Ketogenic Diet And Gallstones
Many of you who are not judgmental are hesitant to go low-carb or ketogenic again. I’m not trying to persuade you, but hopefully, you’ll read some more information and have some more basis for judgment. Today, let’s discuss the relationship between the ketogenic diet and gallstones.
How Do Gallstones Form?
Gallstones are a condition in which stones occur anywhere in the biliary system, including the gallbladder and bile ducts.
Depending on where they occur, they can be categorized as gallbladder stones, extrahepatic bile duct stones intrahepatic bile duct stones, or a combination of these, with gallbladder stones accounting for about half of all stones.
Repeated stimulation of stones can cause inflammation and bile duct obstruction, resulting in abdominal pain, fever, jaundice, vomiting, and other symptoms, and in severe cases, infectious shock, which is life-threatening. To understand the “stone”, let’s review the knowledge about these body organs.
→ Gallbladder
It is a “warehouse” in the body that stores bile, which is produced in the liver and transported to the gallbladder through the bile duct.
→ Liver
The liver is responsible for the production of bile, which is then stored by the gallbladder.
→ What does the gallbladder store bile for?
○ To break down fatty acids
○ Helps absorb fat-soluble vitamins (A, D, E, K1, K2)
○ Helps stabilize blood sugar
○ Suppresses bacterial overgrowth
○ Remove toxic waste from the liver
→ The gallbladder serves 2 main purposes
○ Stores bile and can be called upon at any time, similar to a storehouse for bile.
○ Concentrates bile, bile in the gallbladder maybe 20 times more concentrated, more efficient bile
→ Why do we have gallstones?
This is a very complex question and many conditions can raise the risk of gallstones, such as:
High Blood Sugar: it causes stress and inflammation in the liver, increases the amount of cholesterol in the bile, and causes it to become sticky, and some studies have found that a diet high in sugar and carbon greatly increases the risk of gallstones.
Excessive Estrogen Production: or ingesting foods or medications (birth control pills, etc.) that contain too much estrogen can also cause cholesterol levels to rise, raising the risk of gallstones.
Chronic High Pressure: if you are unable to relax, it reduces the production of digestive juices in the body, the body may become dehydrated, and under high pressure, we use a lot of major electrolytes, which may lead to more viscous bile.
Obesity: in general, fat people have more viscous cholesterol and slower bile peristalsis, which can greatly increase the risk of gallstones.
Rapid Weight Loss: also increases the amount of cholesterol in the gallbladder. Many studies have found that rapid weight loss greatly increases the risk of gallstones, and people who often go through dieting and overeating are also at a very high risk of developing gallstones.
→ Low-fat diets, the main cause of gallstones
This should be one of the most important reasons. First of all, I want to understand that bile is a lime-colored liquid made by the liver from cholesterol and bilirubin, a substance produced by the breakdown of red blood cells.
Bile consists mainly of water, bile salts, bilirubin, and various minerals and has several important functions in the digestive process. One of the main tasks of bile is to break down large fat molecules into smaller fat particles, making fats easier to digest and absorb.
When consumed food reaches the upper gastrointestinal tract (about 30 minutes after eating), fat-sensitive hormones called cholecystokinins (CCK) stimulate the gallbladder to empty bile into the digestive tract.
The amount of bile excreted is determined by the amount of fat consumed. If the fat intake is low, CCK signaling will be weak and the gallbladder will not empty the bile. If the fat content is high, the CCK signal will be strong, the gallbladder will contract strongly and dump its bile load completely into the upper GI tract.
Note that when fat is eaten in low amounts, the gallbladder will not completely empty after each meal, bile will not be peristaltic, bile salts will precipitate out of solution, and stones will slowly form.
In addition, if there is a lack of bile in the digestive tract, it interferes with the body’s feedback loop to control proper blood levels of triglycerides and cholesterol, and may also cause the liver to produce abnormal, sludgy, or thick bile (bile) for example, an imbalance of cholesterol and bile salts, which is another factor in stone formation.
→ Research on the relationship between low-fat diets and gallstones
Abroad, there are a lot of specialized studies on ‘low-fat diet and gallstones’, as well as comparisons between low-fat and medium-fat diets.
Related studies are analyzed:
Study 1: 51 subjects, who had no gallstones by ultrasound before participating in the study, were asked to go on a low-fat diet (one gram per day) after.
The results of the study showed that after 1 month, 4 individuals were examined for gallstones. After 2 months, 13 individuals (a quarter) were examined for gallstones. Finally, three subjects had to be asked to have their gallbladders removed.
Study 2: 19 subjects on an ultra-low-fat diet for 16 weeks. The results of the study showed that new gallstones were found in five individuals (one quarter).
