Kidney Stones and the Impact of Milo Beverage - Urology

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Regarding kidney stones and Milo beverage?


Hello Doctor, my name is Chuang Jin.
I would like to ask you a question.
My friend has a significant interest in Milo and consumes it almost daily.
Recently, she was diagnosed with kidney stones and hydronephrosis due to abdominal pain and has since been discharged from the hospital.
She needs to return for a follow-up appointment in a few months.

I researched some information about Milo and found that coffee and cocoa contain oxalates, which are not suitable for patients with kidney stones.
Additionally, milk contains calcium, which is also not recommended for these patients.
However, oxalates can bind with calcium to form calcium oxalate.
Is it possible for this compound to be excreted in the feces? Some sources suggest that if oxalate-containing foods are accidentally consumed, it is best to also consume calcium-rich foods.
Is there any danger in this, considering both components significantly affect stone formation?
Here are the nutritional facts for Milo per 100g:
- Energy: 404.0 Kcal
- Fat: 11.7 g
- Trans Fat: 0.0 g
- Saturated Fat: 4.2 g
- Protein: 11.7 g
- Carbohydrates: 67.1 g
- Dietary Fiber: 4.0 g
- Minerals: 4.5 g
- Sodium: 150.0 mg
- Potassium: 775.0 mg
- Phosphorus: 550.0 mg
- Calcium: 520.0 mg
- Magnesium: 170.0 mg
- Iron: 10.5 mg
- Moisture: 2.5 g
- Biotin: 107.0 µg
- Vitamin C: 60.0 mg
- Vitamin B1: 1.1 mg
- Vitamin B2: 1.1 mg
- Vitamin B6: 1.7 mg
- Vitamin B12: 0.9 µg
- Pantothenic Acid (B5): 4.6 mg
- Niacin (B3): 12.8 mg
Ingredients include malt extract, skimmed milk, sugar, cocoa powder, palm oil, magnesium phosphate, vitamin C, disodium hydrogen phosphate, iron pyrophosphate, vanilla extract, niacinamide, calcium pantothenate, vitamins, biotin, and vitamin B12.
I am not well-versed in medical knowledge and cannot provide my friend with appropriate advice.
I would appreciate your guidance, Doctor.
Thank you.

Jin, 10~19 year old female. Ask Date: 2013/10/10

Dr. Li Yilun reply Urology


If oxalic acid binds with calcium in the gastrointestinal tract before absorption, it forms calcium oxalate, which is excreted in the feces.
If oxalic acid is absorbed into the bloodstream, it circulates to the kidneys and is excreted in the urine.
When there is an excess of calcium in the blood, it may also be secreted into the urine, potentially forming calcium oxalate.
At this point, the calcium oxalate in the urine can crystallize, leading to the formation of calcium oxalate stones, which may precipitate in the kidneys.
Therefore, it is recommended that patients with kidney stones avoid excessive intake of foods high in oxalic acid and drink plenty of water to reduce concentration and increase the solubility of the crystals.

Reply Date: 2013/10/10

More Info


When discussing kidney stones and dietary considerations, particularly in relation to beverages like Milo, it's essential to understand the underlying mechanisms of stone formation and the role of various dietary components. Kidney stones, primarily composed of calcium oxalate, can form when there is an imbalance in the substances that make up urine. Factors such as dehydration, high oxalate intake, and insufficient calcium can contribute to stone formation.

Your friend’s interest in Milo, which contains cocoa and milk, raises valid concerns. Cocoa is known to be high in oxalates, which can contribute to the formation of calcium oxalate stones. On the other hand, milk is a good source of calcium, which can bind with oxalates in the gut, potentially reducing the amount of oxalate absorbed into the bloodstream and subsequently excreted in urine. This interaction is crucial because while oxalate can promote stone formation, calcium can help mitigate that risk when consumed together.

The idea that consuming calcium-rich foods alongside oxalate-rich foods can be beneficial is supported by some studies. The calcium in the diet can bind with oxalate in the intestines, forming insoluble calcium oxalate that is excreted in the feces rather than absorbed into the bloodstream. This mechanism can help lower the risk of stone formation. However, it is important to note that excessive calcium intake, especially from supplements, can also increase the risk of stones in some individuals.

Regarding the nutritional content of Milo, it is important to consider the overall dietary context. While Milo contains calcium, it also has a significant amount of carbohydrates and sugars, which may not be ideal for someone with kidney stones. The high sugar content could potentially lead to weight gain and other metabolic issues, which are risk factors for developing stones.

In terms of hydration, it is crucial for individuals with a history of kidney stones to maintain adequate fluid intake. Increased fluid consumption dilutes the urine, reducing the concentration of stone-forming substances. Therefore, while Milo can be enjoyed in moderation, it should not replace water or other hydrating beverages.

For your friend, it would be wise to consult with a healthcare provider or a registered dietitian who specializes in kidney health. They can provide personalized dietary advice based on her specific health needs and the type of kidney stones she has. It’s also important for her to monitor her symptoms and follow up with her healthcare provider as needed.

In summary, while Milo can be part of a balanced diet, it should be consumed with caution by individuals prone to kidney stones. The key is to balance oxalate and calcium intake, ensure adequate hydration, and maintain a diet that supports overall kidney health. Encouraging your friend to focus on a varied diet rich in fruits, vegetables, whole grains, and adequate hydration will be beneficial in managing her condition and preventing future stone formation.

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