Study links gallstone to rapid weight loss

I heard a researcher on the radio comment on the results of another
study in Sweden. The results indicate that rapid weight loss led to
gallstone problems for many. I think that this is interesting for
several reasons:

- Perhaps low-carbers should not shoot for extreme levels of weight
loss. It will take a while for the body to adjust to a leaner self.
There are obviously risks involved.

- The study did not focus on the method for weight loss. This means
that that it is the weight loss rather than a high-protein diet which
causes gallstones. I believe that Atkins opponents connect LC to these
problems.

- I did not hear any connection with the energy intake in the
interview. My guess is that it hits especially people who achieve
weight loss through calorie restriction. Too little energy may harm
the body.

Thanks.

H.L wrote:
I heard a researcher on the radio comment on the results of another
study in Sweden. The results indicate that rapid weight loss led to
gallstone problems for many. I think that this is interesting for
several reasons:

This basic finding of rapid weight loss and gallstones is several years,
if not decades, old. We had a brief discussin of gallstones here, and I
looked up the subject a bit.

However, I know of several people in my life who had gallstones with no
weight loss, so the phenomena is caused by or affected by more than
merely the weightloss phenomena. There may, in fact, be more than one
kind of gallstone, for all I know, and more than one mechanism for
creating the one or more kinds of gallstones.


- Perhaps low-carbers should not shoot for extreme levels of weight
loss. It will take a while for the body to adjust to a leaner self.
There are obviously risks involved.

It would depend upon how significant rapid weight loss really is in
causing gallstones. For example, perhaps the rate of gallstone problems
is twice as high in people with rapid weight loss. Since the incidence
of gallstones isn't really high, the net real risk of gallstone
formation may be overestimated.

After all, if you listen to all of the dozens and dozens of things that
COULD contribute to heart attacks, you would tend to just lie in bed and
never get up.

This is a consequence of "risk" without quantification.... you can get
paralyzed with just tiny but nevertheless real risk factors.


- The study did not focus on the method for weight loss. This means
that that it is the weight loss rather than a high-protein diet which
causes gallstones. I believe that Atkins opponents connect LC to these
problems.

Yes, Atkins opponents will connect LC to anything they can think of. It
is emotinal, not logical.


- I did not hear any connection with the energy intake in the
interview. My guess is that it hits especially people who achieve
weight loss through calorie restriction. Too little energy may harm
the body.

Thank you for your "guess". We need another unfounded theory to help out.

We do know that zero energy kills the body - starvation.


Thanks.

Jbuch writes:

Yes, Atkins opponents will connect LC to anything they can think
of. It is emotinal, not logical.

At least it's been a while since anyone asked me how I live without
kidneys -- since low carb makes them fall out, you know. Maybe that
particular bit of nonsense has died out.



--
Aaron -- 285/235/200 -- http://aaron.baugher.biz/

"If you hear hoofbeats, you just go ahead and think horsies, not
zebras."

On Feb 7, 6:28 am, Aaron Baugher wrote:
Jbuch writes:
Yes, Atkins opponents will connect LC to anything they can think
of. It is emotinal, not logical.

At least it's been a while since anyone asked me how I live without
kidneys -- since low carb makes them fall out, you know. Maybe that
particular bit of nonsense has died out.

--
Aaron -- 285/235/200 --http://aaron.baugher.biz/

"If you hear hoofbeats, you just go ahead and think horsies, not
zebras."

Rather than discuss some study without any details, here's what a
quick search produces about the Swedish study:

"Abstract Risk factors for the development of gallstones during rapid
weight loss were assessed in 457 subjects who entered a weight control
program (520 kcal/day). Absence of gallstones in these subjects was
documented by ultrasonography prior to entry into the study.
Ultrasonography was performed again at 16 weeks on the subjects who
remained in the study (N=248). The incidence of gallstones by 16 weeks
of rapid weight loss was 10.9% (27/248). Most factors associated with
gallstones in the general population, eg, older age, female gender,
parity, positive family history, etc, were not associated with
gallstones in this population. The risk factors for developing
gallstones included increased initial body mass index [weight (kg)/
height (m)2], amount of body mass index loss, and serum triglyceride
levels. The positive predictive value of these risk factors was 75%,
but the sensitivity was only 12%. These observations indicate that
risk factors for the development of gallstones during rapid weight
loss are probably different from those in the general population. The
factors identified by this study are useful in predicting patients at
high risk for gallstones. However, since only a minority of gallstones
that form can be predicted, further study is needed to identify
additional factors that will improve our ability to predict gallstone
formation."


