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Gallstones, those pesky little rock-like formations, affect a whopping 20% of adults in developed nations (7). Why should we care? Well, gallstone disease is not only a pain in the gut but also the second most economically burdensome disorder of the digestive tract (1). Surgical removal of the gallbladder, the go-to solution, might be low-risk, but it alters your digestive function forever, and that's a pretty big deal (5).
Let's dive deeper into the dietary strategies that can potentially save you from this rocky road.
What are Gallstones?
Imagine little rocks causing chaos in your gallbladder. There are two main types: pigment stones (30%) and cholesterol stones (70%) (6). Pigment stones are the rebels, harder to control due to genetics, infections, or blood disorders. On the flip side, cholesterol stones are mostly about poor cholesterol management by the liver and can be tamed with the right dietary strategies (6).
Why Do We Get Them?
Cholesterol gallstones form when your liver goes on a cholesterol-producing spree, and the bile becomes too thick for comfort. This causes the formation of tiny particles that can grow into full-blown gallstones if your gallbladder isn't emptying properly (7).
There’s two main strategies to prevent this: keep your liver in check and make sure your gallbladder stays active so that the tiny particles get pushed out before they have a chance to grow up into full-blown gallstones.
What Can We Do About It?
Some risk factors are out of our hands (thanks, genetics), but we can flip the script on controllable factors like diet, exercise, and lifestyle (6), (7).
In terms of movement, a little exercise goes a long way in keeping our gallbladders and digestion moving. Even just a short walk daily helps promote regular bowel movements (which helps move cholesterol out of the body, and prevents it from building up in the gallbladder.)
In terms of food, watch out for periods of high-calorie eating, excessive saturated fat intake, and overdoing it on refined carbs. Increase high-fiber foods, vegetable protein-sources, nuts, and vitamin C (7).
Why do these help?
Fiber:
High-fiber foods are the unsung heroes in the battle against gallstones. They decrease the time it takes for things to travel through your gut, reducing backup in the intestines and gallbladder stasis. Fiber also facilitates excess cholesterol excretion through the stool, preventing cholesterol from concentrating in the bile (2). Additionally, fiber lowers the glycemic index and load of foods, a factor associated with a decreased risk of gallbladder removal surgery (3). All types of fiber play a role in reducing gallstone risk, with the most significant effects observed in overweight and obese individuals (2).
Low Saturated Fat:
High intake of saturated fat has been linked to the formation of cholesterol gallstones (3). In general, saturated fats are all those fats that are solid at room temperature. Think meat-fats, high-fat dairy, butter, and tropical oils like coconut and palm. Healthier fat options for gallstone prevention are the monounsaturated or polyunsaturated fats, like oils, olives, avocados, nuts, seeds, or fatty fish.
Vegetable Protein:
Recent studies suggest an inverse association between vegetable protein intake and gallbladder disease risk, particularly in postmenopausal women (a high-risk group for gallstone formation (7)). Choosing vegetable protein over its animal counterpart would also inadvertently increase fiber intake and lower saturated fat intake, thus being a triple-powered strategy to lower your risk (3).
Nuts:
Nuts get a special mention here! These delicious little powerhouses are packed with healthy fats and dietary fiber, have a beneficial effect of blood cholesterol levels, and are recommended to decrease the risk of gallstone occurrence (3).
Vitamin C:
Vitamin C is another gallstone-fighting superhero. Both foods rich in vitamin C and supplemental sources are shown to have beneficial effects, with regular intake of vitamin C supplements has been linked to a reduced prevalence of gallstones (3). Thankfully Vitamin C is one of the cheapest and most readily available over-the-counter supplements, so is an easy one to incorporate, especially if you struggle to get in enough fresh fruits or veggies.
One thing to be aware of with vitamin C is that food processing and packaging largely impacts its vitamin C content, so if you get a tomato that was shipped from another country, sat on a supermarket shelf for a week, and then was brought home to be cooked it into a pasta sauce, there’s likely not much Vitamin C left. That’s why I’m an advocate for supplementation, especially during the winter months where fresh local produce isn’t as accessible.
Fruits and Vegetables:
A systematic review and meta-analysis found that for every 200g per day increment in vegetable and fruit consumption, gallstone risk decreased by 4% and 3%, respectively (4). For reference, 200g is roughly 1 cup of chopped fruits or veg, so bring on the salads and smoothies!
Breaking Down Gallstones: Myth or Reality?
Sadly, the dream of a magical gallstone-dissolving elixir is mostly anecdotal. In holistic nutrition school we learned about a bunch of different supplements and herbs that could be used to “flush out” gallstones, and I was eager to find some evidence to support this. But unfortunately, I couldn’t. To my best knowledge, this is largely anecdotal evidence and is not yet well studied. In situations where small gallstones are discovered and you’re not in pain, I would certainly try the above dietary measures for prevention, as well as some liver-supportive foods such as turmeric, artichoke, and dandelion to support overall liver function. This would hopefully prevent the stones growing before they get expelled. But in acute situations of gallbladder pain, I would have no hesitations to get the surgery. Acute painful episodes usually call for surgery to avoid gallbladder rupture and the need for more invasive procedures down the road.
(If this was you, and you’ve undergone gallbladder removal surgery - don’t worry. Dietary interventions to help optimize digestion without a gallbladder is coming up next!)
Conclusion: Support Your Gut
In the world of gallstones and digestive health, the power to sway the outcome lies in the choices we make daily. By embracing dietary strategies that prioritize your well-being, you're not just preventing gallstones but nurturing a healthier you.
Remember, your gut is at the core of your overall health. If you're on a journey to optimize your digestive well-being and mitigate the risk of complications, I'm here to help. Feel free to reach out with your questions or for a personalized nutrition and supplement plan tailored to your unique needs.
To your health,
Karen
Sources:
(1) Cai, JS., Chen, JH. The Mechanism of Enterohepatic Circulation in the Formation of Gallstone Disease. J Membrane Biol 247, 1067–1082 (2014). https://doi.org/10.1007/s00232-014-9715-3
(2) Tehrani, A.N., Saadati, S., Yari, Z. et al. Dietary fiber intake and risk of gallstone: a case–control study. BMC Gastroenterol 23, 119 (2023). https://doi.org/10.1186/s12876-023-02752-0
(3) del Pozo, Reginald. "Diet and Gallstone." (2023).
(4) Zhang JW, Xiong JP, Xu WY, Sang XT, Huang HC, Bian J, Xu YY, Lu X, Zhao HT. Fruits and vegetables consumption and the risk of gallstone diasease: A systematic review and meta-analysis. Medicine (Baltimore). 2019 Jul;98(28):e16404. doi: 10.1097/MD.0000000000016404. PMID: 31305451; PMCID: PMC6641782.
(5) Xu F, Chen R, Zhang C, Wang H, Ding Z, Yu L, Tian F, Chen W, Zhou Y, Zhai Q. Cholecystectomy Significantly Alters Gut Microbiota Homeostasis and Metabolic Profiles: A Cross-Sectional Study. Nutrients. 2023 Oct 17;15(20):4399. doi: 10.3390/nu15204399. PMID: 37892474; PMCID: PMC10609985.
(6) Iqbal, Muhammad Nouman, et al. "Gallstones: A fundamental clinical review." Int. J. Res. Med. Sci 7 (2019): 2869-2874.
(7) Lalitha, V., et al. "The indispensable role of herbs and other treatment strategies against gallstones." Annals of Phytomedicine 11.2 (2022): 52-64.
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