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Weight Management and Gallstones

In Health, Healthcare, Medicine on October 26, 2012 at 6:44 am

It is estimated that digestive diseases affect 60 to 70 million people in the United States. Gallbladder disease is one of the more common of these diseases. Experts estimate that as many as 20 million Americans have gallstones.

Most people with gallstones do not know that they have them and experience no symptoms. These people may have painless gallstones, or silent gallstones. Sometimes gallstones cause abdominal or back pain. These are called symptomatic gallstones. In rare cases, gallstones can cause serious health problems. Hundreds of thousands of hospitalizations and operations occur annually as a result of gallstones.

What are gallstones?

Gallstones are clusters of solid material that form in the gallbladder. The most common type is made mostly of cholesterol. Gallstones may occur as one large stone or as many small ones. They vary in size and may be as large as a golf ball or as small as a grain of sand.

Gallstones develop in the gallbladder, a small pear-shaped organ located beneath the liver on the right side of the abdomen. The gallbladder is about 3 inches long and 1 inch wide at its thickest part. It stores and releases bile into the intestine to help digestion.

Bile is a liquid made by the liver. It contains water, cholesterol, bile salts, fats, proteins, and bilirubin (a bile pigment). During digestion, the gallbladder contracts to release bile into the intestine, where the bile salts help to break down fat. Bile also dissolves excess cholesterol.

What causes gallstones to develop?

Illustration of the gallbladder and adjoining organs, the liver, pancreas, and duodenum.

According to researchers, cholesterol gallstones may form in several ways, such as:

When bile contains more cholesterol than it can dissolve.

When there is too much bilirubin or other substance in the bile that causes cholesterol to form hard crystals.
When there are not enough bile salts to break down fat and when the gallbladder does not contract and empty its bile regularly.

 

What are the symptoms of gallstones?

Some common symptoms of gallstones or gallstone attack include:

Severe pain in the upper abdomen that starts suddenly and lasts from 30 minutes to many hours.
Pain under the right shoulder or in the right shoulder blade.
Nausea or vomiting.
Indigestion after eating high-fat foods, such as fried foods or desserts.

Is obesity a risk factor for gallstones?

Obesity is a strong risk factor for gallstones, especially among women. People who are obese are more likely to have gallstones than people who are at a healthy weight. Obesity in adults can be defined using the body mass index (BMI), a tool that measures weight in relation to height. The table below shows how the BMI calculation works. A BMI of 18.5 to 24.9 refers to a healthy weight, a BMI of 25 to 29.9 refers to overweight, and a BMI of 30 or higher refers to obesity.

As BMI increases, the risk for developing gallstones also rises. Studies have shown that risk may triple in women who have a BMI greater than 32 compared to those with a BMI of 24 to 25. The risk may be seven times higher in women with a BMI above 45 than in those with a BMI below 24.

Researchers have found that people who are obese may produce high levels of cholesterol. This leads to the production of bile containing more cholesterol than it can dissolve. When this happens, gallstones can form. People who are obese may also have large gallbladders that do not empty normally or completely. Some studies have shown that men and women who carry fat around their midsections may be at a greater risk for developing gallstones than those who carry fat around their hips and thighs.

Is weight-loss dieting a risk factor for gallstones?

Weight-loss dieting increases the risk of developing gallstones. People who lose a large amount of weight quickly are at greater risk than those who lose weight at a slower pace. Rapid weight loss may also cause silent gallstones (painless gallstones) to become symptomatic. Studies have shown that people who lose more than 3 pounds per week may have a greater risk of developing gallstones than those who lose weight at slower rates.

A very low-calorie diet (VLCD) allows a person who is obese to quickly lose a large amount of weight. VLCDs usually provide about 800 calories per day in food or liquid form, and are followed for 12 to 16 weeks under the supervision of a health care professional. Studies have shown that 10 to 25 percent of people on a VLCD developed gallstones. These gallstones were usually silent—they did not produce any symptoms. About one-third of the dieters who developed gallstones, however, did have symptoms and some of these required gallbladder surgery.