This study is over a decade old, so it's nothing new. Also, note
that these subjects were on a 520 cal/day diet, which is extreme and
not what those doing Atkins or similar are subject to. It's been
well established that gallstones are strongly associated with being
obese. So, these people were already at higher risk for developing
them. Over 10% of the population has gallstones, so apparently
developing them is not necessarily a great crisis. It seems a bit
strange that in the study they didn't follow up on those that
developed stones, to tell us whether they required any treatment,
etc., which would seem important to know. Also, and most
importantly, I didn't see a control group of similar obese subjects
who lost the same amount of weight, but more slowly. For all we
know, they could have developed the same, or even more stones. And
finally, other studies have shown an association between gallstones
and triglyceride levels. So, since on LC trig decrease dramatically,
it's possible those on LC would have less tendency to develop
gallstones.

On 6 Feb 2007 18:21:13 -0800, H.L wrote:

I heard a researcher on the radio comment on the results of another
study in Sweden. The results indicate that rapid weight loss led to
gallstone problems for many.

Dehydration.

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" wrote:

Rather than discuss some study without any details, here's what a
quick search produces about the Swedish study:

"Abstract Risk factors for the development of gallstones during rapid
weight loss were assessed in 457 subjects who entered a weight control
program (520 kcal/day).

With calories that low, the people had to be doing both low carb
and low fat at the time time. Keep the protein up around 100
grams per day, 400 kcal, leaving only 120 kcal for fat plus carbs.
With all carbs that's 30 grams per day. With all fat that's 15 grams
per day. Running those numbers I doubt they stayed up at 100
grams of protein but no matter how they cut it, these folks were
doing low fat.

The reason I considered this - I've read claims that doing Atkins
triggers gallstones but everyone who's ever reported it that I've
been able to ask reported long history of low fat dieting. The
high fat aspect of Atkins should prevent that formation of gallstones
but could trigger the release of existing ones.

Absence of gallstones in these subjects was
documented by ultrasonography prior to entry into the study.

This to me is very important. If they didn't have existing gallstones
then any that appeared would be new ones. It eliminates the
issue of low carb triggering the release of existing ones.

Ultrasonography was performed again at 16 weeks on the subjects who
remained in the study (N=248). The incidence of gallstones by 16 weeks
of rapid weight loss was 10.9% (27/248). Most factors associated with
gallstones in the general population, eg, older age, female gender,
parity, positive family history, etc, were not associated with
gallstones in this population. The risk factors for developing
gallstones included increased initial body mass index [weight (kg)/
height (m)2], amount of body mass index loss, and serum triglyceride
levels.

Speed of loss goes with formation of stones, in folks on low fat very
low calorie diets. Time to try it on folks following Atkins and on
folks following a popular low fat diet for the next study!

This study is over a decade old, so it's nothing new. Also, note
that these subjects were on a 520 cal/day diet, which is extreme and
not what those doing Atkins or similar are subject to.

Time for that next study.

On Feb 7, 3:34 am, Jbuch wrote:
H.L wrote:

I heard a researcher on the radio comment on the results of another
study in Sweden. The results indicate that rapid weight loss led to
gallstone problems for many. I think that this is interesting for
several reasons:

This basic finding of rapid weight loss and gallstones is several years,
if not decades, old. We had a brief discussin of gallstones here, and I
looked up the subject a bit.

However, I know of several people in my life who had gallstones with no
weight loss, so the phenomena is caused by or affected by more than
merely the weightloss phenomena. There may, in fact, be more than one
kind of gallstone, for all I know, and more than one mechanism for
creating the one or more kinds of gallstones.


- Perhaps low-carbers should not shoot for extreme levels of weight
loss. It will take a while for the body to adjust to a leaner self.
There are obviously risks involved.

