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  #196   ^
Old Sat, Nov-20-10, 18:05
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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'YOU assert that if the diet didn't work, people wouldn't go. If the diet didn't work, how would people know?'

Ahh, if Atkins is successful, how do people know?
If you are going to argue about success, about a publicly-traded company, and you're still wondering whether people know that the diet doesn't work, even while the memberships continue, then I'm wondering what you need.
You seem to see a circular argument in the only diet I know in this discussion that actually has a stock price that goes up and down. The memberships fuel the stock price. Sure, the products do too, but the competition from other diet food makers is fairly fierce. It would be difficult to PROVE anything to you about a successful company because you don't accept stock prices, memberships, product sales, book sales, as being as meaningful as - well, there's nothing comparable out there.
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  #197   ^
Old Sat, Nov-20-10, 18:09
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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'How about you let me know when you're done so I can stick all your posts back together again?'

It's easy enough for you to do if it makes it easier for YOU to read them. I'll let you know. I know, I know, you said don't bother letting you know when I've finished with all your ripostes. But you're being too nice. I'll let you know.
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  #198   ^
Old Sat, Nov-20-10, 18:11
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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OK, done!
I'm letting you know so you can start putting them all together, right?
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  #199   ^
Old Sat, Nov-20-10, 20:25
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Valtor Valtor is offline
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Plan: VLC 4 days a week
Stats: 337/258/200 Male 6' 1"
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This thread has some of the most massive wall of texts I ever encountered on a forum. Barely readable!
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  #200   ^
Old Sat, Nov-20-10, 21:08
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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A wall of text!
Good description...
Think graffiti!
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  #201   ^
Old Sun, Nov-21-10, 06:41
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C.Syfert C.Syfert is offline
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Plan: Atkins-Phase 2 OWL
Stats: 230/172.2/140 Female 63
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Quote:
Originally Posted by Valtor
This thread has some of the most massive wall of texts I ever encountered on a forum. Barely readable!

I find it funny how much time some seem to have on their hands!
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  #202   ^
Old Mon, Nov-22-10, 08:58
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Wifezilla Wifezilla is offline
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Posts: 4,367
 
Plan: I'm a Barry Girl
Stats: 250/208/190 Female 72
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Quote:
You think that WW caused your mom to lose her gall bladder?
It's a fact confirmed by her doctor. Low fat intake causes the gall bladder to get, to put it simply, clogged with sludge.

"The gallbladder collects bile fluid but does not discharge it all when a low-fat diet is eaten. This bile fluid stagnates causing the formation of gallstones from the precipitates. The gallstones get large enough to plug the discharge of the gallbladder bile duct. A single meal of fatty food can set off a gallbladder attack when the gallbladder attempts to discharge its contents including the stone or stones. Doctors generally remove the gallbladder rather than attempting to remove the stones. The common bile duct at the junction of the liver bile duct and the gallbladder bile duct cannot be removed when plugged; therefore, the stone must be removed.

A high-fat diet prevents gallbladder disease by causing the gallbladder to discharge the bile fluids for the digestion of the fats. The system remains healthy on the high-fat diet. Gallbladder disease has become epidemic as more people have switched to the low-fat diet during the last 40 years."
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  #203   ^
Old Mon, Nov-22-10, 10:55
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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If WW caused your mom to lose her gallbladder and she has documentation to prove it, Wifezilla, then I'm all in favor of suing the company that dispenses such gallbladder-destroying information. Any lawyer who has that case will make a lot of money from the damages awarded to your mother.

She absolutely should sue, with her solid case. People sue for much, much less.

If she's not the type to want to sue, I can understand that. However, it is the ONE way that any diet plan has its metaphorical feet held to the fire, as the Atkins company found out when they were sued. You get your chance to prove that surely this diet caused this health problem - and would pose this health problem to anyone who followed this diet - or at least, people should be screened for risk factors before following this diet. Which is excellent, useful public information.

Any good lawyer would jump at the chance to present the case. On a contingency basis, the fees he would make would have people lining up to take the case!

I encourage it. I may be skeptical, but there's no one more skeptical than a jury. In a case where people are dealing with health issues that 'hit close to home,' and jurors are people who have dieted and go on diets, the case would be very well-presented by both sides.

I read Eades' explanation of gallbladder problems. It wouldn't be such a stretch for a lawyer to present that case. The case should be made. So that it is proven once and for all that the WW diet (whichever one your mother followed at the time) causes gall bladder disease.

