The Health Edge: translating the science of self-care
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Mark and John
The Health Edge: translating the science of self-care
How Bile Acids Shape Appetite Metabolism And Detox
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Bile might be the most overlooked substance in everyday health, yet it sits at the crossroads of digestion, detoxification, and metabolic control. We take a fresh look at bile quality and bile acids, starting with what the liver makes from cholesterol, what the gallbladder stores, and what gets released when we eat, especially after higher fat meals. From there, the story gets far more interesting: bile acids don’t just help you absorb fat, they also communicate with receptors in the gut and throughout the body in ways that can affect appetite, energy expenditure, insulin sensitivity, lipid patterns, and inflammation.
We also unpack enterohepatic circulation, the recycling loop where roughly 95% of bile acids can be reabsorbed and sent back to the liver. That matters for anyone thinking about detoxification, because bile is a major exit route for fat-soluble toxins, and without the right binders those compounds can circle back. We talk through the practical role of soluble fibre, including beta-glucan and pectin, and why the source matters when you’re balancing bile binding with blood sugar control.
The gut microbiome is the other half of the equation. Your bacteria convert primary bile acids into secondary bile acids, and that conversion can shift bile toward more inflammatory or more protective effects. We connect modern dysbiosis drivers like low fibre intake and antibiotic exposures with downstream bile changes, then get specific about foods that support thinner bile (extra virgin olive oil, flax, black seed oil, oily fish, avocado, nuts) and foods that often do the opposite (refined carbs and fried oils heated to high temperatures). If you’ve ever wondered why fried meals so often precede gallbladder pain, we explain the mechanism in plain language.
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Summer Energy And Fresh Foods
Welcome to The Health Edge, translating the science of self-care. I am Mark Pettis and with my friend and colleague, John Bagnulo. John, good morning, my friend. Good morning, Mark. Great to see you. Great to see you here in early June. The sun is high in the sky, and uh it's it's just a great time of year to uh be embracing longer days and more fresh produce. And uh the mood tends to shift, right, John? Not just in my own personal life, but uh I'll go to a lot of our local sporting events, and uh, you know, parents are in a good mood, the kids are in a good mood, and and there's just something shifts as a year. Yeah. And I think we wait all we wait all, you know, we wait from I guess around early November, maybe even late October until now for the you know, for these long days, and like you said, everything's green. You have so many choices now, and you go to the you know, the local farm stand. It's it's uh yeah, it's a beautiful time of year. It is a beautiful time of year, and one that we do not take for granted.
Why Bile Quality Matters
We have a really interesting topic to uh reflect on uh in this episode, John, around bile quality, bile acids, and the extraordinary and and not frequently discussed interaction between the bile that we produce uh in the liver, stored in our gallbladders, and then excreted with uh with meals that we consume, and the interaction that these bile salts have in relationship to our gut biome, all these fascinating metabolic byproducts and biochemical interactions, and the downstream effects of all of that on human health from appetite management to cardiovascular health to systemic inflammation to gut health. And so uh, well, I I love John that you brought this up in your recent substack because it really opened my eyes to a part of our little biology that people just kind of take for granted. Uh and and and your people are thinking are aware of gallstones and that kind of thing. And a lot of the clinical community is it's you know, bile is all about gallstones. You you either have them or you don't. Uh so that this this takes it into a much more interesting and nuanced context. Yeah, it's it's really incredible. I mentioned a little bit of of the background to hear my my digging into bile.
