#601: Gallstones & Gallbladder Conditions: Impact of Diet – Angela Madden, PhD RD

This episode examines what we actually know (and importantly, what we do not know) about diet in relation to gallstones and gallbladder conditions. Much of the public-facing guidance around gallstones focuses on "avoiding fatty foods", yet Dr. Angela Madden explains that this long-standing practice sits on surprisingly weak direct evidence, particularly when judged against the standards typically expected for clinical dietary recommendations.

A central theme is the need to separate two distinct questions: dietary factors that influence the risk of developing gallstones (prevention), versus dietary strategies intended to reduce symptoms or complications once gallstones exist (management). While the prevention literature suggests plausible, consistent associations with overall diet quality and lifestyle factors, the specific question of prescribing a low-fat diet to manage symptomatic gallstones lacks robust randomized trial evidence.

Dr Angela Madden is a clinical researcher in nutrition and dietetics at the University of Hertfordshire, where she established and led the nutrition and dietetics subject group and now focuses her research on improving nutritional assessment, dietary interventions, and patient-centred outcomes in clinical and public health settings.

Timestamps

[02:09] Discussion with Dr. Angela Madden begins
[06:53] Understanding the gallbladder
[08:08] Gallbladder disorders and their prevalence
[13:42] Risk factors and pathophysiology
[22:15] Dietary factors and gallstone formation
[27:20] Exploring dietary fat and gallstones
[34:09] Broader dietary considerations
[45:44] