Sugar, Saturated Fat and Gallbladders

I’ve been reading a lot about diet and disease. The first book I bought for my Kindle was Good Calories, Bad Calories by Gary Taubes. It is a thick book and I’m only about half way through but it has been enlightening.

I am probably too easily swayed by these kinds of books, ones which set out to prove that conventional wisdom is dead wrong. Years ago, before the Oliver Stone movie, I read way too many books about the Kennedy assassination and was convinced that elements of the CIA were involved (something I still find credible). Later I read a book about how the primary hypothesis about AIDS may well be wrong, and was, for a time, convinced. So I know that I need to temper my enthusiasm for this book.

In the last few years, I’ve had a couple of warning signs about my health. Minor problems, but they were the canaries in the coal mine, warning me that if I didn’t get my act together I’m heading towards obesity, heart disease maybe even diabetes. The first warning sign was my sleep apnea, which was diagnosed in 2003 and seemed to coincide with a gain in weight the year before. Then last year, it was my gallbladder. In my video journal, I talked about “food poisoning” in Scottsdale. After a few big restaurant meals, I experienced some rather nasty abdominal pains and nausea.

Finally after a particularly bad episode over Thanksgiving, I went to see the doctor. After an ultrasound, it was confirmed. My gallbladder was full of sludge which it was having trouble expelling into my digestive tract. Although I had no stones, I might eventually. This was not good. It could require surgery. However, he suggested we try another route. He gave me some medicine and told me to cut back on saturated fats and to exercise. We would meet back in a few months and see how I’m doing.

So that brings me to Taubes book. One of Taubes major points in his book is that fats (even saturated fats) are unlikely to be the kind of poison that we are led to believe. That maybe we don’t all need to be obsessed with cholesterol. And that the scientific evidence points towards refined carbohydrates like sugars, white flour and white rice as the main dietary factor in everything from heart disease to appendicitis. He has made a great argument so far that sugar and other refined carbohydrates are unambiguously bad for us. I’m not so convinced by his ambivalence towards saturated fat though.

I have been doing my own research, trying to find scientific studies published online that contain support for these ideas. Today I found this, a study from 90s which tried to identify risks for gallstones. This study did confirm that sugar likely plays a part in gallbladder problems:

A positive association between intake of refined sugars and risk of gallstone formation has been reported consistently. However, a diet rich in refined sugars is usually poor in complex carbohydrates and fiber; therefore, whether refined sugars and fiber have independent effects on gallstone risk remains to be fully clarified. Our findings suggest that refined sugars and fiber from cellulose may have independent effects.

Well what about fats?

The potential etiologic role of other fats has not been investigated thoroughly. Our study found no evidence of a link between polyunsaturated fats and risk of gallstone formation. The limited available evidence on the relation between these fats and gallstone formation is conflicting. The link between monounsaturated fats and risk of gallstone formation has not been investigated. Monounsaturated fats, as all fats, have been shown to have a powerful effect on the rate of gallbladder emptying. However, the effect is different from that of saturated fats because monounsaturated fats increase the ratio of HDL to LDL cholesterol and therefore may have important protective effects against gallstone formation.

Still the news was not so good for saturated fats, especially for men and saturated fats:

Of potential importance was the observed significant interaction in our study between sex and saturated fat intakes with regard to gallstone formation, indicating that the association between saturated fat intake and gallstone formation may be weaker in women than in men and that men in the highest quartile of saturated fat intake may be at greater risk than women.

You can see in this chart that the associated risk of saturated fat is much more significant for men.

The last week, I’ve shifted my diet towards an Atkins style diet. I’m no longer eating the ‘fat free’ versions of foods like yogurt and cottage cheese. I’m eating more meat (fish, turkey and chicken) and I even had a steak the other night. The main thing I’m restricting is sugar and other carbs. My doctor would not be pleased, but it has broken through my weight plateau. I am losing again. Now, I’ve got to pull it back. I don’t want to aggravate my gallbladder again. It has been getting better the last couple of months, and I can’t afford to be sick right now.