I have had my Gall Bladder removed and I’m wondering if that’s why I am struggling to lose weight on these diets, I have tried the blood sugar diet and 5:2 but with no real success any suggestions…?

The microbiota play a big role in determining how much calorofic value you extract from the food you eat. Might be worth having your biome mapped?

Thank you GrahamSPhillips do you know how i have this done?

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my mum has had her gall bladder removed and she cant eat very much fat at all otherwise she gets terrible pains similar to those she had when she was hospitalised with acute pancreatitis and infected gall bladder. she has massively reduced her fat – butter, cheese, cream, fried foods, bacon etc. and reduced alcohol significantly. she has lost lots of weight and feels better for it but suffers with repeated oral candida infections (GP puts down to steroid inhaler) I am concerned that she has underlying gut health issues and wonder how she can make changes Clever Guts style without having the negative effects from the oils and fats in the recipes? i have suggested live yoghurt but that it needs to be full fat – she is not keen. i have suggested capsulated probiotic supplements from Holland and Barrett but that these need to be consumed with fat to survive the stomach acid. she also takes a digestive enzyme (i forget the name) to replace the job of the gall bladder. she likes fruit and veg and doesn’t have much processed food.
Can anyone give me any advice please? many thanks

Research shows poor technique with inhalers is a widespread problem … Even amongst doctors, nurses and pharmacy staff! Ask the pharmacist to recommend easier to use inhaler products and/ a spacer device, and then have your mother retrained in how to use them correctly.

Review dental health and oral care with the dentist or pharmacist. Consider switching toothpaste and mouthwash free of anionic surfactants (eg. SLS) and drying alcohol if present.

Diet-wise first is the detailed food and symptom diary (p.187), everything weighed and measured. Consider the *balance and variety* of the diet, including *essential* fat soluble nutrients (vitamins A, E and esp. D, long chain omega-3s), and types/ quantities of prebiotic rich wholefoods.

Focus on the long term principles of Clever Guts not the recipes. The full rainbow of bright and dark coloured (p.119-124) low sugar fruits and non starchy vegetables, twenty to thirty varieties a week (p.191), carbohydrate wholefoods richer in resistant starch (p.268-269), fermented vegetables (p.140-146), reduced fat live dairy (kefir/ yoghurt) …

*Whole* flax/ linseeds are not broken down in the human digestive system, the so the fats and minerals are not released. But the prebiotic mucilage (gel) is, soak in a glass of water to see this effect.

Ask the doctor about referral to a registered dietician. Discuss any supplements and the food and symptom diary with the dietician, pharmacist or doctor, because these have access to her medical notes and/ or list of prescribed medication.

Make any changes *slowly one at a time*. Some fat is essential but may well be better tolerated little and often. For example a triple strength fish body oil capsule with each meal (if the relevant medical professional agrees).

Ok thank you. I agree she should be referred to a dietician. Regards the inhaler she always rinses and gargles and spits out the water after using the inhaler. And I think she uses a spacer as well but I’ll make sure she does! Toothpaste is Sls free and she doesn’t use alcohol mouthwash.
So you think low fat kefir/yoghurt is still ok then? Am I wrong in assuming the live bacteria need fat to survive reaching the intended place?

Do still speak with the pharmacist about inhaler use and the dentist about oral health, if nothing else these consultations will help inform the doctor or dietician.

Dairy products supply important nutrients and, as such, are part of the healthy eating guidelines for western countries (UK three servings every day). If someone is unable or unwilling to do that, alternatives need to be discussed with a health professional..

Probiotic microbes are not more important than prebiotics in the diet so don’t get hung up on it. Microbes can grow and survive in fresh low fat yoghurt and kefir, but the populations will be different to those in higher fat aged cheeses. As you say different microbes will have different survival rates in different meal combinations but it is not an ‘all-or-nothing’ situation based on fat AFAIK.

Does your mother know how much fat (grams/ ounces) is in a measured serving of each food, or is she more fearfully avoiding the regular fat versions? For so long semi or skimmed milk was pushed, but full fat is actually only 4%! It is night and day compared with hard cheeses, cream or butter.

Yoghurts are more variable, down to both the milk used and if they are strained to remove the whey (eg. Greek). Depending what the kefir or yoghurt is eaten with, some fat is in the meal. Raw oats work well with set live yoghurt (unstrained) in homemade muesli. Oats are higher fat than some grains, and richer in resistant starch.

Kefir can be made with low fat milk, as can yogurt. I have had my gall bladder removed and I find kefir very helpful.

when I am trying to lose weight I use the Yeo Valley 0% Fat Greek Yogurt. Creamy and lovely to eat.