Toxins Fiber And Enterohepatic Recycling
It's uh, you know, I think a lot of our listeners appreciate its role in detoxification. And that's um what I initially set out to really write about was you know, what does the average American's bile contain? Because I had heard of a study that was that was going on where they were attempting to measure different levels of toxins that we know bile is the primary uh pathway out of the body. And for our listeners that don't understand this, I'll I'll just back up for a moment and say that heavy metals and any toxins that have um really large molecular weights and are uh more fat-soluble, more difficult for the body to get into a water-soluble state. So all of those toxins leave via the bile. And you know, that's the liver's primary outlet for these toxins. And then when that bile carrying those toxins, when it gets into our large intestine, if it's not bound to some sort of soluble fiber, and and different fibers have different affinities for bile, but if that if the bile is not bound to a soluble fiber type, then it ultimately gets uh recycled or it gets absorbed intact and it goes back to the liver. So so the bile and the toxins that the bile contains can essentially be recycled if we don't have something to break that cycle. And that's called, you know, enterohepatic circulation, right? Just things are just going back to the liver. Um, and we want to break that with having the right types of fiber in the gut, um, and also having the right types of gut bacteria that can help metabolize some of those bile acids into things that are less inflammatory, more anti-inflammatory. So that's initially what I was attempting to write about. Um, but when when I really dug into it, Mark, it was incredible for me to realize like, wow, just how much regulatory activity bile has for the body as a whole, outside of the whole detoxification role that it plays. Um, and to your point, most of us just really think about, you know, bile as something that we need to emulsify fat, right? We know that it does have, you know, an influence on, like you said, appetite and things like that. But I had no idea how much it was intricately involved with a person's overall metabolism. I thought for me, that was, you know, I think that was really eye-opening, that bile has a huge stimulatory effect on brown adipose tissue or brown fat, which we know is really metabolically active. And it can become a big part of a person's overall daily energy expenditure or metabolism. So there are all these different things that um, you know, I just really underappreciated the role that bile has in, you know, regulating the microbiome. It has some really strong uh kind of inhibitory effects on pathogenic species of bacteria, which, you know, again, that's we we need all the help we can in terms of regulating some of those more opportunistic bacteria that can cause more inflammation and can cause issues with that ecosystem. So it's just a really incredible molecule. But like you and I always talk, when I look at the role that bile plays in all of these different areas of our physiology, what becomes really clear is that the more paleolithic, more ancestral lifestyle, and the more ancestral foods that are that we would have eaten for thousands of years, those foods are much more supportive of having larger quantities of bile and having bile with the appropriate viscosity, and by and large, a thinner bile, which we can get into in a moment. So, again, that ancestral lens, it seems like without fail, it always you know illuminates uh the lifestyle that really is conducive for us to have the type of bile and the quantities of bile that are ideal for all of that areas of our health. Great context to dive into this, John. And let's uh we'll we'll look at a few um papers, recent papers, uh reviewing these are these are reviews of current understanding of the uh interaction of uh bile bile acids, these metabolites with the biome and and with various aspects of cardiometabolic health. And then we'll we'll uh conclude with uh foods that um are associated with some of these attributes of bile that you touched on, John. And and I love that that paleo anthropo anthropologic lens uh because the the it's clear that uh I just reflect back on my um medical journey and all, you know, it it as a resident back in the early 1980s, you know, the number of uh people coming into the hospital with gallbladder disease, uh their gallbladders would ultimately be removed. Many would then have uh malabsorption issues uh because they weren't breaking down fat as much. Uh and it was kind of uh, you know, as a resonant, and then ultimately as a you know, it's it's my career evolved. I went on to think of it as kind of a nuisance, you know, just um who you know, who needs a gallbladder? Uh, gallstones are, you know, everyone seems to be getting them. Um and it was uh, you know, never really crossed my mind that that this was a phenomenon of contemporary life, like most modern uh chronic complex health issues, and you saw so much of it that you just began to take it for granted. People get gallstones, you tell them to, you know, back then with you the low fat seemed uh you know well uh aligned with reducing gallstone formation, you know, none of that ever really proven. Um but we we again we're reminded that things in our food supply today and things in our environment that alter the the right the gut ecosystem. I mean, it it's it's uh pretty much of a multifaceted assault on on all these drivers ultimately of what appears to be much more than just the likelihood of forming a gallstone or not. Uh and so I really appreciate that context. So let well, I'll pull up some slides, John.