I'm guessing that since I can google 'gall bladder disease weight watchers' and come up with this:
http://abcnews.go.com/Business/weig...tory?id=9668078
anyone can.

'In 1990, Jenny Craig (along with competitor Nutrisystem) was named in a class action that alleged that weight loss programs like theirs contributed to gall bladder disease. The claims were settled -- the companies did not admit wrongdoing -- but they prompted the Federal Trade Commission to begin investigating the companies. '

Just a guess as to why they 'settled out of court': Jenny Craig and Nutrisystem require you to eat their products to lose weight. WW doesn't and never has. When the medical testimony is presented in a courtroom, the case against WW would be based solely on that. So even more reason for your mother to sue and truly illuminate how WW caused gall bladder disease.
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  #204   ^
Old Mon, Nov-22-10, 12:12
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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'It's a fact confirmed by her doctor.'

I've been looking in NCBI for informaton about diet's influence on gall bladder disease. I did not know, for example, that gall stones form over the course of years.

http://www.ncbi.nlm.nih.gov/pubmed/15190042

The entire article (PDF) - in the Journal if the American College of Nutrition - is free. Very informative. The 100-some references at the end of the article look like a good starting place for other searches, too.

Just looking at the first page of studies produced by a search in NCBI, i(130 'hits' from the search 'dietary fat lithogenic diet,' I'm thinking that if I want to reduce the risk of gall stone formation in myself, just me - a woman of my size - I would:

1. increase fiber (do that already!)

2. drink alcohol moderately (done!)

3. increase my intake of vitamin C, with supplementation and natural sources (fruits and vegetables) (done!)

4. lose weight (I wish!)

5. eat more garlic and onion (do that already!)

6. take fenugreek (have some, didn't know what to do with them - make tea, maybe?)

7. raise my HDL levels (must exercise more!)

8. drink coffee (do that already! but more importantly, I do that a LOT already! call me a test case for coffee and gall bladder disease)

9. reduce my saturated fat intake (I'll have to look at my saturated fat intake, which is reported in fitday)

Why did I use the term 'lithogenic diet' in my search? Because I kept seeing it in studies. They produce gallstones in mice, for example, by feeding them a 'lithogenic diet' and I wondered what that was! They aim to produce kidney stones or they aim to produce gall stones, depending on the study's goal.

Interesting to note, from a French study that mentioned 'overconsumption of carbohydrates':

http://www.ncbi.nlm.nih.gov/pubmed/9753282

You can also read that PDF (the study is free)


'Most authors agree that overconsumption of carbohydrates
is a risk for cholelithiasis. In Tel Aviv,
where biliary lithiasis is quite frequent, dairy products
and sugar consumption are high, while dietary fiber
and carbohydrate consumption are low among Israelis
compared to Palestinians, who have a lower incidence
of biliary lithiasis . A diet rich in sugar and
beverages (that contain saccharose ) is a risk factor for
gallstones in both sexes. The equivalent of 40 g of
sugar per day doubles the risk of symptomatic gallstones. By contrast, the amount of sugar originating
from other nutrients is similar in patients with or
without lithiasis. We detected a significant risk of
cholelithiasis in individuals with excessive consumption
of carbohydrate s (. 55 g/day) . Paradoxically, a consumption below 12 g/day was also found to increase
significantly the risk of lithiasis.'

Their assessment of fat in the diet is a good read, too.

Last edited by mathmaniac : Mon, Nov-22-10 at 12:44.
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  #205   ^
Old Mon, Nov-22-10, 16:24
Merpig's Avatar
Merpig Merpig is offline
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Posts: 7,582
 
Plan: EF/Fung IDM/keto
Stats: 375/225.4/175 Female 66.5 inches
BF:
Progress: 75%
Location: NE Florida
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Quote:
Originally Posted by Wifezilla
It's a fact confirmed by her doctor. Low fat intake causes the gall bladder to get, to put it simply, clogged with sludge.
Very true. Back in the late-80s or early-90s I went on the medically supervised Medifast Diet (liquid diet, ultra-low-calorie, ultra-low-fat). I opted to do it because I was able to do it for free by being part of a drug study.

The drug in question was Actigall, which is used to dissolve gallstones. The study started out with the premise that eating a very low fat diet causes people to develop gallstones. What they wanted to see was if giving a person Actigall at the same time that they followed a very low fat diet would prevent gallstones from occurring. I don't know how many people were being enrolled in the study, but of course we were in double-blind cohorts, with some of us getting a standard dose of Actigall, some of us getting a reduced dose of Actigall, and some of us getting a placebo.