Experts believe weight-loss dieting may cause a shift in the balance of bile salts and cholesterol in the gallbladder. The cholesterol level is increased and the amount of bile salts is decreased. Following a diet too low in fat or going for long periods without eating (skipping breakfast, for example), a common practice among dieters, may also decrease gallbladder contractions. If the gallbladder does not contract often enough to empty out the bile, gallstones may form.

A drug called ursodiol that helps dissolve cholesterol in the bile may help prevent gallstones from developing during rapid weight loss. While ursodiol is not approved by the U.S. Food and Drug Administration (FDA) to prevent gallstones, its “off-label” use (the practice of prescribing medications for periods of time or for conditions not FDA-approved) has been shown to be effective and safe. If rapid weight loss is highly likely, you should consider talking with your health care provider about using ursodiol.

Is weight cycling a risk factor for gallstones?

Weight cycling, or losing and regaining weight repeatedly, may increase the risk of developing gallstones. People who weight cycle—especially with losses and gains of more than 10 pounds—have a higher risk for gallstones than people who lose weight and maintain their weight loss. Additionally, the more weight a person loses and regains during a cycle, the greater the risk of developing gallstones.

Why weight cycling is a risk factor for gallstones is unclear. The rise in cholesterol levels during the weight-loss phase of a weight cycle may be responsible. It is also thought that each cycle increases one’s risk for gallstones. However, further research is required to determine the exact link between weight loss and the risk for gallstones.

Is surgery to treat obesity a risk factor for gallstones?

Gallstones are common among people who undergo bariatric surgery to lose weight. Bariatric surgery to reduce the size of the stomach or bypass parts of the digestive system is a weight-loss method for people who have a BMI above 40. This procedure is also an option for people who have a BMI above 35 with comorbid conditions such as diabetes and high blood pressure. Experts estimate that about one-third of patients who have bariatric surgery develop gallstones. The gallstones usually develop in the first few months after surgery and are symptomatic.

How can I safely lose weight and decrease the risk of gallstones?

You can take several measures to decrease the risk of developing gallstones during weight loss. Losing weight gradually, instead of losing a large amount of weight quickly, lowers your risk. Depending on your starting weight, experts recommend losing weight at the rate of 1/2 to 2 pounds per week. Losing weight at this rate commonly occurs for up to 6 months. After 6 months, weight loss usually declines and weight stabilizes because individuals in lower weight groups use fewer calories (energy). You can also decrease the risk of gallstones associated with weight cycling by aiming for a modest weight loss that you can maintain. Even a loss of 5 to 10 percent of body weight over a period of 6 months or more can improve the health of an adult who is overweight or obese.

Your food choices can also affect your gallstone risk. Experts recommend including some fat in your diet to stimulate gallbladder contracting and emptying. Current recommendations indicate that 20 to 35 percent of your total calories should come from fat. Studies have also shown that diets high in fiber and calcium may reduce the risk of gallstone development.

Finally, regular physical activity is related to a lower risk for gallstones. Aim for approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week to manage your body weight and prevent unhealthy weight gain. To sustain weight loss, engage in at least 60 to 90 minutes of daily moderate-intensity physical activity.

What is the treatment for gallstones?

Silent gallstones are usually left alone and sometimes disappear on their own. Symptomatic gallstones are usually treated. The most common treatment is surgery to remove the gallbladder. This operation is called a cholecystectomy. In other cases, nonsurgical approaches—drugs—are used to dissolve the gallstones. Your health care professional can help determine which option is best for you.

Are the benefits of weight loss greater than the risk of getting gallstones?

Although weight loss increases the risk of developing gallstones, obesity poses an even greater risk. In addition to gallstones, obesity is linked to many serious health problems, including:

type 2 diabetes
high blood pressure
heart disease
stroke
certain types of cancer
sleep apnea (when breathing stops for short periods during sleep)
osteoarthritis (wearing away of the joints)
fatty liver disease
For people who are obese, weight loss can lower the risk of developing some of these illnesses. Even a small weight loss of 10 percent of body weight over a period of 6 months can improve health and lower disease risk. In addition, weight loss may bring other benefits such as better mood, increased energy, and positive self-image.

