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Safety Issues
As a widely consumed food, rhubarb is thought to be relatively safe if consumed in moderation. However, the plant contains high levels of oxalic acid, and rhubarb consumption can markedly increase oxalic acid levels in the urine. 1 2 3 This could lead to increased risk of kidney stones , as well as other problems. Rhubarb leaf contains the highest oxalic acid content. The roots and stems contain less oxalic acid, but higher levels of anthraquinones, laxative substances similar to those found in senna or cascara. It is safest to use rhubarb standardized extracts processed to removed oxalic acid.
Contrary to some reports, consumption of rhubarb probably does not impair calcium absorption. 4 Very weak evidence hints that excessive consumption of rhubarb could increase risk of stomach and/or colon cancer. 5 Maximum safe doses in pregnant or nursing women, young children, or people with severe liver or kidney disease have not been established.
References
- Finch AM, Kasidas GP, Rose GA. Urine composition in normal subjects after oral ingestion of oxalate-rich foods. Clin Sci (Lond). 60(4):411-8.
- Vahlensieck EW, Bach D, Hesse A, Strenge A. Epidemiology, Pathogenesis and diagnosis of calcium oxalate urolithiasis. Int Urol Nephrol. 14(4):333-47.
- Massey LK, Roman-Smith H, Sutton RA. Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones. J Am Diet Assoc. 93(8):901-6.
- Goel V, Ooraikul B, Basu TK. Effect of dietary rhubarb stalk fiber on the bioavailability of calcium in rats. Int J Food Sci Nutr. 47(2):159-63.
- Mantani N, Sekiya N, Sakai S, Kogure T, Shimada Y, Terasawa K. Rhubarb use in patients treated with Kampo medicines--a risk for gastric cancer? Yakugaku Zasshi. 122(6):403-5.