It would depend upon how significant rapid weight loss really is in
causing gallstones. For example, perhaps the rate of gallstone problems
is twice as high in people with rapid weight loss. Since the incidence
of gallstones isn't really high, the net real risk of gallstone
formation may be overestimated.

After all, if you listen to all of the dozens and dozens of things that
COULD contribute to heart attacks, you would tend to just lie in bed and
never get up.

This is a consequence of "risk" without quantification.... you can get
paralyzed with just tiny but nevertheless real risk factors.


- The study did not focus on the method for weight loss. This means
that that it is the weight loss rather than a high-protein diet which
causes gallstones. I believe that Atkins opponents connect LC to these
problems.

Yes, Atkins opponents will connect LC to anything they can think of. It
is emotinal, not logical.


- I did not hear any connection with the energy intake in the
interview. My guess is that it hits especially people who achieve
weight loss through calorie restriction. Too little energy may harm
the body.

Thank you for your "guess". We need another unfounded theory to help out.



Well, putting your sarcasm aside, I managed to find a theory
from a Swedish LC doctor. If you keep eating fat, the gall will
need to work by releasing substances often and the risk of developing
a stone is not big. A low fat regime will make it inactive.
The risk is much higher. It is like letting a machine rust.

H.L wrote:
On Feb 7, 3:34 am, Jbuch wrote:

H.L wrote:

I heard a researcher on the radio comment on the results of another
study in Sweden. The results indicate that rapid weight loss led to
gallstone problems for many. I think that this is interesting for
several reasons:

This basic finding of rapid weight loss and gallstones is several years,
if not decades, old. We had a brief discussin of gallstones here, and I
looked up the subject a bit.

However, I know of several people in my life who had gallstones with no
weight loss, so the phenomena is caused by or affected by more than
merely the weightloss phenomena. There may, in fact, be more than one
kind of gallstone, for all I know, and more than one mechanism for
creating the one or more kinds of gallstones.


- Perhaps low-carbers should not shoot for extreme levels of weight
loss. It will take a while for the body to adjust to a leaner self.
There are obviously risks involved.

It would depend upon how significant rapid weight loss really is in
causing gallstones. For example, perhaps the rate of gallstone problems
is twice as high in people with rapid weight loss. Since the incidence
of gallstones isn't really high, the net real risk of gallstone
formation may be overestimated.

After all, if you listen to all of the dozens and dozens of things that
COULD contribute to heart attacks, you would tend to just lie in bed and
never get up.

This is a consequence of "risk" without quantification.... you can get
paralyzed with just tiny but nevertheless real risk factors.


- The study did not focus on the method for weight loss. This means
that that it is the weight loss rather than a high-protein diet which
causes gallstones. I believe that Atkins opponents connect LC to these
problems.

Yes, Atkins opponents will connect LC to anything they can think of. It
is emotinal, not logical.


- I did not hear any connection with the energy intake in the
interview. My guess is that it hits especially people who achieve
weight loss through calorie restriction. Too little energy may harm
the body.

Thank you for your "guess". We need another unfounded theory to help out.




Well, putting your sarcasm aside, I managed to find a theory
from a Swedish LC doctor. If you keep eating fat, the gall will
need to work by releasing substances often and the risk of developing
a stone is not big. A low fat regime will make it inactive.
The risk is much higher. It is like letting a machine rust.



You are still not really helping.

For example, why not give a link to your "findings" so that others can
actually read it for themselves?

If they had a link, they could tell someone else and give them the link too.

Otherwise, it is like the silly game where you whisper a thing to one
person, he or she passes it along, and it gets passed along and after a
while, what is being passed along has nothing to do with what was
actually first said.

My sarcasm was directed at your failure to actually be helpful in giving
people access to the real story.

You just repeated the same failure twice now.

"The risk is much higher" rather than the risk was XXX times higher.

I can believe that you are trying to be helpful. But you could be
actually helpful by giving access to the sources so that others can
actually read the real information.

On Feb 8, 2:35 pm, "Doug Freyburger" wrote:
" wrote:

Rather than discuss some study without any details, here's what a
quick search produces about the Swedish study:

"Abstract Risk factors for the development of gallstones during rapid
weight loss were assessed in 457 subjects who entered a weight control
program (520 kcal/day).

With calories that low, the people had to be doing both low carb
and low fat at the time time.