Refined Carbs And Gallstone Risk
Yeah. And and just while while you're bringing those up, it's interesting. You know, you refer to the early 1980s. Uh and that's as as you know, Mark, that's when kind of the low fat, higher carbohydrate uh dietary recommendations really started to take off, right? And that's when actually some of the best, or I'd consider landmark papers on bile gallstone formation or bile viscosity, which again if becomes more viscous and thicker, tends to lend itself to greater gallstone formation. But some of that, some of that research in those early 1980s was in response to the significant rise in gallstone formations and in the, you know, obviously the removal, the surgeries that really started to explode. Well, it's it's no mystery that those occurred. That that whole in epidemiology, that rise in gallstone issues all occurred in close proximity to those, you know, that new kind of low-fat, high carbohydrate diet approach. So there's actually a paper, and it was a 1983 investigation that looked at the role of refined carbohydrates in gallstone formation. And, you know, the authors conclude that the mucin content of gallstones from an individual on a high carbohydrate diet is considerably greater, and that mucin was one of the primary constituents to that, to those gallstones that was very different from an individual with a lower carbohydrate and less refined carbohydrate in their diet. And, you know, again, that's that's a landmark paper and occurring in 1983 in response to you know what you just shared uh with us in terms of your observations. So yeah, it all goes back to uh how much discord is there between the lifestyle, the diet that you know our ancestors had, you know, 15,000, 20,000 years ago, and how radically things have changed. Well, there's there's usually a consequence to that. And we're seeing that with bile as well, which we can dig into now. But yeah, sorry to interrupt. Fantastic, John. Love that. And um that epidemiology really uh makes so much more sense in the context of what we're talking about here, and still not I I do not hear much discussion of this in mainstream medical clinical uh thinking.
From Cholesterol To Secondary Bile Acids
Uh this was a relatively recent paper that I found, uh John. I in in kind of as you look for systematic reviews, subject reviews, because it is harder to find uh interventional trials uh under the uh sort of topic. Uh uh again, unless you're talking specifically about gallstones, which is right, that's where the money is. Um so if there's any research is how can you manage a gallstone without cutting the gallbladder out, that's that's what it ultimately gets reduced to. But this is a nice uh recent uh paper and uh just a few graphics from this paper, which I'll I'll just touch on briefly, John, and then I'll let you run with this because it the this the this biology biochemistry is so uh fascinating and and again uh you know it just helps to remind our listeners that uh cholesterol, which is uh uh one of the uh perhaps most important molecules in human biology, is again the backbone for um bile production. And uh um uh cholesterol uh essentially in these cytochrome uh uh enzymes, of which there are many in the liver, uh to the point that you made earlier, John, that help us uh uh modify molecules for elimination. And uh so you see this uh cholesterol is being managed by these liver, uh many liver enzymes, ultimately producing these primary bile acids, uh colic acid and quinodeoxycholic acid, right? Great, great scrabble words. This is what the bile releases, uh what the liver releases uh into the gallbladder, which is really a kind of a storage um um structure for bile that can then be contracted and released in temporal proximity to the consumption of the food that we're eating to help help break that down. And uh and then we see that these primary bile acids are really uh in terms of all of the interesting metabolic effects and detoxification effects. Uh, this is the substrate that ultimately uh in the gut is modified through these uh hydrolases. Hydrolases, this is a very common um oxidation chemical reaction that adds a what we call a hydroxyl group, right? This this oxygen-hydrogen group. Um you can also see dehydroxylases where where a hydroxyl group might be removed. And the addition and the uh deletion of a hydroxyl group can totally change the function of that bile acid metabolite. But ultimately you get these secondary bile acids which are listed here: the deoxycholic, the lithocolic, and the earthioxycolic acid. This is where you start to see active um functional um effects of these ultimately these mediators of cardiometabolic health and gut health. Uh and so it's a uh a beautiful, complex uh um uh production and modification system. And then to just to uh re-emphasize an important point that you made, John, 95% of what is produced can get reabsorbed in this enterohepatic, and uh it basically goes through this recycling process. And so if you're carrying toxins and you want to be eliminating more, you need to be thinking about what you can do to enhance recycling of bile salts that aren't accompanied with with toxins and then elimination of those that are. And um so yeah, that's just a brief overview, John. Do you want to add anything to that?
