If you are confused about just what that image is to the left of this post, it is a lovely hand crocheted gallbladder complete with stones produced with care by my son (the stones are an equally sick grey). My eleven and ten year old sons are doing anatomy and physiology this year and this charming organ is a part of their felt human body. Nobody ever accused us of being just like everyone else. We do it with style. Or something, at any rate.
Like a lot of people, I had my gallbladder out four years ago. It unfortunately had seen too much abuse before I knew better and it just was no longer possible to keep it. My mother was very, very into soy foods in the 1970s and we ate an enormous amount of soybean oil, soynuts, soybutter, texturized soy protein and other versions through our childhoods. As an adult, I developed symptoms of gallbladder disease which I mistook and misunderstood for years (HERE). When I was pregnant with baby number nine, I started passing stones into my liver and I needed to get it out. My mother, her mother, my mother-in-law and my father-in-law all have had theirs out and it is unfortunate. You can live perfectly well without one and still eat a nutrient dense diet full of healthy fats but it does take some attention to what fats. If you have some stones, your doctor might tell you that changing your diet might make it possible to avoid surgery (which is always best) but often they will tell you to avoid fats, which makes a nutrient dense diet all but impossible and hinders your ability to absorb the vitamins in your food.
This is because the gallbladder stores and releases bile to emulsify and break down fats in your diet and without bile, you would experience too much fat in the intestines which could contribute to diarrhea. You can find out more about how your gallbladder works HERE; notice the appealing green color of the gallbladder in the illustration and look back at Eli's handiwork. Impressive, no? The role of these bile salts in the digestive system is to break down monoglycerides and long chain fatty acids (both are kinds of fats found in animal and plant foods) into smaller, easily worked with pieces. Short and medium chain fatty acids are able to pass directly through the membranes (see HERE). When you eat long chain fatty acids, your body is stimulated to release bile salts and this comes from the gallbladder, which flexes to expel them. Any stones in the gallbladder can either cause irritation or at times actually block the ducts or pass into other organs like the pancreas and liver. To reduce this irritation, doctors often recommend low-fat diets.
While reducing fat overall would obviously reduce the amount of monoglycerides and long chain fatty acids that people are eating, it also has the overall effect of lowering the ability to absorb vitamins, convert vitamin precursors and cause other problems associated with low fat diets as well as preventing the benefits that diets high in proper fats have (see HERE). You can also choose to reduce the amount of monoglycerides and long chain fatty acids that you are eating and instead concentrate on short and medium chain fatty acids. This is what my husband has chosen to do to reduce his risk of gallbladder disease and it is how I eat following a gallbladder removal. Fortunately there are a lot of choices that provide for a healthy diet and won't strain a weakened gallbladder.
Monoglycerides are often used as food additives and as such are readily visible on food labels. Keep an eye out for them as they show up in strange places like chewing gum. As for long chain fatty acids, they are fats found largely in animal foods (see HERE). There are many, many healthful long chain fatty acids, it is just that since they need bile salts, they do put strain on the gallbladder. We have chosen to limit these but not exclude them all completely. It has been, in our unprofessional experience, a matter of finding the proper balance for our own bodies. Butter, beef tallow, mutton tallow are high in stearic acid and palmitic acid which are long chain fatty acids but only in the range of 24%-26% and palm shortening is only 45% palmitic acid (see HERE). We use these oils but not exclusively. Examples of largely long chain fatty acids include safflower oil and soybean oil. We strongly limit safflower oil and completely avoid soybean oil for all the health risks it poses (see more on soy dangers HERE). The most highly utilized fats in our household is coconut oil, which is largely medium chain fatty acids and therefore does not bile salts to process them. If you need ideas on how to use more coconut oil in your diet try this post HERE as well as my coconut oil-honey spread HERE, and you can read about how we treated asthma in our children with coconut oil HERE.
Have you had your gallbladder out? Are you using diet to avoid having it out?