← OxalateWatch   All posts

Seafood, Mercury, and the Stone Table: A JAMA Study That Adds Context to a Low-Oxalate Protein

2026-08-11 · By Marcus Reed, Content Editor · Dietary reference, not medical advice
Why this matters now: A study published in JAMA Network Open and circulating in the news this week followed 17,294 US adults and found no significant association between seafood consumption — or the blood mercury levels that come with it — and the risk of dying from any cause or from heart disease. The study adds useful context for stone patients, because seafood is one of the cleanest low-oxalate proteins on the stone table, and the mercury worry has kept some patients away from it.

What the Study Found, With Its Date Stated

This is a 2021 study that has resurfaced in the news cycle; the findings are not new, but they remain relevant. Researchers analyzed data from 17,294 adults in the 2003 to 2012 cycles of the US National Health and Nutrition Examination Survey, with mortality records linked through 2015. After adjustment, an increase of one ounce-equivalent of seafood per day was not associated with higher all-cause or cardiovascular mortality — the hazard ratios were 0.84 and 0.89, both with confidence intervals crossing 1.0. Blood mercury levels, comparing the highest to the lowest quartile, were likewise not associated with higher mortality (hazard ratios 0.82 and 0.90). The authors' conclusion: at current low-to-moderate mercury exposure, seafood consumption was not associated with mortality risk.

Two limits belong in the reading. The study is observational, so it shows association rather than proof — and it cannot settle the mercury question for people who eat very large amounts of high-mercury fish. The practical message that survives: for typical US consumption, the seafood-and-mercury worry does not match the mortality data.

Why Seafood Matters on the Stone Table

Seafood is one of the stone diet's best protein groups: fish and shellfish measure zero oxalate, and they provide the animal protein the stone plan counts alongside poultry and eggs. The measured version of the seafood rotation keeps the fish at the protein slot of the plate and watches the two stone-relevant extras: the high-sodium preparations (breaded, battered, and sauce-heavy fish) and the shellfish, which carry the same zero-oxalate column but need the portion eye on their sodium. The mercury worry, per this study's data, does not support skipping seafood at typical consumption levels.

The Seafood Table, Measured

The table below shows the measured values of the common seafood options — the oxalate column is zero across the group, and the measured choices are about preparation and portion.

FoodOxalate (mg)ServingRating
Salmon, baked04 ozSafe
Cod, baked04 ozSafe
Tuna, canned in water03 ozSafe
Tilapia, baked04 ozSafe
Shrimp, cooked03 ozSafe
Crab, cooked03 ozSafe
Breaded fish (high-sodium)01 filletSafe
Oysters, cooked03 ozSafe

The Measured Seafood Week

The stone-safe seafood week is two to three fish servings at the protein slot, prepared plainly — baked, broiled, or grilled — with the lemon and herbs for flavor and the water or milk as the drink. The breaded and fried versions are the sodium items to portion, and the shellfish are fine in the same rotation. The person who has been avoiding fish out of mercury worry has, per this study's data, been avoiding one of the stone plan's cleanest proteins without a mortality-based reason — the measured version brings it back to the plate.

Frequently Asked Questions

Is seafood safe with kidney stones?

Yes — fish and shellfish measure zero oxalate, which makes them among the cleanest proteins on the stone table. The measured choices are the plain preparations; the breaded, fried, and sauce-heavy versions carry the sodium to portion.

Should I worry about mercury in fish?

At typical US consumption levels, the 2021 JAMA study of 17,294 adults found no association between seafood intake or blood mercury and mortality risk. The data do not support avoiding seafood at ordinary amounts; people eating very large quantities of high-mercury fish can follow the FDA's guidance on those specific choices.

What is the best fish for a stone diet?

Salmon, cod, tilapia, and tuna all measure zero oxalate and carry the omega-3s. The measured version is the plain preparation — baked or broiled — with water or milk as the drink, and the breaded or fried versions portioned for their sodium.

The Preparation Question

The seafood question on the stone table is mostly a preparation question: the fish itself measures zero oxalate, and the measured choices are about what happens to it before it reaches the plate. The breaded and fried versions — fish sticks, fried shrimp, battered fillets — carry the sodium and the oil, and the sauce-heavy preparations (the sweet-and-sour, the teriyaki, the cream sauces) add sugar and sodium to a clean protein. The measured version is the plain preparation — baked, broiled, grilled, or poached — with the lemon, the herbs, and the vegetables on the same plate. The canned options fit the same rule: tuna and salmon canned in water are the clean versions, and the oil-packed or flavored versions are the ones to read the label on. The person who cooks the fish plainly has solved the seafood question without a second thought.

The serving rhythm closes the loop: two to three fish servings a week at the protein slot, with the water or milk as the drink and the urine color check as the day's gauge. The seafood rotation is one of the stone plan's easiest, because the oxalate column is zero across the whole group — the measured work is in the preparation, not the choice.

Sources:
Harvard T.H. Chan School of Public Health Oxalate Database (2024); USDA FoodData Central; Sun Y et al., JAMA Network Open 2021 (NHANES 2003-2012, n=17,294) via PubMed All oxalate values are lab-measured via ion chromatography. This page is a dietary reference tool, not medical advice.

See how oxalate values are measured and verified on our data methodology page.

Medical Disclaimer: This site is a dietary reference tool based on published food composition data. It does not provide medical advice, diagnose, or treat any condition. Talk to your doctor or a registered dietitian before changing your diet, especially if you have kidney stones, kidney disease, or other medical conditions.