Anti Inflammatory Bile And Gut Bacteria
Um, yeah, I mean, this is an awesome slide, Mark. Thank you so much for for digging this one up and including it. Because I think it really uh it shows the the different fates here of bile. And you know, the one that I I guess I could speak to the most of is out of those secondary bile acids is lithocholic acid that also abbreviated LCA in papers that talk about bile metabolism. That one is anti-inflammatory, um, it has antiproliferative effects on potential uh colon cancer sites. It's a really interesting molecule, but of course, you need the right gut bacteria to catalyze the formation of that. And what research has shown is that diets higher in vegetable fiber, not fiber from grains or even from fruit for that matter, but vegetable fiber, which, you know, again, it can be made up of both insoluble and soluble fiber. And I think a lot of researchers feel that it's the soluble fiber that's most responsible for establishing the right gut bacteria for optimal metabolism of bile. But that LCA is what you want to have more of when you're talking about bile acid metabolism. Because if bile acids are not altered in any way, they can be, you know, very inflammatory to the cells of in the lining of the large intestine and can be a huge risk factor for colon cancer. Um, those unbound bile acids are really, really a problem. So it's about having the right gut bacteria. And, you know, again, to build it, the ecosystem that you need to have those right gut bacteria, it's it's it's having more soluble fiber and getting that from more vegetables and less from bran and things like that. Now, in terms of if you just go back to that slide for one second, because I I liked how it showed 95% of that of that bile going back to the liver, to get that number from what you see there in terms of what's lost. Here it's around 5%. To get that 5% up to 10 or 15%, it it really requires the inclusion of some specific types of soluble fiber. One of those is again, there's another really great Scrabble word. I like that, how you how you coined that. Um Beta D glucan. So that's beta hyphen, capital D hyphen, and then glucan is the type of soluble fiber that has the greatest affinity or ability to bind on to bile acids and to carry those out of the body so that they don't get recycled. Now, beta D glucane is found in a few different foods, some of which I think are better for overall health than others. So, like oats, for instance, oats are incredibly high in beta D glucane, but again, oats are a very carbohydrate-dense food. They're not really that nutrient-dense. And I think for someone with insulin resistance or someone that wants to lose weight, I don't think oats are a great choice. But you also have uh beets and carrots as being great sources of beta D glucane. And I think those are really a lot more going for them and are much more um conducive to overall health. So, you know, again, that's one of the best qualities of oats would be the soluble fiber, the beta D glucane. But I think you can get really similar levels from eating beets, and you can get other benefits from those as well, much higher potassium levels. And so, yeah, you've got different choices when it comes to some of these types of fiber. And then the next, the next type of soluble fiber that is not quite as good as beta D glucane, but is still very good is pectin. You know, pectin is found in uh it's it's found in things like obviously the peels of citrus fruits, like you know, lemons and limes. If you use a lemon peel, for instance, in in making a smoothie, you can get a really a robust amount of pectin. Some people take pectin uh as a powder, they mix it with water and they drink it, and that's fine as well. Uh, you know, again, it just depends on you know how much people want to add to the things they're drinking, but pectin is phenomenal as well at disrupting this enterohepatic circulation. Yeah, thanks. I just wanted to just mention that. Great stuff, John. Great stuff. And we'll we'll come back to um foods that one look at in a in a more discerning way. Uh,
Oats Versus Root Veg Fiber
but I have a nuance, John, that you uh brought. Bring to the distinction between beta D glucane from let's say an oat source versus a root vegetable like beets or carrots, uh molecule. Uh and and and I could imagine, John, some might be a little surprised to hear some consternation of oats. Yeah, yeah, I'm sure. Which, you know, uh is is uh probably one of the more frequent um cultural means uh as a health food. Um and so we make the distinction often, given the high, high prevalence of insulin resistance, uh conservatively 70% of the American population and oats as an example, uh they're redeeming values clearly, but but as a carbohydrate-dense food that is accellular, we we often talk about how the uh the carbohydrates in oats are not contained within a cell wall. They're more easily accessible, they they break down and rise very quickly. And anyone who has a continuous glucose monitor will be will find their data pre-post a bowl of steel coat oats. I've done that many times, and it and I'm just stunned at how high my sugar will rise, um, as opposed to uh the beta D glucan that you'll find in, say, a root vegetable, um, which is within the membrane, the cell membrane of that of that plant, and uh it takes a little more work to break it down, and the excursions of sugar and ultimately insulin aren't as great. So there's a really nuanced example. I just want to emphasize um that really awesome point that you made, John.
