Contrary to popular belief, cholesterol is not bad. In fact, it is essential to many bodily functions and is used in the formation of the membranes of cell walls. It is so necessary that the body has the ability to make its own cholesterol. The liver makes all the cholesterol it needs. Cholesterol is a precursor to all the steroid hormones, and to Vitamin D. It also aids in the process of digestion in that it is used to manufacture bile. However, in spite of cholesterol being essential, high cholesterol levels may lead to numerous health issues. Among the diseases associated with it, the development of cholesterol stones is probably the least concerning, given its relatively low mortality rate. However, stones can be extremely painful and curb your eating habits in a major way.
Gallstones – Pigment Stones and Cholesterol Stones
And yet the prevalence of gallstones could be considered alarming. In the United States alone, the third National Health and Nutrition Examination Survey has estimated that over 30 million men and women have gallstones. It is so typical that up to 20% of Americans are said to develop stones at one point in their lives.
Gallstone formation (also known as cholelithiasis) is a slow and complex process. Various reasons prompt this progression like the presence of abnormally high levels of bilirubin in the body or the accumulation of concentrated bile residue. These events can lead to the development of pigment stones – which account for only a fraction of known gallstones.
In Western populations, cholesterol stones make up about 90–95% of known gallstone cases. This happens when there is an imbalance between the bile salts and cholesterol in the body. As the bile thickens, cholesterol crystals may form through supersaturation, which leads to the development of gallstones. Once the bile fluid turns into sludge, the cells lining the gallbladder will also no longer be able to efficiently absorb fat and cholesterol.
Despite the fact that the bile only has 5% cholesterol under average conditions, about three-fourths of the gallstones diagnosed and removed in the US are formed from cholesterol. There are numerous contributing factors to the formation of cholesterol gallstones but high cholesterol is a common one as well as one that can be modified through lifestyle changes including diet and exercise, among others.
High Cholesterol and Gallstone
There are conflicting studies about whether or not overeating of cholesterol in the diet plays a role in the formation of cholesterol stones. Rather, the issue seems to be more of a malfunction in the reabsorption of cholesterol from the small intestine. However, when that defect is already present, dietary cholesterol then becomes a contributor as well.
A recently concluded study found in the Journal of Biochemical and Molecular Toxicology also supported earlier findings about the connection between high cholesterol and gallstones. The paper explained that excessive cholesterol may lead to cholestasis which is basically a stagnation of bile flow. This condition is also associated with hypercholesterolemia (high cholesterol in the blood) which is a precursor for gallstone formation.
In another review about the role of diet in cholesterol gallstone formation, it was hypothesized that there are three major factors contributing to the formation of gallstones. These are:
- gallbladder dysmotility
- cholesterol supersaturation of the bile and
- crystallization of cholesterol
When they compared the bile acids and phospholipids of gallstone patients and those with healthy gallbladders, they found that there is indeed a significantly higher concentration of cholesterol in those with the disease.
However, other studies showed that higher bilirubin (the breakdown products of old red blood cells) was more significant than high cholesterol in the formation of stones.
So how does all this translate to practical life? I would say the most important takeaway would be this:
⦁ If you have both high cholesterol and you have cholesterol stones, then dietary fat intake is something to be concerned with. However, this applies to fried foods or trans fats, saturated fats such as red meats, hydrogenated and partially hydrogenated fats, and sugars (which get stored as fat). Eating healthy fats like omega-3 fish oils and moderate amounts of olive oil could actually help.
⦁ Eat a minimum of 1-2 cups of fresh, organic vegetables with every meal. Eat fresh, organic fruit daily. The fiber in these foods helps to reduce cholesterol in the blood. The good news here is that if you’re following your gallbladder diet, you are already doing this.
⦁ When moderate exercise is added to the above changes in diet, the bad cholesterol levels (LDL) drop, and the good cholesterol (HDL) levels which help to remove the bad, rise. Translation? Get off the couch and get some exercise!
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