If you are thinking about starting an eating and physical activity plan to lose weight, talk with your health care professional first. Together, you can discuss various eating and physical activity programs, your medical history, and the benefits and risks of losing weight, including the risk of developing gallstones.

 

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Understanding Heartburn: Day 1

In Health, Healthcare, Medicine on August 30, 2012 at 8:00 am

What is Heartburn/GERD?


Gastroesophageal reflux disease (GERD) is a more serious form of gastroesophageal reflux (GER), which is common. GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux or acid regurgitation, because digestive juices—called acids—rise up with the food. The esophagus is the tube that carries food from the mouth to the stomach. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach.When acid reflux occurs, food or fluid can be tasted in the back of the mouth. When refluxed stomach acid touches the lining of the esophagus it may cause a burning sensation in the chest or throat called heartburn or acid indigestion. Occasional GER is common and does not necessarily mean one has GERD. Persistent reflux that occurs more than twice a week is considered GERD, and it can eventually lead to more serious health problems. People of all ages can have GERD.

50 Ways to Prevent Diabetes

In Health, Healthcare, Medicine on August 14, 2012 at 8:00 am

 

Learn how you can prevent or delay diabetes by losing a small amount of weight by being physically active for 30 minutes, 5 days a week and following a low-fat, reduced calorie meal plan. To get started, use this guide for ideas on moving more, making healthy food choices and tracking your progress.

Small Steps for Big Rewards!

Reduce Portion Sizes

  1. Less on Your Plate, Nate.photo of shrimp dish
  2. Keep meat, poultry and fish portions to about 3 ounces (about the size of a deck of cards).
  3. Try not to snack while cooking or cleaning the kitchen.
  4. Try to eat meals and snacks at regular times every day.
  5. Make sure you eat breakfast everyday.
  6. Use broth and cured meats (smoked turkey and turkey bacon) in small amounts. They are high in sodium. Low sodium broths are available in cans and in powdered form.
  7. Share a single dessert.
  8. When eating out, have a big vegetable salad, then split an entrée with a friend or have the other half wrapped to go.
  9. Stir fry, broil, or bake with non-stick spray or low-sodium broth and cook with less oil and butter.
  10. Drink a glass of water 10 minutes before your meal to take the edge off your hunger.
  11. Make healthy choices at fast food restaurants. Try grilled chicken (remove skin) instead of a cheeseburger. Skip the french fries and choose a salad.
  12. Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).
  13. Eat slowly. It takes 20 minutes for your stomach to send a signal to your brain that you’re full.
  14. Eat a small meal, Lucille.
  15. Teaspoons, salad forks, or child-size utensils may help you take smaller bites and eat less.
  16. You don’t have to cut out the foods you love to eat. Just cut down on your portion size and eat it less often.
  17. Make less food look like more by serving your meal on a salad or breakfast plate.

Move More Each Day

  1. Dance It Away, Faye.woman walking on treadmill
  2. Show your kids the dances you used to do when you were their age.
  3. Turn up the music and jam while doing household chores.
  4. Deliver a message in person to a co-worker instead of e-mailing.
  5. Take the stairs to your office. Or take the stairs as far as you can, and then take the elevator the rest of the way.
  6. Make fewer phone calls. Catch up with friends on a regular basis during a planned walk.
  7. Photo of bowling ball and pinMarch in place while you watch TV.
  8. Park as far away as possible from your favorite store at the mall.
  9. Select a physical activity video from the store or library.
  10. Get off of the bus one stop early and walk the rest of the way home or to work several times a week.

