Warwickshire Dietetic Service

A Guide to Healthy
Eating for People with
Gall Stones

This information can be issued to patients by Dietitians,

Doctors, Practice Nurses, District Nurses, Community
Nurses, Community Rehab Teams and Allied Healthcare
Professionals.
A Guide to Healthy Eating for People with Gallstones

Gallstones are hard crystals of various substances that can form in the gallbladder. The main
function of the gallbladder is to help digest foods by storing and releasing bile into the small bowel.
The bile breaks down fats and other nutrients so that they can be digested and absorbed.

Many people who have gallstones have no symptoms but others suffer from abdominal pain,
bloating, nausea and vomiting. In some people, gallstones can cause pain in the upper-right side of
the abdomen or indigestion after eating foods high in fat.

Studies have shown that being overweight or obese can increase your chances of having
gallstones, especially if you are female. Those who carry a large amount of fat around their waist
are also more likely to develop gallstones than those who carry fat around their hips and thighs.

For people who are overweight or obese, even a small amount of weight loss of 10% of body weight
over a 6 month period can improve health. Adopting a very low fat or a fat-free diet to achieve rapid
weight loss (more than 1.5 kg or 3 lb. per week) is not advised as this may increase your chances of
developing gallstones or increase the size of gallstones.

There is no specific diet for treating symptoms. However eating a healthy balanced diet low in fat
may help.

Use the ‘Eatwell Guide’ on the following page to ensure you have a balance of healthier and
more sustainable food. This includes:

 eating plenty of fruit and vegetables; at least 5 portions a day

 eating some potatoes, bread, rice, pasta and other starchy carbohydrates at each meal
especially the high fibre varieties
 having small portions of beans, pulses, fish, eggs, meat and other proteins every day
 choosing some dairy products each day
 using unsaturated oils and spreads in small amounts
 having small portions of foods and drinks high in fat and/or sugar very occasionally
 eating food without adding too much salt
 drinking at least 6—8 cups of fluid each day.

If you lose too much weight or find your condition difficult to control while following the advice in this
leaflet, ask your doctor to refer you to a Registered Dietitian for specialist advice.

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A Guide to Healthy Eating for People with Gallstones

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Diet Sheet Title Here

Fruit and Vegetables

This group includes: all fresh, frozen, dried and tinned fruit and vegetables and salad. Aim for at
least five portions of a variety of vegetables and fruit every day.

How much is a portion?

Vegetables e.g. cauliflower, cabbage, peas, car- 3 tablespoons

rots, swede, courgettes, broccoli, green beans

Salad 1 dessert bowl

Whole fresh fruit 1 apple 1 pear
1 orange 1 banana
1 peach
Tinned fruit, fruit salad, stewed fruit 3-4 large tablespoons
Large fruit and vegetables 1 slice melon or pineapple
½ grapefruit , avocado or pepper
Small fruit 2 plums
2 kiwi
1 cupful grapes, cherries, strawberries
Dried fruit 1 tablespoon
Fruit juice, smoothie 1 small glass or carton (150ml)

Tips for eating more vegetables and fruit

 Add fruit such as banana or berries or a handful of dried fruit on breakfast cereal.
 Add salad to your sandwich fillings.
 Have a healthy dessert: try whole fruit, fruit salad, fruit tinned in juice or stewed fruit.
 Have at least one portion of vegetables or salad with your main meal.
 Try home-made vegetable soups.
 Add extra vegetables to stews, casseroles, curries and sauces.
 Fruit and raw vegetables can make a healthy snack if you are hungry between meals.

Useful facts about fruit and vegetables

 They contain antioxidants, vitamins and minerals, which can help protect your heart.
 They contain soluble fibre which can help reduce cholesterol levels.
 They are low in calories.
 Steaming vegetables rather than boiling helps reduce the loss of vitamins in cooking.
 Frozen vegetables can contain as many vitamins as fresh.
 Soaking vegetables in water is not a good idea as vitamins are lost.

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Diet Sheet Title Here

Potatoes, bread, rice, pasta and other starchy carbohydrates

This group includes: All breads, breakfast cereals, pasta, grains, rice, flours, potatoes and
chapattis. Choose at least one food from this group at every meal.

Tips for eating more starchy carbohydrates

 Choose wholegrain or high fibre varieties such as:
 wholemeal, granary, high fibre white bread, crispbreads or wholemeal pitta
 porridge oats and oat bran cereals, e.g. Oat Crunches, Common Sense Oat,
Oats So Simple, Oatibix, oat biscuits, wholegrain breakfast cereals, e.g. Bran-flakes,
Weetabix, Wheat-flakes, Fruit and Fibre, Shredded Wheat
 brown rice
 wholemeal pasta or noodles.

 Avoid sugar, honey-coated or chocolate based breakfast cereals.

