move on from taking out the whole bush. In the same way, if you consume a high amount of greens you have to rotate them.
- sharts 3y agoThat's cool. It's probably still better than knocking down several diet sodies per day (e.g.: https://www.tiktok.com/@tlctv/video/7023764315417120006?lang=en https://www.tiktok.com/@tlctv/video/7023764315417120006?lang...). Even if you're going heavy on juicing or what not, it's important to diversify instead of drinking the same thing for days or weeks at a time. Generally people who run into these problems are the ones taking shortcuts --the same type that'd be doing steroids instead of spending 6-7 years in the gym on a regular basis.
- 1lint 3y agoOn a more general note, a human eating a vegetable is a predatorial relationship, and like any prey, the vegetable will evolve defenses against such predation. Obviously the vegetable can't run away, so it produces compounds that are harmful against its human predators. Artificial selection through farming may reduce the harmful compounds, but constitutes a small fraction of their relevant evolutionary history. On the other hand, we have the opposite relationship with fruits. When our ancestors ate fruits, they played a pivotal role in facilitating the plant's reproductive fitness by dispersing the seeds, at times with the excellent complimentary fertilizer that is human excrement. In this case, the plant has an evolutionary incentive to produce more nutritious fruits to encourage such human consumption. There are a lot of "vegetables" that are actually botanical fruits such cucumbers, zucchini, tomato, etc. (note they all contain seeds). They are much better alternatives than true vegetables (spinach/kale) for juicing if you are trying to avoid sugar or somehow don't like sweet juice. It also doesn't sound right to me to refer to liquified vegetables as "juice", when I've long thought the term refers to the liquid produced from squeezing a fruit (not to mention liquified spinach/kale sounds a bit nasty)
- uslic001 3y agoAs a gastroenterologist I see so many gastrointestinal issues caused by smoothies. They also cause a lot of weight gain as they are usually high in calories. Just eat your fruits and vegetables.
- chihuahua 3y agoThis is very interesting. It's also refreshing to hear about food and nutrition from someone who has observed the effects in practice. Other than the calories, what's the problem with smoothies?
- hnfong 3y ago(I have no medical background) Another problem with smoothies is that they are blended, which speeds up absorption and causes blood sugar to spike. That forces your body to increase production of insulin, and spiky insulin increases the risk of blood sugar issues. If you just eat the fruits and veggies normally, the digestive system has a couple more hours to slowly absorb the calories and nutrients, helps smoothen things out a bit. And if you have to chew and eat the food, you probably end up consuming less of it.
- 6502nerdface 3y ago(2017)