Make Healthy Food Choices

  1. man fixing a saladSnack on a Veggie, Reggie
  2. Try getting one new fruit or vegetable every time you grocery shop.
  3. Low-fat macaroni and cheese can be a main dish. Serve it with your favorite vegetable and a salad.
  4. Try eating foods from other countries. Many dishes contain more vegetables, whole grains and beans and less meat.
  5. Cook with a mix of spices instead of salt.
  6. Find a water bottle you really like (from a church or club event, favorite sports team, etc.) and drink water from it wherever and whenever you can.
  7. Always keep a healthy snack with you, such as fresh fruit, handful of nuts, whole grain crackers.
  8. Choose veggie toppings like spinach, broccoli, and peppers for your pizza.
  9. Try different recipes for baking or broiling meat, chicken and fish.
  10. Try to choose foods with little or no added sugar.
  11. Gradually work your way down from whole milk to 2% milk until you’re drinking and cooking with fat-free (skim) or low-fat milk and milk products.
  12. Eat foods made from whole-grains—such as whole wheat, brown rice, oats, and whole-grain corn—every day. Use whole-grain bread for toast and sandwiches; substitute brown rice for white rice for home-cooked meals and when dining out.
  13. Don’t grocery shop on an empty stomach. Make a list before you go to the store.
  14. Read food labels. Choose foods low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.
  15. Photo of fruits bowlFruits are colorful and make a welcome centerpiece for any table. Enjoy the company of family and friends while sharing a bowl of fruit.
  16. Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a slice of cake. Peel and eat an orange instead of drinking orange juice.
  17. Try keeping a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.

Nurture Your Mind, Body and Soul

  1. Photo of scented candles and oilsYou Can Exhale, Gail.
  2. Don’t try to change your entire way of eating and increasing your physical activity all at once. Try one new activity or food a week.
  3. Find mellow ways to relax—try deep breathing, take an easy paced walk, or enjoy your favorite easy listening music.
  4. Give yourself daily “pampering time.” Honor this time, whether it’s reading a book, taking a long bath, or meditating.
  5. Try not to eat out of boredom or frustration. If you are not hungry, do something else, such as taking a long walk.

Be Creative

  1. Honor your health as your most precious gift.

There are many more ways to prevent or delay diabetes by making healthy food choices and moving

Photo of opened book

more. Discover your own and share them with your family, friends, and neighbors.

 

Weight-loss and Nutrition Myths: Day 15

In Health, Healthcare, Medicine on July 31, 2012 at 8:00 am

 

Myth: Certain foods, like grapefruit, celery, or cabbage soup, can burn fat and make you lose weight.

Fact: No foods can burn fat. Some foods with caffeine may speed up your metabolism (the way your body uses energy, or calories) for a short time, but they do not cause weight loss.

Tip: The best way to lose weight is to cut back on the number of calories you eat and be more physically active.

This ends our series of most common myths on weight-loss and nutrition. Hope you enjoyed it.

 

Weight-loss and Nutrition Myths: Day 12

In Health, Healthcare, Medicine on July 28, 2012 at 8:00 am

 

Myth: Eating red meat is bad for your health and makes it harder to lose weight.
Fact: Eating lean meat in small amounts can be part of a healthy weight-loss plan. Red meat, pork, chicken, and fish contain some cholesterol and saturated fat (the least healthy kind of fat). They also contain healthy nutrients like protein, iron, and zinc.
Tip: Choose cuts of meat that are lower in fat and trim all visible fat. Lower fat meats include pork tenderloin and beef round steak, tenderloin, sirloin tip, flank steak, and extra lean ground beef. Also, pay attention to portion size. Three ounces of meat or poultry is the size of a deck of cards.

 

Weight-loss and Nutrition Myths: Day 9

In Health, Healthcare, Medicine on July 25, 2012 at 8:00 am

 

Myth: Eating after 8 p.m. causes weight gain.
Fact: It does not matter what time of day you eat. It is what and how much you eat and how much physical activity you do during the whole day that determines whether you gain, lose, or maintain your weight. No matter when you eat, your body will store extra calories as fat.
Tip: If you want to have a snack before bedtime, think first about how many calories you have eaten that day. And try to avoid snacking in front of the TV at night—it may be easier to overeat when you are distracted by the television.