 Use spreading fats or a low fat spread sparingly on bread.
 Use tomato-based sauces instead of creamy or cheese based ones.
 Do not add fat to potatoes, chapattis or noodles.
 Choose boiled rice instead of fried rice.

To increase your fibre intake, other suggestions include:

 Kidney beans in chilli con carne
 Butter beans in stews or casseroles
 Lentils in soups and dhals
 Baked beans in shepherds pie
 Baked beans on toast
 Mixed beans in salads.

Useful facts about starchy carbohydrate

 High fibre foods can help you to feel fuller for longer
 High fibre foods help prevent constipation, but only when you drink plenty of fluid as
well.
 This group is high in essential B vitamins

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Diet Sheet Title Here

Dairy and alternatives

This group includes: Milk, cheese, yoghurt, fromage frais, milky puddings e.g. custard, semolina,
tapioca, rice pudding; and sauces such as parsley, cheese or bread sauce. It also includes milk
substitutes that are unsweetened and fortified with calcium (e.g. soya or almond milk).

Aim for 3 portions a day.

Tips about dairy and alternatives

 Choose lower fat alternatives of milk, cheese, yoghurts, fromage frais.

 Choose varieties with no added sugar.
 Use skimmed milk to make sauces and milky puddings.
 Grate cheese to reduce the amount you use or use smaller amounts of strong flavoured cheese.

Useful Facts about Dairy and alternatives

 Dairy foods are good sources of calcium.

 Skimmed, semi-skimmed milk and 1% milk contain just as much calcium as whole milk.
 Lower fat cheeses include cottage cheese, reduced fat Cheddar, Edam, Brie,
Camembert, Quark and low fat cheese spread.

Beans, pulses, fish, eggs, meat and other proteins

This group includes: all types of beans, lentils, dhal, poultry, fish, eggs, meat, nuts and other meat
alternatives such as Quorn, soya or tofu.

Aim for 2—3 portions a day.

Tips about proteins

 Eat more beans, lentils and pulses.

 Eat less red and processed meat, aim for no more than 70g (just under 3oz) per day.
 Try to eat 2 portions of sustainably sourced fish a week, one of which is oily
 Trim off any visible fat on meat and take skin off chicken, turkey and duck.
 Do not add oil in cooking. Grill, bake, steam, microwave or dry fry instead.
 Add peas, beans and lentils to casseroles, soups and stews.
 Choose fish canned in tomato or water rather than oil or brine.

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Diet Sheet Title Here

Useful facts about proteins:

 Red meat is an excellent source of iron and zinc.

 The soluble fibre in beans and pulses may help reduce blood cholesterol.
 Omega-3 fatty acids found in oily fish have a beneficial effects for heart health. Aim to
eat at least one portion of oily fish per week, e.g. mackerel, sardines, salmon.

Foods and drinks high in fat

High fat foods include: butter, margarine, low fat spread, oils, mayonnaise, oily salad dressing,
cakes, chocolate, ice-cream, tarts, pies, pastries, crisps.

Fat is the most calorific nutrient. Some fat is essential, so oils and spreads are the only fats
included in the Eatwell guide (see page 3). All other foods and drinks high in fat should be eaten in
small amounts and only occasionally.

The fat in most food is a mixture of three main types - saturates, monounsaturates and
polyunsaturates. It is important to limit all types of fats, but particularly saturated fats.

Saturated fats are more likely to increase your risk of heart disease. Saturates are found in:
 Butter, hard margarine, lard, dripping, suet, coconut oil, palm oil and any foods made
from these including biscuits, cakes, pastries or cooked using them, e.g. chips, crisps
 Fatty meat and meat products such as burgers, sausages, pepperoni, pâté, meat pies,
especially pork pies
 Cheese especially hard cheese and some cheese spreads.

Monounsaturated fats are found Polyunsaturated fats are found in:

in:

 Rapeseed oil  Vegetable oils, e.g. sunflower, corn oil or soya oil
 Olive oil  Oily fish, e.g. mackerel, kippers, herrings
 Groundnut oil  Nuts and seeds

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Diet Sheet Title Here

Other types of fat

Omega-3 Fatty acids are found in oily fish. They have beneficial effects for heart health. Eat at least
one portion of oily fish per week, e.g. mackerel, sardines, salmon. The darker the colour of the fish the
more Omega-3 fatty acids it is likely to contain.

Trans fatty acids (trans fats) are found in small quantities in some foods from animal sources,
including meat and dairy products. They can also be found in foods containing hydrogenated
vegetable oil.

Like saturated fats, trans fats raise cholesterol levels in the blood so increasing the risk of coronary
heart disease. Most people in the UK do not eat a lot of trans fats. On average, we eat about half the
recommended maximum. Food manufacturers in the UK have lowered the levels of hydrogenated
vegetable oil they use, which means that trans fat levels have been reduced as well.