To be accepted for the study you had to first undergo an ultrasound of your gallbladder to make sure you didn't already have stones. My gallbladder was fine, so I was accepted into the program, which lasted for 16 weeks.

I started out at 330 pounds, and after 16 weeks of a 500-calorie-a-day low-fat diet my weight dropped to 264 (which I promptly gained back and then some once I began eating solid food again). I also developed gallstones! Sure enough, the follow-up ultrasound after the 16 weeks showed that I now had gallstones.

They were not large stones, more like sand, but definitely there. So either Actigall didn't work as a preventative, or I was on the placebo or the reduced dose. At any rate I was given a prescription for a free year's supply of Actigall to dissolve the stones, and I never had a gallbladder problem again until it began acting up in 2007, but I still have not had it out. These days I take milk thistle to control gallbladder issues, and I can tell if my milk thistle runs out and I have forgotten to get more, I start getting twinges again!

But it all began with the super-low-fat Medifast diet. The doctors running the study said that gallstones are a classic side effect of very low fat eating.
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  #206   ^
Old Mon, Nov-22-10, 18:38
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
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Progress: 13%
Location: U.S.A.
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'So either Actigall didn't work as a preventative, or I was on the placebo or the reduced dose. '

I'm reading your post and wondering what you think of that yourself. I know I went to NCBI and looked up Actigall myself!

The fact that gallstones (obviously not all gallstones) develop over several years suggests screening for gallstones before going on a 'liquid, ultra low-calorie, ultra low-fat diet,' is probably a very good idea. WW is none of those things, though.

You developed gallstones after four months.

'So either Actigall didn't work as a preventative, or I was on the placebo or the reduced dose. At any rate I was given a prescription for a free year's supply of Actigall to dissolve the stones, and I never had a gallbladder problem again' (It does seem like the milk thistle keeps that under control. What would happen if you didn't take the milk thistle? I have no qualms about the use of milk thistle. I have some myself, although I never actually used it!)

From what you say, it could be that you were on the placebo or reduced dose. And in four months of the diet (fiber free? should I be able to guess that?), taking Actigall didn't act as a preventative. That seems clear! For other people in the trial, did it prevent gallstones for them? What were the results of the trial?

A recent review of what's known about gallstone prevention referred to several factors. One was 'rapid weight loss'; could that have been the case for you? This abstract has the summary:

http://www.ncbi.nlm.nih.gov/pubmed/17127188

This study, produced in 1993, is about 'Gall Stone Formation and Weight Loss' too:

http://www.ncbi.nlm.nih.gov/pubmed/16350561

It says:

'Despite the potential health benefits of weight reduction, very-low-calorie diets appear to increase the risk for cholesterol crystal and gallstone formation. The incidence of gallstone formation seems to be dependent on the degree of caloric restriction, the rate of weight loss, and the duration of the dietary intervention. Thus, faster rates of weight loss for longer periods of time are associated with increased risk. Available data obtained from prospective studies of subjects during active weight loss suggest that newly formed gallstones occur within 4 weeks and with incidence rates 15 to 25-fold higher than in the general obese population.'





'But it all began with the super-low-fat Medifast diet. The doctors running the study said that gallstones are a classic side effect of very low fat eating.'

(Very low-fat eating would cause rapid weight loss, right? But then, fasting would also cause that. And possibly, any other diet that worked quicky if you adhered to it and lost weight quickly. Atkins, even. One thing WW tells its members is that there is a pace of weight loss that is more healthy, and that is 1-2 pounds a week. My doctor agrees.)

If those doctors, in the 90s, said that about diet and gall stones, then I'm wondering why the studies have not shown that. Did you read the article that gave a 2004 review of the factors for gallstone formation (from studies), 'Diet as a Risk Factor for Gall Stone Disease'?

As I've said in other posts, I lost 20 pounds in the 80s, on a supervised (but not liquid, however 'ultra-calorie') diet that required daily meetings with a counselor to discuss my food intake. The company went out of business and I never knew why. Since they had to have a doctor on site at the center, you had to have a doctor's approval to start (who would send anyone to such a plan if it was guaranteed to produce gallstones?) and they had to have nurses and diet counselors to spend time with all the people on the diet, reporting in every day! Overhead-heavy, I would say. It was a 700-calorie-a-day diet and I managed it quite well after the shock of the first weeks. I was not anywhere near the weight I am today. I kept the weight off until after the birth of my first child.

