Question:
I need eat only a half-inch piece of avocado in a sushi roll and I have nausea for hours. Eggs will also do this to me though eggs in baked goods do not affect me. As I have gallstones and do better without animal fat, I wonder if it is linked to that? (I was sensitive to fructans on the Fodmap testing diet.)
Answer:
Avocados are nutritious and popular, so much so that the famous cafe staple of avocado on toast has spawned an annual Wellington Avocado Toast Award. But is it off the menu for those with symptomatic gallstones?
Gallstones are hard lumps that resemble pebbles. They form in the gallbladder from the materials used by the body to make bile. Bile is released during digestion to help break down fatty acids. While gallstones are common, particularly among women from age 40 onwards, not everyone who has gallstones will experience symptoms. The most common type of problem associated with gallstones is biliary colic and includes symptoms of pain in the upper right section of the stomach, with nausea and vomiting.
Gallstones are formed from bile, which is excreted by the body to help digest dietary fats. This suggests a possible interaction between diet and gallstone formation. Many health professionals and health websites state that eating fatty foods may trigger an attack. Patients with gallstone symptoms are often advised online to avoid avocado, and eggs cooked with butter or other fats, to reduce painful attacks and manage their condition.
However, the British Dietetic Association has called the latter recommendation “clinical dogma” because there is no clear evidence to support or disprove the theory that reducing fatty food intake helps with gallbladder symptoms.
An ongoing Cochrane Review of studies has so far found no substantial evidence that a low-fat diet was more beneficial than a standard diet for treating gallstones.
In the absence of clear, research-based advice, your experiences should not be ignored. If you find fatty foods seem to worsen your symptoms, it would make sense to carefully balance your diet to avoid them. The findings from the Cochrane Review will help health professionals better understand whether a low-fat diet (excluding high-fat foods like avocado) could reduce the symptoms of gallstones. This does not help you right now, though.
Without a complete assessment of any other symptoms, we do not know if your avocado-related symptoms are caused by gallstones or something else. As you have already performed a Fodmap testing diet, typically supervised by a registered dietitian, it would be ideal to return to the same one for advice. Dietitians can provide expert nutrition advice and help manage various health conditions.
For everyone else, avocados are packed with healthy fats, vitamins, minerals, and fibre. A single avocado contains 8g of fibre, a sizeable contribution to the daily target of 25g for women and 30g for men if you eat a whole one. In contrast, a kiwifruit has 1.7-2.2g of fibre, a banana 2g and an apple about 2.7g. And avocados are a rich source of many healthy varieties of fat. A single fruit has about 44g of fat, of which 31g is monounsaturated, 5g polyunsaturated and 6g saturated.
The predominance of monounsaturated fat qualifies avocados as good for heart health. A recent meta-analysis that reviewed 18 studies on avocado intake and cardiovascular disease risk found clear evidence that adding avocado to your diet increases levels of healthy HDL cholesterol, irrespective of what else you eat. So, enjoy those avocados while they are in season.
Email your nutrition questions to listenerlife@aremedia.co.nz
