Dietary Assessment of Lithogenic Factors in Plant-Based Meat Products

Patients who form kidney stones are typically advised to limit intake of nondairy animal protein. Plant-based meat products may be a processed substitute protein source for these patients and have recently gained popularity because of health concerns, increased retail availability, decreased environmental impact, and meat supply shortages during the COVID-19 pandemic. Despite these perceived benefits and tangential association with whole food plant-based diets, the potential lithogenic risks associated with these products are not well characterized. The U.S. Department of Agriculture database was queried with a sample of plant-based meat products widely available to U.S. consumers. Nutrient profile data were compiled and compared with animal protein data using standardized serving sizes. Primary protein sources were identified using verified ingredient lists. Oxalate content was extrapolated based on dietary data sources. A total 47 plant-based meat products (16 beef, 11 pork, 10 chicken, and 10 seafood) were analyzed. Compared with their respective animal protein, most products contained on average fewer calories (plant-based beef 77%, pork 94%, chicken 86%, and seafood 83%) and less protein (plant-based beef 68%, pork 96%, chicken 53%, and seafood 54%). Most products used soy protein as the primary protein source (55%). Soy-based beef contained the highest average oxalate content (18 mg per serving), whereas soy-based seafood contained the lowest (7 mg). The most common non-soy protein source was pea protein (30%), containing trace amounts of oxalate. Sodium content was higher in most plant-based products overall (72%) and in each category (plant-based beef 109%, pork 128%, chicken 100%, and seafood 148%). Calcium content was higher (plant-based beef 317%, pork 144%, chicken 291%, and seafood 295%) compared with animal protein. Most plant-based meat products consist of protein sources that are, relative to animal protein sources, higher in oxalate, sodium, and calcium. Stone-forming patients should be counseled about the potential lithogenic risk of these processed products.