And I never got gallstones. I also have had ultrasounds that detected fatty liver disease but never gallstones but then, again, I don't know how closely they look for that.

That's MY experience being a human guinea pig for gall stones. It could be that the 200 calories more on my diet made all the difference. The WW diet, with points, or without, does not tell you to eat that level of calories (points are assigned according to your weight and the more you weigh, the more points you get. As you lose weight, your points are adjusted downward - and not right away, either!)

But - most importantly - I'm still trying to find out what the 'lithogenic diet' for gallstones is. So far, it looks like feeding mice 1% cholesterol and 0.5% cholic acid, added to their normal pellet chow,produces gallstones. I don't think that is low fat.

That lithogenic diet:
http://www.ncbi.nlm.nih.gov/pubmed/10402171

If anything, look to a liquid diet - this particular study did:

http://www.ncbi.nlm.nih.gov/pubmed/7489033

The authors say:

'Results of this study indicate that an increased risk of gallstones is not limited to very-low-calorie diets and that the incidence of this complication should be assessed in persons who consume popular over-the-counter meal replacement plans.' (Published in 1995. I'm pretty sure the doctors from your Actigall study would design their study differently, given the passage of those few years' time.. maybe the Actigall study produced useful data about the dangers of a liquid diet - it wouldn't be the first time.)

Actigall stuff:

http://www.ncbi.nlm.nih.gov/pubmed/10148919

http://www.ncbi.nlm.nih.gov/pubmed/2031947

http://www.ncbi.nlm.nih.gov/pubmed/8323995

The study that followed around 80,000 nurses for four years, 'Weight, diet, and the risk of symptomatic gallstones in middle-aged women.' tracked them for 4 years. From the abstract:

'Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (greater than 8200 J per day), as compared with a low energy intake (less than 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of at least 5 g per day was associated with a decreased incidence as compared with abstention'

http://www.ncbi.nlm.nih.gov/pubmed/2761600

There were letter to the editors after the study was published in NEJM. The letter, of which, some basically said, 'You forgot about hormones!' In particular, 'parity' (having had children). The authors wrote a reply to the letters, which challenged that the important factors of parity, moderate alcohol use and age were not given more weight.

Last edited by mathmaniac : Mon, Nov-22-10 at 19:19.
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  #207   ^
Old Mon, Nov-22-10, 19:16
teaser's Avatar
teaser teaser is offline
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
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Location: Ontario
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http://www.ncbi.nlm.nih.gov/pubmed/8781321


Quote:
The role of gallbladder emptying in gallstone formation during diet-induced rapid weight loss.

Obese persons are at risk for cholesterol gallstones because their bile is saturated with cholesterol. The risk increases during rapid weight loss by means of certain very-low-calorie diets or gastric bypass surgery. Gallstone risk factors during rapid weight loss include increased bile cholesterol saturation index and gallbladder stasis. Obese subjects were randomized to one of two low-calorie liquid diets for rapid weight loss: a 520-kcal diet with less than 2 g fat/d, and a 900-kcal diet with 30 g fat/d (including one 10-g fat meal to stimulate maximal gallbladder emptying). Bile and blood lipids, saturation index, leukocyte 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activity, and ultrasonographic gallbladder emptying were measured repeatedly during dietary treatment. Both diets produced comparable weight loss of 22%. Bile cholesterol saturation index increased during both diets (26%), but fell to 15% below prediet level after weight loss. Compared with subjects' maximal gallbladder emptying fraction of 66%, the 520-kcal diet provided poor gallbladder emptying (35%), whereas the 10-g fat meal of the 900-kcal diet provided maximal emptying. Gallstones developed in four of six 520-kcal subjects and none of seven 900-kcal subjects (P = .021), an unanticipated difference that resulted in premature study termination for ethical reasons. Blood lipids and HMG CoA reductase activity in mononuclear leukocytes fell at week 8 during both diets, but recovered while weight was still being lost. The findings suggest that gallstone risk during rapid weight loss may be reduced by maintenance of gallbladder emptying with a small amount of dietary fat. Ultimately, weight loss reduced bile cholesterol saturation and improved highdensity lipoprotein (HDL) levels.



Fasting counts as a zero-fat diet, as far as digestion is concerned. As far as the gall-bladder is concerned, at the very least, a low-carb plan is very different from a low-fat plan, even when the calorie intake is the same.

