Gallbladder removal is the most common elective abdominal surgery in America. Gallstones, just one reason the gallbladder fails, affect 10-15% of Americans, or 20-25 million people. More importantly, why has gallbladder disease risen by 20%+ in the last 30 years?1
In the 1960s, America was told a lie that fat would cause heart disease! Since then, health-conscious folks and food manufacturers have sought to consume and manufacture lower-fat foods. In particular, saturated fat was demonized—the kind found in butter, coconut oil, and meat.
Decades later, on a low-fat diet, heart disease is still the number one killer in America! But low-fat and no-fat diets have had some other severe ramifications on our health: anxiety, depression, gluten intolerance, chronic digestive health concerns, sleep issues, and even autoimmune concerns.10,11
Ground zero for the low-fat lie is in the gallbladder. Don’t worry if you’ve had it taken out—we have a plan for that!
Fat for Bile Sludge
Did you know that a low-fat diet is considered a primary contributor to gallbladder issues?
One study finds that diets containing essentially no fat (1-2g fat per day) result in increased production of cholesterol gallstones. They conclude that a higher-fat diet may result in less gallstones and gallbladder congestion and that at least 10g fat at each meal is needed for the gallbladder to fully empty. Low-fat meals do not force the gallbladder to completely empty, making bile sludge and gallstones more likely.2
The gallbladder is a storage sac for bile made in the liver, storing bile 15-20x more concentrated than the fresh bile the liver produces.3
Logically, one would assume that if we have stored super-concentrated bile, eating a low-fat diet would cause it to congeal, congest, and harden. That is exactly what studies have found.
So, the question begging to be answered is: Why do we need a sac of 15-20x concentrated bile? Why did we evolve to have so much bile, ready to be released at a moment’s notice from the gallbladder?
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As hunter-gatherers and scavengers, we consumed large amounts of fat in one intense sitting. Even though early hunter-gatherers were not great hunters, when they did kill, they ate the entire animal with reverence, respect, and gratitude.
Fatty parts, like brains, organs, and intestines, would go bad quickly, while muscle meat could be dried and reserved for later. If the kill was a woolly mammoth, imagine the amount of fat consumed in that one sitting! To ingest brains and guts of a large grazing mammal, extreme amounts of bile on demand is critical to ensure delivery of fat-soluble vitamins (A, D, E, and K) that were so scarce.
In fact, according to Harvard professor Daniel Lieberman, in his book The Story of the Human Body, hunter-gatherers had a total fat consumption of 20-35% of their diet, with only 8-12% of that being saturated fat.12 Early hunter-gatherers were not great hunters, depending greatly on gathering, but when they did eat animal fat, it was a lot and all in one sitting. It’s hard to believe for some of us, but that was our history: there were no vegetarian hunter-gatherers.
Today, few of us eat a diet requiring so much bile delivered to the small intestines. Even at that time, such a fatty meal was not an everyday occurrence, as is suggested in a ketogenic diet, where 70-80% of calories are fat.
So the liver makes bile on demand, but it takes time to replenish bile, which is why it’s recycled back to the liver and gallbladder from the intestines and can be reused up to 15 times before it is depleted and finally excreted through the bowels.
In this regard, eating a high-fat meal once in a while, or seasonally, makes sense as a way to exercise the gallbladder. Or you can eat a healthy (not ketogenic) amount of fat each meal, which studies say is at least 10g, the minimum amount to fully empty the gallbladder and avoid risk of bile sludge and gallstone formation.1
What Does Bile Do?
As a result of years of low-fat, highly processed vegetable oils, risk of bile sludge, gallstones, and gallbladder concerns increases dramatically.
Think of the bile as a Pac-Man for the body, gobbling up fat-soluble toxins and fatty nutrients, earmarking them for excretion or nutrition. Without delivery of good fats to be used as fuel, we begin to struggle to meet energy demands, leading to fatigue, immune concerns, depression, brain fog, and sleep concerns. We need fat to sleep, as it is the long-lasting energy supply.
Bile is also a regulator of healthy bowel function and a buffer for the stomach’s acid production. With poor bile flow, the stomach is reluctant to make acid it needs to break down hard-to-digest proteins in wheat, grains, beans, nuts, and seeds.
In my book Eat Wheat, I describe underlying digestive issues that can cause us to not digest foods like wheat and dairy. Instead of only removing these foods, I offer a digestive troubleshooting guide to identify digestive issues and correct them with whole foods and herbs.
I have also written many articles on this topic. Learn more here.
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Overview of Bile Functions4
- Scrubs intestinal wall of toxins
- Cleans liver
- Creates regular bowel movements
- Buffers stomach digestive acids
- Stimulates pancreatic enzyme flow
- Digests fats
- Balances blood sugar
- Stabilizes mood
- Detoxes environmental pollutants + chemicals
Exercise Your Gallbladder
If you don’t have a gallbladder, you must still exercise and encourage healthy bile production from your liver directly into the intestinal tract. As mentioned above, make sure you get the right amount of good fat in your diet.
Learn more here.
Beware of Fasting
If not careful, fasting can mimic negative gallbladder effects of a low-fat diet, as they both can inhibit gallbladder contraction. The more the gallbladder sits without regularly contracting and excreting stored bile, the greater risk of bile sludge (thick bile) and gallstones.4-9
USC Longevity scientist Dr. Valter Longo recommends a calorie-restricted, fasting-mimicking diet over fasting because research suggests extended fasting can be problematic for the gallbladder. His fasting-mimicking diet, proven to boost stem cells and autophagy, was almost the exact protocol of the Ayurvedic cleanses we use at LifeSpa, the Short Home Cleanse and the Colorado Cleanse. Our new Kaya Kalpa Cleanse uses the precise calories prescribed by Dr. Longo’s research, while adhering to the most effective form of Ayurvedic cleansing.13
Ayurveda historically recommends a cleansing approach combining calorie restriction with a higher-fat diet to mitigate risk of gallbladder concerns.4-9
At LifeSpa, we use ghee to force the gallbladder into contraction/emptying, while employing calorie restriction with a kitchari monodiet. These cleanses mimic fasting for the beneficial effects (autophagy and stem cell activation), without the potential detriments.
Ayurvedic cleanses adhering to these ancient evidence-based principles are: