Gallstones and Obesity: Why Do They Associate?

Gallstones and obesity are often found together. But why? What drives this association?

KEY POINT: Dietary carbohydrates appear to be able to cause gallstones.

According to the Caloric Balance Hypothesis, obesity arises from what nutritionists call a "positive caloric balance." We overeat and/or lead inactive lives and somehow this causes our bodies to accumulate fat in our fat tissue. This is what we all have been taught. But Caloric Balance provides no mechanism to explain how those "excess calories" somehow make us more vulnerable to developing stones.

The alternative idea, the Lipophilia Hypothesis, gives us a radically different view. It tells us that carbohydrates and insulin "disregulate" our fat tissue; thus, we're driven to overeat calories and/or under burn calories. The fundamental cause is hormonal and physiological.

Lipophilia argues that high carb diets and chronic hyperinsulinemia cause the "diseases of civilizations." So that's why stones and obesity are found together; because they're different manifestations of the same underlying problem.

Let's look at some evidence/arguments to confirm or refute our two theories:

1. Here's a quote from a book called "The Genetic Basis of Common Diseases."

"It is likely that complex carbohydrates, by inducing enterohepatic cycling of bilirubin, may be a factor in black pigment gallstone formation in humans."[1a]

The authors continue:

"Cleave and Campbell (1966) wrote a highly speculative but influential book proposing a "saccharine" hypothesis for many western diseases. Sarles et al. 1969 on the basis of a large Mediterranean cohort suggested that refined carbohydrates are conducive to elevating cholesterol, saturation of bile, and causing stones. Heaton, 1973, proposed a refined carbohydrate hypothesis for cholesterol, cholelithiasis, independent of obesity, which implies a high sucrose white flour diet that was fiber depleted, results which were corroborated in a case controlled study by Scragg et al."[1b]

The article goes on and on like this, discussing experiments which support Lipophilia.

2. Here's a thread from the www.proteinpower.com website:

"A persuasive article in the June issue of Gut, a British Gastroenterology journal, present[s] data on the relation of excess carbohydrate intake in men to the development of galstone disease."[2]

References