Quote:
8. drink coffee (do that already! but more importantly, I do that a LOT already! call me a test case for coffee and gall bladder disease)

9. reduce my saturated fat intake (I'll have to look at my saturated fat intake, which is reported in fitday)


Not sure about these. Most people I know like a little bit of saturated fat with their coffee. A possible protective effect of cream (saturated fat and all), might need to be accounted for.
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  #208   ^
Old Mon, Nov-22-10, 19:36
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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My point was about the rapid weight loss with fasting (actually, rapid weight loss, period, no matter how it's done.)

And I drink my coffee black, thanks! I used to drink it with skim milk, which is an option I used at Starbucks when ordering.

But thanks, teaser, for that study! It does say that rapid weight loss is the factor, not low-fat. What it says about fat is that if you are going to lose weight rapidly, add a little bit of fat. That is what I got from reading the abstract. It didn't even say you had to add a lot of fat.

'The findings suggest that gallstone risk during rapid weight loss may be reduced by maintenance of gallbladder emptying with a small amount of dietary fat. Ultimately, weight loss reduced bile cholesterol saturation and improved highdensity lipoprotein (HDL) levels.'

Again, WW stresses a moderate pace for weight loss (described as 1-2 lbs a week) and they do not think slow weight loss is a bad thing. They do say that fast weight loss is not good - mainly because you will not be able to keep the weight off, but the 'science' behind that recommendation is solid. It is 'rapid weight loss' that is mentioned in the study you cite. Not only that, but, again, it is a liquid diet that produced the weight loss.

'Gallstones developed in four of six 520-kcal subjects and none of seven 900-kcal subjects (P = .021), an unanticipated difference that resulted in premature study termination for ethical reasons.'

Gallstones did not develop in the 900-cal subjects? WW would say that's the best reason its points are given to an individual, not one point or narrow point range given to a group.

If anything, in the very early days of WW, certainly before 'points' were developed, the diet may have been low-fat compared to what people were eating, generally, but it was nearly probably around 1600 or 1700 calories, if you checked off your daily vegetables, protein, starches and fats. If anything, this would tell me that if gallstones did not develop in subjects on a 900 calorie diet, they wouldn't develop in WW members.

'As far as the gall-bladder is concerned, at the very least, a low-carb plan is very different from a low-fat plan, even when the calorie intake is the same.'

However, high fat has been associated with gall stones (as other studies have shown). But if you are going to lose weight rapidly (and in particular, with a liquid diet), you only need a little fat, according to this study, to stave off gall stones. So the two diet plans may be different, and with low-carbing, you are not going to concern yourself with fat. That saturated fat is a factor for gall stones is also known. The study cited here did not even try to be low-carb, so we don't know about a rapid weight loss diet with a liquid replacement meal that is low-carb. Look, I guess, to the studies of liquid replacement meals (see the link I gave to companies that were sued for their meal replacement plans that brought on gall stones in participants.)

Why would the liquid diet part be important? Because, first of all, it's mentioned in the studies as being a hazard. It does bring about rapid weight loss if you adhere to the diet. What I think is important is that it removes any doubt about what the person has ingested - if the person adheres to the diet. Telling what you ate and giving a report of various foods is not even in the same ballpark as having to take premeasured food, and only that, when it comes to accuracy about diets.


From a study of 'liquid' meal replacements:

http://www.ncbi.nlm.nih.gov/pubmed/17344485

'However, regular daily consumption of sugared liquids need
not automatically result in weight gain. Clinical evidence has
shown that regular consumption of sugar-containing liquid MR
products by overweight patients can lead to a significant and
sustained weight loss . Liquid MR shakes, provided free of
charge, are the preferred treatment modality in the LookAHEAD
(Action for Health in Diabetes) Study , a multicenter, randomized
controlled trial of 5145 participants undergoing intentional
weight loss. Liquid MRs were included in the 1200–1500
kcal diet because they simplified food choices (85), improved
glycemic control , and led to a significantly greater weight
loss as compared with isocaloric diets composed of conventional
foods .'

The calorie range of the diet mentioned is above the 900 calories mentioned that did not produce gallstones in the study you cited. It used sugar, too. And it led to significantly greater weight loss than a diet of the same amount of calories using conventional foods (a metabolic advantage!).

