Wednesday, June 5, 2013

The gallbladder

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The gallbladder is a storage facility for bile produced by the liver. It also serves to concentrate the bile during storage, making it more potent. When fat is consumed, the gallbladder releases bile into the small intestine to help emulsify the fat. Once emulsified by bile into much smaller droplets, fat can then be more easily digested by lipase (the fat-digesting enzyme). Without emulsification, the fat globules remain large and mostly inaccessible by lipase. Emulsification increases the surface area of the globules and allows greater access and more complete digestion. So, although your liver will still produce bile without a gallbladder, it will no longer be concentrated in the gallbladder and super potent.

So yes, when it comes down to it, you simply don’t have as much fat-digesting equipment as most people. That’s fine, and you can still eat healthy and Primal, but it does mean your ideal macronutrient ratio may look slightly different from mine or the next person’s. Don’t think you have to eat the quantities of fat promoted by others. I like the high-fat approach for myself and most other people coming from a Standard American Diet, simply because it seems to work best. You have to work with what you’ve got. You can’t try to replicate what others are doing because those people aren’t you and they aren’t dealing with your situation. You may – gasp – have to eat less fat than you thought you would be eating on a Primal eating plan. As long as you stick to the basics – animals, plants, good fats – and avoid grains, refined sugar, and processed seed oils, you’ll do great. Heck, it seems like you’re already doing great. Tweak the fat, carb, and protein ratios until it works for you, and don’t get caught up in any kind of perceived “ideal macro ratio.”

There are also a few other ways to support your gallbladder-less digestion:
Ox bile: Since you don’t have a gallbladder, supplementing with ox bile can partially replace the bile your nonexistent gallbladder would have been producing. To use, take a 500 mg (the usual starting dose for ox biles) pill a few minutes before consuming fat. Note your digestion and the supplementary bile:dietary fat ratio. If all is well, you likely have the right dose. If you get diarrhea, you may need a different dose next time.
Bitters: We possess the ability to perceive bitter tastes for a couple reasons. First, “bitter” often indicates the presence of toxins or poisons. When something is bitter, we know to be wary of it (and sometimes, that bitterness indicates the presence of polyphenols (plant “toxins”), which in adequate amounts can act as healthy hormetic stressors to increase antioxidant action in our bodies). Second, bitter herbs – and the concoctions made from them – have the interesting tendency to stimulate the digestive process. When something bitter is tasted, salivation increases, gastric acid production increases, pepsin (which breaks down protein) is released, and bile production is upregulated in the liver. This may be the body’s way of moving things forward to get the offensively tasting food (and possible toxin) out of the body quickly, but it has the helpful effect of stimulating digestion of all subsequently consumed foods. If you don’t have a gallbladder, using bitters ten to fifteen minutes before eating a meal that contains fat might help you produce more bile than you otherwise would.
Though I haven’t used it expressly as a digestive aid, I do keep a bottle of Angostura bitters around in case I want to make the odd rum cannonball or Carrie makes sangria for a party.
Short-chain fats: Shorter chain fats, like coconut oil and pastured dairy, require less “work” from the gall bladder. When you do add fat, consider favoring these sources.

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