Oil and spreads

Try to choose monounsaturated or polyunsaturated oils and spreads, but still use them in
moderation. Look for spreads containing the least saturated fat and most unsaturated.
Examples include:
Monounsaturated - Rapeseed and olive oil spreads, such as Bertolli, Olive Gold, Carapelli, and
supermarket own brands
Polyunsaturated - Sunflower oil and spreads, such as Flora, Vitalite and supermarket own
brands.

Tips for reducing fat:

 Avoid deep fried foods.

 Have pastries, pies, crisps, or cream for occasional treats only
 Measure the oil you add to a pan using a teaspoon rather than just pouring it in
 Foods containing ‘Plant Sterols’, e.g. Benecol, Flora ProActiv or supermarket own brands are
designed to reduce cholesterol levels but are not essential.

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Diet Sheet Title Here

Foods and drinks high in sugar

This group includes: biscuits, cakes, chocolate, ice-cream, jam tarts, sweets, sugary
drinks (including fruit juice), jam, marmalade and honey.

Sugary foods are not essential for health so eat less often and in small amounts.

Sugar can be listed in lots of ways on food labels.

 Check ingredient lists. The nearer sugar comes to the start of the list, the more sugar
it contains (see page 10 for more information on reading food labels).
 Look out for honey, treacle, molasses, syrup, sucrose, maltose, invert sugar, fructose,
maltodextrin. These are all sugar.

Tips for reducing sugar

 Aim to cut out or reduce sugar in tea and coffee. You could use an artificial sweetener
instead.
 Use diet, zero or sugar-free squashes and fizzy drinks.
 Choose fruit or sugar free yogurt and have sweet pastries, pies, puddings, cake and biscuits
for occasional treats only.

What about salt?

Salt is the common name for sodium chloride. Too much sodium in the diet contributes to high
blood pressure and therefore heart disease and strokes. Six grams of salt per day is the
recommended maximum daily intake for adults. Children need less.

Tips for reducing salt

 Avoid adding salt to your food at the table and only add a small pinch when cooking.
 Limit salty foods such as salted nuts, crisps, jars and packets of soups and sauces,
ready-made meals and processed meats such as bacon, sausages and tinned meat.
 Salt substitutes are not recommended as they do not reduce the taste for salt and can be
harmful in some conditions.
 Sea salt has no major benefit over common salt. Despite containing some extra
minerals, it still contains sodium so therefore should be kept to a minimum.
 Try using herbs, spices, lemon juice or pepper to flavour your food.

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Diet Sheet Title Here

What about drinks?

As your body is made up of approximately two thirds water, it is essential for good health to keep your
body well hydrated. An average adult needs about 3 pints or 1.5 litres of fluid every day; this is about
8-10 cups. Try plain water, low fat milk, squash, tea and coffee.

If you drink alcohol, follow the low risk national guidelines. There is no evidence that drinking alcohol
can be absolutely safe, but by sticking within the guidelines, you can lower your risk of harming your
health. The guidelines state:

 Men and women are advised not to regularly drink more than 14 units a week.
 Spread your drinking over three days or more if you drink as much as 14 units a week. A good
way to keep to the low risk guidelines is to have several drink-free days each week.

Guide to Food Labelling

Look at the nutritional label and use the tables below to help you to make healthier choices.

Drink per 100ml High levels Low levels

Sugars 11.25g 2.5g
Fat 8.75g 1.5g
Of which saturates 2.5g 0.75g
Salt 0.75g 0.3g

Food per 100g High levels Low levels

Sugars 22.5g 5g
Fat 17.5g 3g
Of which saturates 5g 1.5g
Fibre 3g 0.5g
Salt (Sodium) 1.5g (0.6g) 0.3g (0.1g)

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Equality Statement

At South Warwickshire NHS Foundation Trust we are fully committed to equality and diversity,
both as an employer and as a service provider. We have a policy statement in our Equality
Strategy that clearly outlines our commitment to equality for service users, patients and staff:

You and your family have the right to be treated fairly and be routinely involved in decisions
about your treatment and care. You can expect to be treated with dignity and respect. You will
not be discriminated against on any grounds including age, disability, gender reassignment,
marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex or sexual
orientation.

You have a responsibility to treat other service users, patients and our staff with dignity and
respect.

Our information for patients can also be made available in other languages, Braille, audio tape,
disc or in large print.

PALS

We offer a Patient Advice Liaison Service (PALS). This is a confidential service for families to
help with any questions or concerns about local health services.
You can contact the service by the direct telephone line on 01926 600 054 by email:
[email protected] or by calling in person to the PALS Office which is located in the Lakin Road
Entrance to the hospital.

If you have any queries about your diet, please contact us:

Dietetic Department Dietetic Department

George Eliot Hospital Warwick Hospital
Nuneaton Warwick
Tel 024 7686 5098 Tel: 01926 495321 Ext 4258

Author Registered Dietitian

Department Dietetics

Contact no 024 7686 5098/01926 495321 x4258

Published August 2016

Review August 2021

Version no 3

SWH No 00791