Bile Signaling GLP 1 Satiety And Fat Burning
And now let's look at uh just another graphic here of the um uh ways, the many ways. Uh this is just a kind of an overview, and I'll let you run with this, John, of how these secondary bile acids have multiple uh metabolic effects. Uh and John, how I'll let you. Well, look, I mean, I I think the best thing we can say about this, and I I'm sure the GLP1 uh molecule here really stands out, right? Because there's just so much interest and uh momentum with that particular uh you know, GLP1 type drugs. I I would say the greatest thing about this is that everybody knows that a high-fat meal has a greater satiety value, right? We if we eat a couple high fat meals a day, we're not looking for food for the rest of the day. That would be like my real high-level summary here is that when we eat a higher fat meal and we get a greater release of bile acids, um, there those bile acids are communicating with our metabolism, with our appetite, with the body's tendency to expend energy energy from different stored sources. And again, we could back up, we could look at the Paleolithic kind of human experience and say, well, our ancestors ate, you know, a much, much higher fat diet. And because of that, bile was released in much larger quantities, and it had all of these very favorable effects on our ancestors' physiology and our ancestors' ability to really thrive when there were going to be greater windows of time between meals. So that's something I always want to emphasize is that bile, which again, you've already mentioned this, but for our listeners' sake to hear it twice, we tend to release greater amounts of bile with higher fat meals. And, you know, the bile is, yes, it's emulsifying that dietary fat. It's allowing us to digest it properly, it's creating a greater interface between our digestive juices and the fat in our diet, which can, you know, which can tend to separate right from those. So it's accomplishing that. But what we tend to, and I have always failed to fully appreciate, is that the bile is also governing where the body is going to generate energy from. And if the body is experiencing this surge in bile acids, the bile acids communicate with the body to basically burn fat. So it's really turning up the body's thermostat in a way. It's saying, you know what? There was a high fat meal just consumed. Now let's burn. Let's burn fat, let's raise our energy expenditure, let's get things done. Again, this is just, you know, again, real high-level stuff, but you can see that you have appetite suppression, you have a higher level of insulin sensitivity that's going to be generated from this. Um, you're not going to be producing the same types of lipids. You know, bile acids have also been shown to really influence the type of LDL molecule we we produce, for instance. So I I think that that that would be my real my high-level summary of this, Mark. And that's just an amazing example of how, again, um bile acids as a byproduct of sort of uh day-to-day metabolism, right? They they they sit in these receptors on the liver, in the gut, in the pancreas, on muscle, and exert this network of metabolic effects. So you you um um really see how these uh pathways interact in such uh integrated and and coordinated ways. Uh of course uh all of this is happening, right? You've got literally billions of biochemical reactions, all in some way synchronized and choreographed to optimize metabolic function. And that that that was the mandate for human uh survival, and uh this is just a really elegant uh graphic in terms of the many ways that a seemingly trivial bile salt uh exerts many profound uh metabolic effects. And
Dysbiosis Antibiotics And Modern Disruptors
in the same way, uh you and you've touched so nicely, John, on the um um the things that we we frequently emphasize, the importance of fiber quality, diversification of the gut biome, and and we're reminded that in modern life, uh the foods that we eat, uh the antibiotics, uh that are in so many uh food products, um the uh uh extent to which the standard American diet is so deplete of quality fiber. Um, in this graphic from the review article that we showed earlier, you can see how uh dysbiosis, uh which has so many modern American drivers. Well, we've talked about uh the research of the Sonnenbergs at Stanford. Yeah. And uh they've got some great reviews of sort of the epidemiology of why it is that the modern American gut biome ecosystem looks so different than it probably once did, uh, and certainly very different from ancestral uh research that has looked at at cultures like the Hadza and you know uh Jeff Leach's work. Uh but you can see how dysbiosis uh interferes with this conversion of the primary to secondary bile acids, how antibiotics, whether we're taking them for an infection that may not otherwise require an antibiotic or we're getting them from the foods that we eat. We know glyphosate, for example, has antimicrobial activity. Uh so we're we're we're in these modern environments that are well suited to assault this system. And so here again, you see reduced secondary bile acid synthesis because of uh changes in the in the biome, and then um the extent to which a lack of quality soluble fiber will also interfere with these bile acid pathways, right? So you you you begin to see how we're lacking uh many of the things that we need to drive the system more optimally, and we're getting exposed, overexposed to things uh that we probably need to be managing a bit more thoughtfully, also uh disrupting uh the ways in which these systems support our health. Anything else on this graphic, John? No, just the last component there, physical activity uh lowering bile acid concentrations in by really moving things along by speeding up peristalsis, those wave-like contractions. So it's it's amazing how physical activity sort of clears the playing field of right of bile acids, yeah. Great.
