Barbara Burke

Health Options

By Alan Titchenal & Joannie Dobbs

Wednesday, August 18, 1999

Painful stones gall
many U.S. adults

WHAT do some people have in common with Albert Einstein that they wish they didn't? Gallbladder troubles! Apparently Einstein was plagued by gallbladder problems for much of his adult life.

It is estimated that about 12 million women and 4 million men have gallstones. More than 500,000 gallbladders are removed each year, making this operation the most common form of abdominal surgery in the United States. Fortunately, most people can get along just fine without their gallbladder.

The gallbladder is a small balloon-like organ that collects bile produced by the liver. Bile works like a detergent in the intestine, breaking up fat into small particles to facilitate its digestion. The gallbladder's main function is to squirt bile through a small tube (called the bile duct) into the upper intestine. This occurs primarily after consuming a meal that contains fat or protein.

Gallstones are solid lumps that sometimes form in the bile inside the gallbladder. They may cause no problem. However, when a gallstone passes into the bile duct, it can be extremely painful and may even require surgery.

While the cause of gallstones is not clearly understood, a number of factors seem to increase or decrease the risk of developing them. For some reason, gallstones are more common in Caucasians than they are in Blacks or Asians and are more common in women than in men. Getting older increases your risk. About one out of four people over the age of 50 develop gallstones and autopsies indicate that one out of three people over 70 have gallstones. Obesity is another risk factor.

ONE factor in causing gallstones is not using the gallbladder enough. The longer bile sits in the gallbladder, the more concentrated it gets, making it more likely that stones will form. When people fast or go on very low-calorie, low-fat or low-protein diets, there is less stimulus for the gallbladder to contract. Consequently, the bile in the gallbladder becomes more concentrated and the risk of gallstone formation is greatly increased. This problem is one of the arguments against rapid weight loss.

Some of the things that may reduce the risk of getting gallstones may surprise you. One study on men recently published in the Journal of the American Medical Association reported that men who were regular coffee drinkers had a much lower incidence of gallstone disease. Apparently, caffeine stimulates contraction of the gallbladder.

Another surprise, a study conducted in northern Italy found that people who consumed alcohol had a lower risk of developing gallstones than nondrinkers. A second Italian study reported a decreased incidence of gallstones in people who consumed more wine, coffee, fish, and whole meal bread.

Regular aerobic exercise helps to reduce the risk of developing gallstones. It is not known exactly why. But it makes sense since people who exercise more are likely to eat more food more often, helping to keep the gallbladder moving.

In general, vegetarians have a lower incidence of gallstones. This could be due to a number of dietary factors. One theory is that a higher level of antioxidants in the diet can reduce the risk of gallstones. Also, diets higher in dietary fiber may help reduce the risk.

Again there is another reason to exercise and eat more fruits and vegetables.

Alan Titchenal, Ph.D., C.N.S., is a sports nutritionalist in the
Department of Food Service and Human Nutrition,
University of Hawaii-Manoa.

Joannie Dobbs, Ph.D., C.N.S., is a food and nutrition consultant
and owner of Exploring New Concepts, a nutritional consulting firm.
She is also responsible for the nutritional analyses indicated
by an asterisks in this section.

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