All we know is the total calorie intake. We have no way of knowing
for sure what the fat/protein/carb mix was period.




Keep the protein up around 100
grams per day, 400 kcal, leaving only 120 kcal for fat plus carbs.
With all carbs that's 30 grams per day. With all fat that's 15 grams
per day. Running those numbers I doubt they stayed up at 100
grams of protein but no matter how they cut it, these folks were
doing low fat.

The reason I considered this - I've read claims that doing Atkins
triggers gallstones but everyone who's ever reported it that I've
been able to ask reported long history of low fat dieting. The
high fat aspect of Atkins should prevent that formation of gallstones
but could trigger the release of existing ones.


Now, there you go again, making outlandish medical statements, as if
it were established fact. What is the basis for this claim that high
fat/LC prevents gallstones, but could trigger release of existing
ones? A simple google search will show that there is some evidence
of risk factors for gallstones. But apparently only you know that
high fat on Atkins will prevent them.




Absence of gallstones in these subjects was
documented by ultrasonography prior to entry into the study.

This to me is very important. If they didn't have existing gallstones
then any that appeared would be new ones. It eliminates the
issue of low carb triggering the release of existing ones.

And more evidence you don't know anything about what you're talking
about. This is the first time I've heard "release", used in
connection with gallstones. AFAIK, gallstones don't suddenly release
and cause a problem. They slowly develop over time and stay in place
unless removed with surgery, drugs or other treatment. Kidney stones
can release and be passed, but gallstones?



Ultrasonography was performed again at 16 weeks on the subjects who
remained in the study (N=248). The incidence of gallstones by 16 weeks
of rapid weight loss was 10.9% (27/248). Most factors associated with
gallstones in the general population, eg, older age, female gender,
parity, positive family history, etc, were not associated with
gallstones in this population. The risk factors for developing
gallstones included increased initial body mass index [weight (kg)/
height (m)2], amount of body mass index loss, and serum triglyceride
levels.

Speed of loss goes with formation of stones, in folks on low fat very
low calorie diets. Time to try it on folks following Atkins and on
folks following a popular low fat diet for the next study!


Again, all we really know is the diet was very low cal. If the diet
was 70% fat, I think in common terms, that would not be called low
fat, as the term is most frequently used to refer to percentage of
diet fat, not absolute amount. And AFAIK, the study hasn't been
duplicated, confirmed, etc. It was done on 200 subjects and there was
no control group to see if others who lost weight slower did not also
develop gallstones. So, I wouldn't take it as established fact.



This study is over a decade old, so it's nothing new. Also, note
that these subjects were on a 520 cal/day diet, which is extreme and
not what those doing Atkins or similar are subject to.

Time for that next study.

Quoting the Swedish text by a doctor at the URL
http://blogg.passagen.se/dahlqvistannika/20051119

Most gallstones are cholesterol stones.

A high intake of carbohydrates causes a high level of blood sugar. A
high level of blood sugar causes a high level of blood
insulin. A high level of blood insulin triggers the formation of
cholesterol in the liver and serves to increase the
amount of cholesterol in the gall.

When you eat plenty of fat a lot of gall is produced in order to break
down the fat in the bowels. The gall travels rapidly through the
gall bladder and the propensity for gallstones is reduced.

A low intake of fat requires less gall to be produced. as there is so
little fat in the bowels.

The gall will then remain longer in the gall bladder. A high amount of
cholesterol in the stationary gall leads to sedimentation
and the generation of gallstones.

Hence a diet regime low in fat and rich in carbohydrates means an
increased risk for the formation of gallstones.

If you already have gallstones in the bladder from a high carbo-low
fat diet, a meal with a high fat content may well
cause problems with the gall, because the release of gall will be
impeded by the existing stones.

The stones may exit through the gall valve unless they are too large.
The attack would then die out after a while. If the
stone is too big it is unable to pass through the gall valve and stays
in the gall bladder. If it clogs the path of the gall
it may be necessary with surgery.

Hence a high carbohydrate intake causes the formation of gallstones,
but fat intake triggers the symptoms.

A person who righfully wants to prevent the disease should eat more
fat and less carbohydrates.

This was found in the pathology textbook by my daughter.