hi Nicola,
Don't know if you had the chance to read my reply to your previous post about CCL and stalling (?) ... I'll try to address the gallstone problem here, though ..
First, obesity itself is a risk factor, as you know. Also,
rapid weight loss can aggravate an already present gallbladder disease, usually from very low calorie, lowFAT diets. I have heard anecdotally that extremely lowFAT dieting (less than 20% of total calories from fat) will trigger gallstones --- in fact, two of my nursing colleagues who lost over 50 lbs. each developed gallstones requiring surgery within 6 months of losing their weight on a lowfat diet.
Here's what happens - the gallbladder is basically just a storage receptacle for bile, which is produced in the liver. When fat is eaten and reaches the small intestine, the gallbladder responds by contracting -- "squirting" the bile through the bile duct into the intestine to digest the fat. It's estimated that nearly 40% of us have some gallstones, but they're so tiny that they're easily flushed out with the force of the contraction or "squirt". If the diet is very low FAT, not a lot of bile is required, and the gallbag doesn't have to contract very much. This allows the acids, sterols and minerals in the bile to "pool", thus providing opportunity for the tiny, microscopic debris to accumulate and form into bigger stones. And then one day, some fat is eaten and the gallbladder tries to contract, and it can't because there's a stone lodged in there somewhere, and YEOWWWCH, pain results. Or worse scenario, the stone is freed and gets squirted into the bile duct, which then becomes blocked, and even more Pain & Agony results, as well as the risk of the bile duct rupturing, which is very serious indeed!
Now, I'm not a doctor, just a nurse, so you need to follow your physicians advice. But some general recommendations are -
- Lose your weight gradually and steadily; aim for losses of no more than 1 or 2 lbs a week. In other words, keep to the upper limits of your CCL.
- Eat some fat. The best thing would be to eat smaller meals, more frequently, to avoid a big load on the gallbladder. Try to avoid meals and snacks that are just carb only -- ie, have some meat or cheese with your lowcarb fruit, or some full-fat yogurt (sugar-free, of course). If you choose to eat lowcarb muffins, bread and the like, ALWAYS eat it with some fat-containing protein. If you eat a meal or snack without some fat in it, the gallbladder won't contract and flush itself out.
- Your query about avoiding saturated fat is a good one. It would be better to eat less animal fat overall, choosing fish, fowl, eggs, tofu, etc more often, and red meats, cheese and cream less often. However, adding essential Omega-3 fatty acids in the form of flax or fish oils would be beneficial, and in my opinion, therapeutic for inhibiting the production of gallstones. Also olive oil, avocados, and nuts (but not peanuts, which are a legume) are highest in monounsaturates, which will have a beneficial effect on bile and cholesterol production.
On the subject of insulin-response triggered by eating artificially sweetened "legal" treats, I believe the Hellers have some comments in their "Carbohydrate Addicts" books. I think the response is indirect, in that eating a sweet-tasting food causes certain EMOTIONAL triggers, which lead to surges in neuro-hormones like serotonin, endorphins, etc..... and this sets up a cascade of physical events in the body -- like an adrenalin "rush", and this is what stimulates insulin.
Anyway, hope this helps ..
Doreen