Study 3: Controlled study, low-fat diet versus medium-fat diet for three months.
The results of the study showed that in the low-fat diet group: out of 11 people, 6 people (more than half) had new gallstones. In the medium-fat diet group, no one had new gallstones.
There have also been studies that have found that a high-carb diet also raises the risk of gallstones. If you’re on a high-carb, low-fat diet, your chances of getting gallstones are very high, which is why many older people are now more likely to get gallstones.
Of course, doctors still recommend a low-fat diet for gallstone patients because as soon as you eat fat, it may cause bile peristalsis and the stones to move, leading to pain.
→ Low-carb, high-fat diets to drain gallstones
Many people on a high-fat diet experience pain, but, because of bile peristalsis, helps eliminate gallstones. The survey found that many people were previously on a high-carbon, low-fat diet, which led to gallstones. Later, after slowly restructuring their diets to a high-fat diet, the gallstone problem disappeared in many people, but the process was accompanied by some pain.
145 patients with previous gallstones participated in this survey after trying a high-fat diet:
68% surprisingly found that their gallstones disappeared, 17% were cured, and 12% of those whose gallstones improved, did not experience any improvement
Although not much-targeted research was found, this survey more or less gives some data to support that a low-carb high-fat diet can even expel gallstones, and in fact, there is evidence to suggest that a high-fat diet is a better choice for preventing gallstones.
High-fat diet to reduce gallstone formation
In 1998, a team of experts conducted a trial, the main purpose of this study, was to evaluate the long-term effects of 2 different fat-content diets (low-calorie), on gallbladder emptying and gallstone formation in obese subjects.
After six months, 22 subjects ended the study, 11 in each group, and all subjects achieved significant weight loss. However, gallstones developed in 6 (54.4%) of the lower-fat diet group, but none of the 11 in the higher-fat diet group were found to have stones.
In the first 3 months of dieters (the very low-calorie phase), the high-fat meals always resulted in a higher degree of gallbladder emptying and an initially higher and then lower cholesterol index than in the low-fat diet group, with no difference between the two groups.
Conclusion of the study: In obese people who lose weight rapidly through very low-calorie diets, higher fat intake may prevent gallstones from forming.
Gallstones form from cholesterol and bilirubin, not dietary fat, mainly because cholesterol has not been sufficiently broken down by the body. However, most of the cholesterol in the body is produced by the body, not from dietary sources, and it is common medical knowledge that dietary cholesterol has little to do with cholesterol levels in the body, as many of you know.
The production of gallstones is related to the body’s ability to mobilize cholesterol from the liver. Eating fat prompts the body to release bile, which is a function of the gallbladder. If bile is not released on a regular or efficient basis, it can lead to stone formation, making fat intake very important for maintaining a healthy gallbladder and liver.
If you have a slow metabolism (hypothyroidism) or have digestive problems (constipation, diarrhea, farting, acid reflux, etc.), then your body may also have difficulty digesting the food you eat.
Better Digestion and Reduced Risk of Gallstones
→ Apple cider vinegar, which breaks down hardened gallstones
Containing malic acid, which helps soften and eventually dissolve stones, if you have indigestion and find that taking apple cider vinegar makes your stomach feel better, then you may have a problem with your gallbladder. Taking 1-2 tablespoons of apple cider vinegar several times a day can help soften stones.
→ Lemon juice can help dissolve gallstones
→ Drinking water ensures that there is enough fluid in your body to store the bile in your gallbladder
→ Supplementation with the mineral “magnesium”
It can prolong the time food stays in the body, and one study found that there may be a link between magnesium deficiency and gallstones.
→ Supplementation with bovine bile salts and protein digestive enzymes
Helps the body produce enough acid to digest fats and proteins, plus it encourages the body to produce enough bile to speed up the breakdown of food. A high-fat diet that doesn’t metabolize much fat at first may require supplementation of these to train the body to break down fat more efficiently.
→ After a meal, walk appropriately
When people are in a kind of curled position, the intra-abdominal pressure increases, gastrointestinal peristalsis is limited, not conducive to the digestion and absorption of food and bile excretion, sedentary after meals will also affect the reabsorption of bile acids, bile in the ratio of cholesterol to bile acids is out of proportion, cholesterol is easy to be deposited down.
When you have gallstones, do not deliberately eat less fat, gradually begin to increase fat, or normal moderate fat diet, and slowly mobilize the bile peristalsis, you may not have new gallstones formation. Also, as fat intake gets higher, the bile flow gets faster and the bile gets clearer. If lucky enough, those old gallstones may be expelled.