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Excessive fasting is the real reason for the increased risk of gallstones.
To prevent gallstones, what you eat for breakfast is more important.
Drink more milk, more fruits and vegetables, and less refined carbohydrates and fried, high-calorie foods.
Women, frequent dieting, and rapid weight loss are all risk factors for gallstones.
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From time to time, readers come to ask: I heard that you will get gallstones by skipping breakfast. Is it true? But I really don’t have time for breakfast in the morning…
Today, I will have a good chat with you about whether skipping breakfast will cause gallstones.
What do domestic and foreign research say?
The causes of gallstones are very complex. Any factor that affects the ratio of cholesterol to bile acid concentration in bile and causes bile stasis will increase the risk of gallstones.
Many doctors often mention “don’t eat breakfast” when discussing risk factors for gallstones with patients. However, some people say that the claim that “no breakfast causes gallstones” is not supported by reliable research evidence.
What does domestic research say?
“China’s Consensus Opinions on the Diagnosis and Treatment of Chronic Cholecystitis and Cholecystolithiasis (2018)” mentioned that “don’t eat breakfast” is a risk factor for cholecystolithiasis:
Main risk factors for gallbladder stones in my country include greasy diet, obesity, fatty liver, diabetes, hypertension, hyperlipidemia, lack of exercise, and no breakfast and family history of gallstones. 
But looking at the source literature for this conclusion , the key is not skipping breakfast, but excessive fasting >.
“Irregular breakfasts and long fasts result in slower gallbladder emptying and more bile residue.”
“Eating breakfast often has a protective effect on cholelithiasis in middle-aged women, which may be related to shortened fasting period.”
A meta-analysis published in 2015, which comprehensively analyzed 30 case-control studies (1987-2014) on the risk factors of cholelithiasis in my country, also pointed out:
Compared with people who ate breakfast regularly, people who ate breakfast irregularly extended the fasting time, resulting in a decrease in bile acid secretion, while cholesterol secretion remained unchanged.< strong>Bile composition changes, and the proportion of cholesterol is relatively increased, thus increasing the possibility of gallstones.
What about foreign studies?
Several meals per day, with or without snacks, were not significantly associated with gallstone development, but excessive overnight fasts strong> is associated with an increase in the diagnosis of clinical gallstones.
Some prospective studies have shown that excessive overnight fasting (14 hours), dieting, and low dietary fiber intake, It increases the risk of hospitalization for gallstones in women.
There are also studies indicating that fasting for more than 8 hours and a low-calorie diet of 700kcal per day are risk factors for gallstones, especially in obese people and parenteral nutrition lasting more than two weeks [ 8].
The key is not breakfast,
It’s fasting time instead
As you can see from these studies, what helps to prevent gallstones is to eat every meal regularly and avoid prolonged fasting.
A person who eats a late-night snack from 0-1 a.m. and brunch at 11 a.m. may not necessarily have a higher risk of developing gallstones than a person who eats breakfast every day but skips lunch. high.
The impact of early morning eating on health is another big question.
“2016 European Society of Liver Diseases Clinical Practice Guidelines: Prevention, Diagnosis and Treatment of Cholelithiasis” states that a regular diet can increase the normal output of the gallbladder Empty to reduce cholestasis and have a preventive effect on cholesterol gallstones .
Eating breakfast regularly can be beneficial.
Women be especially careful
Due to the effects of estrogen and fertility, women are inherently more likely to develop gallstones than men[1,10].
Influenced by the “skinny” culture of modern society, women are more likely than men to have negative comments about their bodies. A study found that 73.36% of women who thought they were fat had a BMI in the normal range (18.5 ≤ BMI or even thin (BMI
And regardless of whether they consider themselves fat or not, nearly half (42.1%) of the women tested are dieting or have been on a diet.
China’s classic domestic science textbook “Practical Internal Medicine” clearly states that “frequent dieting and rapid weight loss” are risk factors for gallstones.
Image from reference 
Women who want to lose weight, if your BMI is really overweight or obese, or if your previous dietary intake is far more than your body needs, then Control your weight and dietary intake To the healthy range, it is good for preventing gallstones.
But don’t over-diet, control your calorie intake to a very low level, and pursue rapid weight loss. There are already shortcomings in the innate configuration, so don’t add additional risk factors!
This kind of dieting and weight loss at the expense of the body, in addition to increasing the risk of gallstones, also affects endocrine, digestion, metabolism, cognition…
And, once a normal diet is resumed, it usually rebounds! Because of the impaired basal metabolism, maybe he will be fatter than before…
Prevention of gallstones,
What you eat for breakfast may be more important
The causes of gallstones are very complex, and there are many related risk factors. Too long fasting time or skipping breakfast does not account for a large proportion of them.
The more important risk factors, age, gender, genetics, etc., cannot be changed. Diet and lifestyle are our choices.