Last edited by mathmaniac : Mon, Nov-22-10 at 20:27.
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  #209   ^
Old Mon, Nov-22-10, 21:45
teaser's Avatar
teaser teaser is offline
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Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
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My point with the coffee wasn't about you in particular, MathManiac, it was more along the lines of the general association of coffee intake with cream.

Is saturated fat associated or causative? And in what overall dietary context?
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  #210   ^
Old Mon, Nov-22-10, 22:49
mathmaniac mathmaniac is offline
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Posts: 6,639
 
Plan: Wingin' it.
Stats: 257/240.0/130 Female 65 inches
BF:yes!
Progress: 13%
Location: U.S.A.
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I know it wasn't about me in particular. I was just reporting my own preference. I don't know how most people drink their coffee!

From what I see with studies, they just say what is 'associated' with what. When they do that, it suggests other studies can either expand on their results or provide some counterbalancing study that refines the conclusion.

'Association ' is not a 'weasel' word - it's just a way to deal with the 'chicken or the egg' situations of most questions. In what overall dietary context? Depends on the study. Gall stones and gall bladder disease have been studied a lot!

From a very small study 'Gallbladder motility and lithogenesis in obese patients during diet-induced weight loss.' (2000)

http://www.ncbi.nlm.nih.gov/pubmed/10711462


'Stone et al studied GB
emptying in response to various stimuli in obese and
normal-BMI subjects, showing that a liquid meal containing
less than 1 g fat resulted in blunted GB
emptying and that the addition of at least 10 g of fat
to the meal restored GB emptying to the maximalstimulus
level. This may thus help to explain the
predisposition to cholelithiasis of patients on extremely
low fat diets and the resistance to stone
formation with normal fat containing diets. However
cholelithiasis from rapid weight loss may not be solely
attributable to GB stasis, as shown by recent experiments
by Vezina et al indicating that increasing
the fat content of a liquid diet over that required to
obtain a maximal GB emptying (16 g vs 30 g fat daily)
did not reduce significantly the risk of cholelithiasis
(17% and 11.2% respectively; P 5 0.18).
In our patients we used a diet with 26 g/day fat and
this probably is the main reason why we observed a
relatively low incidence of gallstone formation in our
obese dieters (1/10). Gebhard et al showed that
four of six obese subjects on a 520-kcal/day diet with
2 g fat per day developed gallstones, while none of
seven patients did on 900-kcal/day with 30 g of fat per
day. Both diets induced comparable weight loss of
about 22%, and a significant increase in CSI during
dieting. These findings suggest that the risk of gallstone
formation during weight loss may be reduced,
providing 20–25 g of fat in the diet. Similar results
have been shown recently by Festi et al comparing
the effect of two different very-low-calorie diet
regimens (3 vs 12.2 g fat/day) in 22 gallstone-free
obese subjects. Our group did lose 14% of their initial
weight, but we did not observe significant changes in
CSI during weight loss.
In summary, obese subjects have a significantly
larger GBFV than nonobese controls. This finding
may be explained by their larger body size. Considering
that in our study only one patient developed
gallstones, not too many conclusions can be drawn
about this outcome. Nevertheless, during weight loss
we did not observe significant changes in any of the
lithogenic variables studied, including gallbladder volume
measurements for individual patients.
The relatively
low incidence of gallstones in our study (1/10)
could be partly explained by the fat content of the diet
and by the normal GB emptying observed in these
patients during the study. The only subject who developed
gallstones showed a sluggish initial GB emptying
and cholesterol crystals in bile. These signs
could be considered premonitory for gallstone formation,
and it could be useful to study them in obese
subjects entering a weight reduction program, to select
patients susceptible to stone formation and prevent
it by the oral administration of ursodeoxycholic
acid.'

This was a study of ten people. The one person who developed gall stones was measured to have 'sluggish' initial GB emptying. There were 10 participants but only 6 completed the study! GBFV=Gall Bladder Fasting Volume. NT=nucleation time.

(Note: 26 grams of fat to avoid gallstone formation? That's 134 calories worth of fat in a day. That's not even two tablespoons of olive oil!)

And the last line of this study

http://www.ncbi.nlm.nih.gov/pubmed/7637561

says:

'These studies indicate that substitution of 18:1 for saturated fatty acids in low-fat diets reduces gallstone formation without affecting the lithogenic index. Furthermore, intake of 18:2 at or below the EFA requirement does not appear to be a major factor in this model.'

18:1 is olive oil.

Last edited by mathmaniac : Tue, Nov-23-10 at 00:20.
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