Dietary approaches to gallstones

It’s funny what sticks in your mind sometimes. While a lot of what I learned a medical school has long evaporated from my grey matter, I do remember the dictum often trotted out by my teachers that gallstone sufferers are typically female, forty and fat. The knowledge that gallstones are more common in those carrying excess weight, coupled with the fact that the majority of stones are composed of cholesterol, underpin the traditional advice given to sufferers to eat a diet low in fat. However, despite being well established, new evidence has come to light which suggests that the rationale behind the conventional diet recommended for gallstones is far from rock solid.

At fist glance, it seems to make perfect sense for those wishing to stop or slow the development of cholesterol-composed gallstones to cut back on their intake of supposedly cholesterol-boosting foods such as red meat, eggs and dairy products. However, what is often gets lost in the recommendations regarding dietary control of cholesterol is the fact that great majority of cholesterol in the body does not come directly from the diet, but is made in the liver. One potential stimulus for the production of cholesterol in this organ is the hormone insulin, which is secreted in response to carbohydrates (sugars and starches) in the diet. This means, in theory at least, that it may be an excess of insulin-stimulating carbohydrates, rather than foods rich in fat, that may predispose to gallstone creation.

Evidence for this dietary association has recently come from a study published in July’s edition of the American Journal of Clinical Nutrition (AJCN). This study examined the link between waist size and gallstones risk in almost 30,000 men. Excesses of insulin in the system tend to encourage the deposition of weight around the midriff (so-called abdominal obesity), and increased waist size is believed to be a good guide to a surfeit of insulin in the system. The AJCN study found that compared to men with a waist size of less than or equal to 34 inches, men with a waist size of more than about 40 inches had more than twice the risk of gallstones. Even when overall weight taken into account, this association between waist size and gallstone risk remained.

This study appears to raise some questions about standard anti-gallstone advice. The low-fat diet often recommended for this problem is usually high in carbohydrates such as breakfast cereals, bread, potatoes, rice and pasta – all foods that tend to stimulate considerable quantities of cholesterol-inducing insulin. Accompanying this study in the AJCN was another one which casts further doubt on the effectiveness of low-fat diets in management of gallstones. In it, researchers assessed the relationship between nuts (a high-fat food that is usually regarded as verboten for gallstone sufferers) and gallstone risk in women. Women eating 150 g or more of nuts each week had a 25 per cent reduced risk of gallstones compared to those eating little or no nuts.

The fact that nuts tend to induce very modest amount of insulin (and actually help to lower cholesterol levels in the body) may help to explain their apparent ability to ward off gallstones. In some gallstone sufferers, eating foods rich in fat can cause discomfort as these will tend to cause the gallbladder to contract. However, as long as they do not provoke symptoms, the evidence suggests that nuts are a cracking good food for those seeking to protect themselves from gallstones.

5 Responses to Dietary approaches to gallstones

  1. Christina 28 March 2009 at 12:36 pm #

    This is a great article. I’ll be sure and add more nuts to my family’s diet. I’ve had gallstones and don’t want my daughter or husband to go through the pain I experienced.

  2. Karin 23 October 2009 at 5:14 pm #

    Dr Briffa,

    I’m surprised you don’t mention the apples, olive oil and lemon juice remedy. This actually did work for my husband. He was on an ultra low fat diet when he was diagnosed with gallstones. Neither of us wanted his gallbladder removed and he was willing to try a natural remedy first. I’ve seen several variations. What he did was eat at least 4 apples or pears every day, plus one tablespoon of olive oil mixed with one tablespoon of lemon juice first thing in the morning and right before bed every day. It took about a week for him to pass them. The pain from the stones slowly diminished over the course of the week. He could feel them passing, but they didn’t cause him any pain. I just wanted to share for anyone else who might be interested. Now, by the way, we eat a low carb diet. It’s been over 3 years since he did the remedy and the gallstones have never returned.

  3. Robert White 30 March 2010 at 11:47 pm #

    Very interesting, Dr. Briffa, I didn’t realize carbohydrates could induce even more cholesterol than fatty foods. That will make me re-think a lot of the diet guidelines I had been following for several years since I was diagnosed with gallstones.

    If you have gallstones, I suggest you try any natural methods to get rid of your gallstones and save your gallbladder before you decide to get surgery. Gallbladder surgery does have many complications doctors won’t tell you about. They also will probably not tell you about natural options since it might go against their ‘financial’ judgment.

    In my case, I once had gallstones and severe gallbladder inflammation. All the doctor wanted to do was remove my gallbladder, but I had a feeling there was another way. I searched for a long time for an answer until I eventually come across this very safe, effective natural treatment:

    All I can say is that it worked for me and the pain is completely gone. Good luck whatever you decide to do.

  4. liza 29 February 2012 at 3:06 am #

    Thanks for this advice – I have gall stones and they are getting more and more painful every day – am currently trying the apple juice and oli/lemon detox and am hoping that this will sort it out. So Karin, Robert, I assume that your husband and you Robert both kept your gall bladders and they now work perfectly fine? I keep reading that once you get stones, the gall bladder no longer works and it has to come out…?

  5. Kim 28 May 2012 at 11:03 pm #

    I agree with Dr Briffa – The fruit or fruit juice + oil treatment is all over the internet. Just do a little research, collate the info, and choose ANY ONE OF THEM that looks at all attractive to you and it will probably work. The basic info can be contained in one or two paragraphs. They worked for me. Low fat diets DID NOT work for me – in fact they caused even MORE GB plain. Robert Whites’s is an example of a very high intensity “sell, sell, sell” website you’ve all seen before…. paragraph after paragraph of densely-worded prose which repeats itself over and over – as if something repeated often enough will seep into your mind and become truth. Well, it will if you’re weak and succumb to the sell job. Robert White is just another internet marketing guru who has found a niche. Keep the internet free and avoid this type of website. In the long run patronizing these sites will just keep you uninformed.

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