What you eat for breakfast may be more important to prevent gallstones.
What’s for breakfast?
my country’s “Practical Internal Medicine”, when it comes to risk factors for gallstones, clearly puts forward the three dietary risk factors of high-calorie diet, ultra-fine carbohydrate diet, and low-fiber diet /strong>.
Image from reference 
For convenience, many people buy a steamed bun or fritters at the breakfast stall in the morning, add a cup of sweet eight-treasure porridge/rice porridge, or buy some cakes in advance, which is really a hit with everything. Dietary risk factors.
Eat these foods regularly every morning, and it’s hard to say which one has a greater risk of gallstones than skipping breakfast…
Drink more milk
High-protein diet can inhibit cholesterol saturation in bile, thereby inhibiting the formation of stones, and high-calcium diet can reduce bile It is a hydrophobic bile acid, which increases the normal emptying of the gallbladder to reduce cholestasis , and also prevents the reabsorption of bile refluxed from the intestine and changes the bile composition, reducing the possibility of gallstone formation .
Milk is not only rich in protein, but also rich in calcium ions. Many studies in my country have confirmed that milk is a protective factor for gallstones, preventing gallstones [2-5].
Add fruits and vegetables
Fruits and vegetables are rich in dietary fiber and protective against gallstones.
If you don’t want to eat salad for breakfast, and cooking is too time-consuming, buy some fruit that is easy to clean and easy to eat, and eat it at home or take it to work as a snack.
Eat more whole grains,
Less fried high-calorie foods
Researchers speculate that refined carbohydrates are less potent to stimulate gallbladder contractions, can also cause dramatic blood sugar swings, increase the risk of gallstones, and oil Fried, high-calorie diets increase serum cholesterol and triglycerides, thereby increasing the risk of gallstones [8,12,13].
It is recommended that you replace the steamed buns, noodles, bread, cream pastries, fritters, oil cakes, fried cakes, fried eggs, etc. in breakfast with whole-wheat steamed buns, whole-wheat bread, and no additional sugar. The oatmeal, boiled eggs, and eight-treasure porridge are actually good, but pay attention to choose the ones without extra sugar.
Although the above is a breakfast suggestion, it actually applies to lunch and dinner.
Finally, be careful not to sit for long periods of time, exercise moderately, and control your weight, all of which can help prevent gallstones.
. Consensus opinion on medical diagnosis and treatment of chronic cholecystitis and cholecystolithiasis in China (2018)[J]. Chinese Journal of Digestive Medicine, 2019(02):73-79.
 Shi Jian, Liu Su, Xie Weifen. Meta-analysis of risk factors for cholelithiasis in my country [J]. Gastroenterology, 2005(04): 217-222.
 Fang Dongsheng, Li Li, Xiong Qiru. Study on the association between dietary factors and cholecystolithiasis [J]. Journal of Disease Control, 2000(04):337-339.
 Zhang Dongmei, Chen Feihu, Li Tao. The relationship between dietary factors and cholelithiasis in middle-aged women[J]. Journal of Anhui Medical University, 2002(04):276-277.DOI: 10.19405/j.cnki.issn1000-1492.2002.04.009.
Wang Yuan. Meta-analysis of risk factors for cholelithiasis in my country[D]. Shandong University, 2015.
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Sichieri R, Everhart JE, Roth H. A prospective study of hospitalization with gallstone disease among women: role of dietary factors, fasting period, and dieting. Am J Public Health. 1991 ;81(7):880-884.doi:10.2105/ajph.81.7.880
García V, Serra I, Palma R. Factores de riesgo nutricionales en la litiasis vesicular. Análisis epidemiológico [Nutritional risk factors for gallstones. Epidemiological analysis]. Rev Med Chil. 1998; 126(10):1247-1254.
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017 Jul;67(1):145 -172. doi: 10.1016/j.jhep.2017.03.022.
Lin Guowei, Wang Jiyao, Ge Junbo. Practical Internal Medicine: 15th Edition[M]. Beijing: People’s Medical Publishing House, 2017.
 Yin Huajuan. Research on the negative body self of female obesity and its relationship with poor eating behaviors [D]. Suzhou University, 2019. DOI: 10.27351/d.cnki.gszhu.2019.001148.
Méndez-Sánchez N, Zamora-Valdés D, Chávez-Tapia NC, Uribe M. Role of diet in cholesterol gallstone formation. Clin Chim Acta. 2007;376(1-2 ):1-8.doi:10.1016/j.cca.2006.08.036
Park Y, Kim D, Lee JS, et al. Association between diet and gallstones of cholesterol and pigment among patients with cholecystectomy: a case-control study in Korea. J Health Popul Nutr. 2017;36(1):39. Published 2017 Nov 23. doi:10.1186/s41043-017-0116-y