Best Fats For Thinner Bile
And then um uh we can just as we we conclude this, John, uh, in a recent Substack uh published that you have you got a nice list of uh foods that can support this process in a more optimal way and foods that that can disrupt it. And so maybe we can just go through these quickly and then we'll we'll bring it home. Yeah, all of these uh foods listed here contain specific fatty acids that have been shown to promote a uh a thinner, less viscous bile, one that will have uh a greater ability to be released or purged, I guess, from the gallbladder when necessary. So again, thinner, thinner bile, when the gallbladder contracts, you're gonna get a greater amount of that bile released. It's gonna typically be more effective. Um, it's not going to form that thicker sludge and uh have you know increase the risk for forming gallstones. But again, downstream, so to speak, once it's released from the gallbladder, thinner bile is also much more effective at communicating with all the different facets of our physiology that we've talked about. So, you know, black seed oil, um very, very high on the list here because of some of the unique fatty acids that it contains that you really have a hard time getting anywhere else. Um, freshly ground flax seeds or flaxseed oil, extra virgin olive oil. Again, that's high in squalene. And squalene is a really interesting molecule. Um, it's also found in some, again, it's found in shark cartilage. It's only found in a handful of foods on the planet, but it does end up in bile. Um, and it it does have a very profound effect on the bile's consistency and and being very protective against that bile thickening. So that's why, you know, extra virgin olive oil, again, not that it needs more more evidence or support. It's it's often looked at as you know, the healthiest fat that a person can consume. And I think that um it's great when things are actually true because there's so much of that uh misinformation out there. But in the case of olive oil, it it really sticks in just about every application. So then again, oily fish, small oily fish, excellent for bile consistency and having healthier bile avocados, almonds, pecans. And you'll see that most of these have high monounsaturated fat contents. That's I think something that you could safely draw a conclusion around here is that monounsaturated fat tends to have, um, just like it does for most areas of our of our overall health, it it really lends itself to having better bile qualities. Uh, and then you get in down into the coconut oil and in the pasture raised butter, and again, some of the unique shorter chain saturated fatty acids that those contain. So these are your those are your best fats and oils for for having that. What you don't see on here, obviously, is you don't see um, you know, highly polyunsaturated seed oils. Uh, you don't see some of the altered fats, which I'd like to refer to as fats that have been brought to really high temperatures. Those are, you know, those are the worst fats. And what I found, and you may have heard this too over the years, Mark, is that for many individuals, I and I don't have a there's no I have no clinical study to to support what I'm about to share, but it's just been 25 years of counseling people and hearing about the last meal or the last few meals that precipitated a gallstone attack. And time and time again, it was a a meal that was comprised largely of some type of fried food, uh, whether that be French fries, whether it be fried chicken or fried clams, whatever it was, people have repeatedly shared with me. That was the last meal before they had to go to the emergency room. And you know, it's it's really um it's easy to understand that because when a oil is brought to really high temperatures, it starts, it's its molecular structure starts to change in a way that it becomes very stiff, very rigid, um, much, much more difficult to digest. But also when those fatty acids ultimately do get absorbed into circulation, their role in the subsequent bile formation that would include them really alters that the thickness of that bile. So bile will really thicken and gallstone formation will really accelerate when you have these kind of altered oils in the diet that ultimately start to, you know, contribute to the composition of what's in the gallbladder. So that's why you see the worst foods are those which are foods fried at high temperatures and in the case of donuts, also contain a very high refined carbohydrate content. That's where you get like that's a double whammy. When you have a food that's high in sugar, high in refined carbohydrates, and it's fried, or you have a meal where you know someone's drinking, you know, let's say someone's having a soft drink or soda and they're having some type of fried, you know, whether it's fried chicken or something, then you, you know, you're asking a lot of the body in general, but you're asking a lot of the gallbladder, and you're really creating issues with bile, the way bile is formed in the gallbladder when those types of meals uh become frequent over the over a day or two. So those are the worst foods, refined carbohydrates, foods which are made up of oils that have been brought to really high temperatures. Hydrogenated oils luckily have started to really, you know, they've they've started to disappear from the, at least from the average American's diet, because you know, they're just, you know, states like California and New York, you know, had legislature put in place that you know prevented food manufacturers from from selling those in those states. And that really helped a lot. Uh so you know, hydrogenate oils aren't on the list uh per se because they're not as common now as they were 15 to 20 years ago. But that would also be an example of an altered oil. Great.
