Dietary taboos for high total bile acids

The core dietary taboos for high total bile acids are essentially to avoid foods that will increase the metabolic burden on the liver and gallbladder, stimulate abnormal bile secretion, or impede excretion. The core food taboos to avoid are high cholesterol, high saturated/trans fat, highly irritating, and high-sugar and deeply processed foods. There are no foods that must not be touched. Specific taboos need to be adjusted based on your own basic liver and gallbladder conditions.

Last week, I met a 28-year-old programmer in the outpatient clinic. He was so panicked when he took the physical examination form. The total bile acid was three times higher than the upper limit of the normal value, and the transaminase was also a little bit high. After questioning, I found out that the day before, I had licked 20 skewers of fat lamb kidneys with my friends, paired them with half a dozen cold beers, and showed off two braised pig trotters. I had just stepped on most of the minefields.

Don’t think that only heavy meals with oil and alcohol will cause problems. Many of the things you eat every day can cause problems if you’re not careful. For example, the braised sausages and fried pork rinds that are often cooked at home during the holidays, as well as the pig brains and foie gras that many people like to eat, have ridiculously high cholesterol content. After eating them, the liver has to work overtime to synthesize more bile for metabolism. If you have problems with cholestasis and gallstones, the bile cannot be excreted and directly flows back into the blood, and the total bile acids will rise upwards.

When it comes to this, the first reaction of many people is that egg yolks cannot be eaten. This issue has actually been controversial clinically for a long time. A few years ago, the view was that as long as the total bile acid was high, egg yolks should be completely discontinued. The consensus in the past two years has changed: If the total bile acid is simply high, there is no cholecystitis or gallstones, and other liver function indicators are normal, one whole egg a day is absolutely fine. High-quality protein can help liver cells repair. ； But if you already have bile duct obstruction or frequent gallstones, you really need to eat less egg yolks. 2-3 egg whites a week is enough.

There is also a common misconception that plant-based fats are safe. Don’t let this fool you. For example, the trans fat in milk tea, egg tart pastry, and cream cakes made from hydrogenated vegetable oil sold in supermarkets has a heavier metabolic burden than lard, which will directly increase the viscosity of bile and increase the resistance to excretion. I used to have a little girl who worked in operations. She basically relied on takeout for three meals a day. She had at least one cup of milk tea every day. For three consecutive months, her total bile acid was found to be high. She stopped milk tea and replaced it with sugar-free oolong tea, and replaced her cooking with olive oil. Within a month, it fell back to the normal range.

By the way, there are also high-sugar foods that many people ignore. Do you think sweet things have nothing to do with bile? Wrong, excess sugar will be converted into endogenous fat in the liver, which will also increase the metabolic burden. Last month I met a young man who doesn't like to eat fat but loves to drink Coke and eat tiramisu. He is 175cm tall and 180cm tall. His total bile acid level was almost 4 times higher. This is a problem caused by eating high-sugar foods every day.

You should also avoid eating highly irritating foods as much as possible. The first thing to suffer is alcohol. Whether it is white wine, beer or red wine, as long as it contains alcohol, it will directly damage liver cells and disrupt the synthesis and secretion rhythm of bile. Drinking alcohol while having high total bile acid is equivalent to "adding fuel to the fire" to the liver and gallbladder. There are also particularly spicy spicy hot pot, spicy fragrant pot, as well as the cold beer and smoothies that you like to drink in summer, which will stimulate the biliary tract or gastrointestinal smooth muscle spasm. Bile that is not excreted smoothly will be more likely to flow back into the blood after being stimulated by this.

The most extreme example I have seen is an aunt in her 50s. After she was found to have high total bile acid, she immediately stopped eating all animal foods. She had white porridge with vegetables every day, and only dared to add a few drops of oil. The three-month follow-up showed that it was even higher, and she was still weak and weak. In fact, there is no need to overdo it. Steamed seabass and prawns have very low fat content and high-quality protein, so they are suitable for eating. As long as you don’t touch high-cholesterol seafood such as yellowed female crabs and shrimps.

There are also some tips for daily cooking. Try to use steaming, boiling, and stir-frying methods. Don't fry or braise. Don't put more cooking oil than an ordinary porcelain spoon at a time. Try to use oils with high unsaturated fat content such as olive oil and tea seed oil. Don't use boiled pork fat. Don’t overeat when eating. Seventy-eight percent full is enough. Especially don’t eat late-night snacks at night. After falling asleep, liver and gallbladder metabolism slows down. If you eat too much, it will become blocked in the stomach, and bile will accumulate more easily.

To be honest, many people are found to have high total bile acids temporarily, either because they ate too much oil the day before, or they stayed up late at night. If they adjust their diet and rest for two weeks and then check again, most of them can fall back to the normal range, so there is no need to be too anxious. But if it is high in two consecutive re-examinations, accompanied by yellowing of the skin and a dull pain in the right upper quadrant, then don’t just rely on dietary adjustments, and quickly find a doctor to check for organic problems such as hepatitis and gallstones. Don’t delay treatment.