 

Weight-loss and Nutrition Myths: Day 7

In Health, Healthcare, Medicine on July 23, 2012 at 8:00 am

 

Myth: Fast foods are always an unhealthy choice and you should not eat them when dieting.

Fact: Fast foods can be part of a healthy weight-loss program with a little bit of know-how.

Tip: Avoid supersized combo meals, or split one with a friend. Sip on water or fat-free milk instead of soda. Choose salads and grilled foods, like a grilled chicken breast sandwich or small hamburger. Try a “fresco” taco (with salsa instead of cheese or sauce) at taco stands. Fried foods, like french fries and fried chicken, are high in fat and calories, so order them only once in a while, order a small portion, or split an order with a friend. Also, use only small amounts of high-fat, high-calorie toppings, like regular mayonnaise, salad dressings, bacon, and cheese.

 

Weight-loss and Nutrition Myths: Day 6

In Health, Healthcare, Medicine on July 22, 2012 at 8:00 am

 

Myth: Low-fat or fat-free means no calories.

Fact: A low-fat or fat-free food is often lower in calories than the same size portion of the full-fat product. But many processed low-fat or fat-free foods have just as many calories as the full-fat versions of the same foods—or even more calories. They may contain added sugar, flour, or starch thickeners to improve flavor and texture after fat is removed. These ingredients add calories.

Tip: Read the Nutrition Facts on a food package to find out how many calories are in a serving. Check the serving size too—it may be less than you are used to eating.

 

Weight-loss and Nutrition Myths: Day 5

In Health, Healthcare, Medicine on July 21, 2012 at 8:00 am

 

Myth: “I can lose weight while eating whatever I want.”

Fact: To lose weight, you need to use more calories than you eat. It is possible to eat any kind of food you want and lose weight. You need to limit the number of calories you eat every day and/or increase your daily physical activity. Portion control is the key. Try eating smaller amounts of food and choosing foods that are low in calories.

Tip: When trying to lose weight, you can still eat your favorite foods—as long as you pay attention to the total number of calories that you eat.

 

Weight-loss and Nutrition Myths: Day 1

In Health, Healthcare, Medicine on July 17, 2012 at 8:00 am

 

Weighing too much may increase your risk for developing many health problems. If you are overweight or obese, you may be at risk for:

  • type 2 diabetes
  • coronary heart disease and stroke
  • metabolic syndrome
  • certain types of cancer
  • sleep apnea
  • osteoarthritis
  • gallbladder disease
  • fatty liver disease
  • pregnancy complications

You may be able to lower your health risks by losing weight, doing regular physical activity, and eating healthfully.

“Lose 30 pounds in 30 days!”
“Eat as much as you want and still lose weight!”
“Try the thigh buster and lose inches fast!”
And so on, and so on. With so many products and weight loss theories out there, it is easy to get confused.

Myth: Fad diets work for permanent weight loss.

The phrases food faddism and fad diet originally referred to idiosyncratic diets and eating patterns that promote short-term weight loss, usually with no concern for long-term weight maintenance, and enjoy temporary popularity. “Fad diet” is a term of popular media, not science

Fact: Fad diets are not the best way to lose weight and keep it off. Fad diets often promise quick weight loss or tell you to cut certain foods out of your diet. You may lose weight at first on one of these diets. But diets that strictly limit calories or food choices are hard to follow. Most people quickly get tired of them and regain any lost weight.

Fad diets may be unhealthy because they may not provide all of the nutrients your body needs. Also, losing weight at a very rapid rate (more than 3 pounds a week after the first couple of weeks) may increase your risk for developing gallstones (clusters of solid material in the gallbladder that can be painful). Diets that provide less than 800 calories per day also could result in heart rhythm abnormalities, which can be fatal.

Tip: Research suggests that losing 1/2 to 2 pounds a week by making healthy food choices, eating moderate portions, and building physical activity into your daily life is the best way to lose weight and keep it off. By adopting healthy eating and physical activity habits, you may also lower your risk for developing type 2 diabetes, heart disease, and high blood pressure.

 

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