Why Fried Foods Trigger Attacks
Thank you for that, John. Yeah, that that we we had a um a uh an acronym or or mnemonic uh when um people presented with usually it was abdominal pain, nausea, maybe vomiting. And of course, their pain could usually be localized to the right upper part of their abdomen where their wall bladders were. And the mnemonic, it it was the F's, uh female, fat, um, and uh fried foods. Yeah. And uh almost always that that was the context whereby uh they would present. And uh so I love that list. Uh and of course, these are the these are the foods that are just so highly palatable and uh and that right people love. Uh and let me we'll we'll end um John with this um uh last list of really uh positive food considerations that um uh really touch, I think, this important issue of of soluble fiber. And
Bitter Greens Beets And Bile Flow
uh and I'll let you go through this list, John, and then we'll Yeah. Yeah, so the groups of of vegetables or greens, I should say, that have the most uh really positive effect on bile production, bile qualities, and have very great protective effects against gallstone formation, are members of the chicory family, and then greens in the brassica family. Now, the common denominator across all of those greens, which again make up the top five on this list, and then also make up, you know, two or three of the bottom, um, is that they're collectively they're referred to as the bitters, you know, the root of that word, you know, from European uh I guess heritage you'd say, where bitters were used for different medicinal purposes. But one thing, whether it's in you know Chinese medicine, wherever you look in the globes, that bitters have very profound effect on gallbladder uh contraction, bile production, bile secretion. And so that's why you see, like, for instance, dandelion greens are a member of the chicory family. So are, you know, so are Radicio, Endive. These are really bitter greens. Um, you know, I would put coffee in there as well, even though, you know, obviously coffee's a beverage, but the one of the most positive attributes about coffee is the bitterness and the bitter content that we know. And I'm pretty sure, Mark, that you and I have already talked about the associations with coffee consumption and gallbladder disease, gallbladder diseases appears to be very protective from what I've looked at. I think we talked about that maybe it was a year ago or so. Yeah, but so your brassicas, your members of the chicory family, which are dandelion greens, ridiculo, endive, there are a few others, uh, but those are all very, very potent gallbladder uh contraction, bile secretion stimulants, which is good to have on a somewhat regular basis. And then your brassicas, which are going to be arugula, mustard greens, collard greens, uh kale to a much lesser extent because it's not as bitter as, let's say, mustard greens. Um, but these are, you know, those are again the bitters. And then you have beets, you'd see here again, and that has more to do with the ability of beets to um bind on to bile acids, carry them out of the body. And one thing I failed to mention, which is important here, is that when bile acids are repeatedly recycled, when you don't break or when an individual doesn't break that enterohepatic circulation, recycled bile, when it starts to appear the second and third time, it it that in itself starts to lend itself to a thicker bile and a in a greater risk for forming gallstones and having kind of that sludge-like consistency that we don't want. So, you know, that's why beets are on that top 10, is that's the most effective food for really eliminating those bile acids and not letting them get recycled. Well,
Key Takeaways And Share Request
that's a great place to um adjourn on, John. It it it hopefully our health edge listeners appreciate uh a very different and nuanced uh context of what's happening in their bile production in gallbladder function and ultimately uh so many aspects of metabolic health and detoxification, uh, and some great suggestions for how one can incorporate paleo ancestral principles, um uh not just the nutrition and the movement which you touched on, the peristalsis. Uh it all has a remarkable place. So uh fun discussion, John. Thank you for uh the topic. Yeah, thank you. I really appreciate the the opportunity that you and I have to talk about these things. It's I look forward to it every week, Mark. It's great. Well, yes, as do I. And we uh uh want to thank our listeners for tuning into the Health Edge. If this is content that you find has value for you or maybe someone you love and care about, please share with them. Uh John and I have an absolutely pathetic social media presence. Uh and um uh we're we're we're happier because of it. Uh and uh but it doesn't always allow content to reach as as many people, so be it. Uh so we we appreciate our loyal Health Edge family, and we'll continue to uh scour research that is um uh really changing, I think, the way we think about self care and lifestyle functional medicine. And Josh, just always a pleasure and and great to see you and have an awesome week. We'll see you next week. Same here, my friend. Uh take care, buddy. Take care.
