The Truth About Gallstones: Prevention, Treatment

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Q. I just found out I have gallstones. Should I be following a special diet?

A. That depends. Gallstones are solid clumps of mostly cholesterol that form in the gallbladder, which stores and releases bile into the intestine to aid digestion. Gallstones can be as small as a grain of sand or as big as a golf ball. Most are asymptomatic, so-called "silent" gallstones, and require no treatment.

Diet Rx. Roughly 20% to 40% of gallstone sufferers have symptomatic stones and need to cut back on fat in order to prevent discomfort or pain. Eating fat-containing foods signals the gallbladder to contract. Depending on the size of the stones, these contractions may bring on pain.

But the traditional "one-size-fitsall" 40-gram-a-day fat diet is difficult to follow and doesn't account for differences in calorie needs and body size. Leslie Bonci, M.P.H., R.D., spokesperson for the American Dietetic Association, advocates an individualized eating plan with 25% of calories from fat. In addition, most people find they tolerate small, frequent meals better than two or three large ones. If these diet strategies don't help, consult your doctor; surgery may be indicated.

Historically, a low-fat diet has also been prescribed after having a gallbladder removed. Now, doctors generally give the green light to resume a normal diet within a month.

What causes gallstones in the first place? Several theories exist.

Link to Overweight. Several studies have shown that obese women have at least twice the risk of gallstones as lean women. However, crash dieting is not a solution. In fact, it may be part of the problem. Going for long periods without eating and skipping breakfast-practices common among dieters--decreases gallbladder contractions. If the organ doesn't contract often enough to empty out bile, then stones can form.

Link to Vitamin C. Not getting enough vitamin C may also predispose you to gallstones. Research shows that women with high blood levels of vitamin C have less gallbladder disease than women with lower levels. Vitamin C helps break down cholesterol into bile acids for excretion, making them unavailable to form stones. Eating lots of C-rich fruits and vegetables should, then, help protect against gallstones.

Web Finds www.Justmove.org
This web site, sponsored by the American Heart Association, offers no-nonsense practical information on how to get and stay active, especially if you've had or are at risk for a heart attack or stroke. In addition to covering the basics like target heart rate, a calorie-burning activity chart and nutrition information, it also provides a personalized exercise diary, discussion forums and all the latest news on fitness and health.

www.encarta.msn.com
Looking for a back-to-basics primer on nutrition? Check out Encarta's encyclopedia site and type in "human nutrition." In addition to providing links to more specific nutrition topics, you'll get a refresher course on proteins, fats, carbs, vitamins and minerals, plus explanations of the Recommended Dietary Allowances and the Food Guide Pyramid.

Write to us if you have a question. We'll answer those of most interest to our readers. We regret, however, that we cannot personally respond. Send to:

Environmental Nutrition, Inc. 52 Riverside Drive, Suite 15-A New York, NY 10024-6599

fax: (212) 362-2066

e-mail: envnutr@compuserve.com

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