The main function of the gallbladder is for the concentration and storage of bile, which is secreted by the liver. During this concentration process, water is absorbed into the lining of the gallbladder, leaving bile salts and cholesterol to become highly concentrated in the bile. Bile assists in the digestion and absorption of fats and fat-soluble vitamins, and also certain minerals.

Gallstones, known in scientific circles as cholelithiasis, is one of the most common forms of gallbladder disease. If the gallstones form in the absence of infection, they may cause no symptoms whatsoever. If however, they slip into the common bile duct, the passage of bile is interrupted and cholecystitis (inflammation of the gallbladder) can develop. Since the preferred treatment for gallbladder diseases is surgery, diet plays more of a preventative than therapeutic role in management.

Diet can be a causal factor

The precipitation of the cholesterol found naturally in bile to form cholesterol gallstones depends upon the saturation of bile with cholesterol — the higher the rate of synthesis and secretion of cholesterol by the liver the more likely the individual is to have bile that is supersaturated with cholesterol.

Gallstone formation is three to fourfold more common in obese than non-obese people. Weight loss and maintenance of a stable weight is usually associated with a decrease in the saturation of bile.

The high incidence of gallbladder diseases in Western societies has also been linked to a diet that is low in fibre. It may well be that fibre has an advantageous effect on the composition of bile, although it has not been shown to reduce gallstone formation.

Treatment

As far as dietary intervention is concerned, fat restriction plays the most important role in gallstone prevention and management. With an acute attack of cholecystitis, the gallbladder should be kept as inactive as possible. All dietary fats should be omitted as they cause pain by stimulating the sphincter of Oddi, the valve that allows the passage of bile into the intestines. Due to the interrupted passage of bile into the small intestine, fat absorption is impaired and diarrhoea can occur. In the case of chronic (long-term) gall bladder disease, a diet that is low in fat is required. Severe limitation of fat is not recommended since fat in the intestine is important for some gall bladder stimulation and drainage of the biliary tract.

Many people with gallbladder diseases complain of foods they believe to be gas forming. Potential offenders include legumes, broccoli, brussel sprouts, cabbage, cauliflower, onion, corn, cucumbers, avocado pears, apples and melons. It may be worthwhile eliminating these foods if you find that they affect you.

Also, it is always important to eat smaller meals more frequently throughout the day.

Restricting fat in the diet

Most of us have yet to meet sensible dietary recommendations regarding a lowering of fat intake. But with more of a variety of lower-fat food choices available, and a few simple dietary changes, dietary fat intake can be considerably reduced without having to make too many sacrifices.

Here are some tips on how to lower the fat in your diet, looking at specific food groups:
Dairy products
Avoid

  • Full cream milk, full cream yoghurt and full-cream ice-creams
  • Full-cream cheeses or yellow cheeses (such as Cheddar)
    Healthier alternatives
  • Fat-free or low-fat milk or yoghurt and sorbet ice-creams
  • Low-fat and fat-free cheeses (e.g. cottage, mozzarella, ricotta, etc.)

    Meat, fish and Poultry

    Avoid

  • Fatty meat eg mutton, pork, lamb, sausages, ham, bacon, salami, polony, fatty biltong, boerewors (dried or cooked), liver, kidney, meat pies, duck, fried chicken and fried fish
    Healthier alternatives
  • Use low-fat meats like veal, venison, lean mince, grilled/baked fish or skinless chicken breasts.
  • Always trim off all visible fat from meat or chicken before cooking.
  • Remove poultry skin either before or after cooking.
  • Where possible, choose light meat (breast) instead of dark meat (leg, wing, thigh).
  • Rather bake, grill or steam these foods.
  • Keep protein portions relatively small since they are naturally "high" in fat.

    Eggs
    Avoid

  • Eggs that have been fried/scrambled in oil.
    Healthier alternatives
  • Rather poach, boil or else fry/scramble eggs in a non-stick frying pan.

    Starches
    Avoid

  • Commercial biscuits, cakes, pastries, pies, cream crackers, crisps, French fries. Healthier alternatives
  • Opt for naturally low-fat products, such as rice cakes, plain popcorn, baked/boiled potatoes
  • Select high-fibre options wherever possible, such as wholegrain breads and rolls, wholewheat crackers (eg Provita biscuits), low-fat bran muffins, brown rice, etc.

    Fats
    Avoid

  • Full-fat spreads like butter, margarine, lard, mayonnaise and salad dressing. Healthier alternatives
  • Use low-fat versions instead wherever possible.
  • Only use small amounts of low-oil margarines, salad dressings and mayonnaise, since they still do contain fat in them.
  • Bear in mind that olive oil, although a "healthy" fat due to its rich content of monounsaturated fat, is still high in fat, so use sparingly. Vegetables
    Avoid
  • Those that are creamed or fried in butter, margarine or oil Healthier alternatives
  • Rather steam or boil them, as opposed to frying them.
  • Add seasonings, herbs and spices for flavour, instead of fat.

    Sauces and soups
    Avoid

  • Cream-based pasta sauces (e.g. alfredo), white sauces and full-cream cheese sauces.
  • Creamed soups made with full-cream milk, cream or fatty meat.
    Healthier alternatives
  • Go for tomato-based pasta sauces eg neopolitana or arrabiata
  • Use low-fat yoghurt and skim milk powder to thicken white sauces.
  • Have vegetable soups and clear soups instead of cream-based soups.

    Desserts and sweets
    Avoid

  • Chocolate, toffees, pancakes, custard, etc.
    Healthier alternatives
  • Rather opt for jelly, lite custard, boiled sweets, wine gums, jelly babies, marshmallows. These should only be eaten in moderation as part of a healthy, balanced diet, since they are largely "empty" calories.

    Some extra tips on reconsidering the way you cook foods:

  • Red wine or stock can be used to sauté onions instead of oil or butter.
  • Stir-fry, bake, grill or roast food rather than frying.
  • Cook roasted meat or poultry on a wire rack so that the fat can drip off.
  • When preparing rice, noodles, couscous and other grains, season with herbs, spices and broths rather than added fat.
  • Prepare soups, gravies and sauces in advance. Refrigerate and then remove the layer of fat that forms on the top.
  • Herbs — basil, bay leaf, oregano, or rosemary — add distinctive flavours and colours to meat, vegetables and salads.
  • Spices — cinnamon, ginger and nutmeg — enhance the sweet taste of foods.
  • Seasoning blends — chilli powder, curry powder — provide complex flavours.


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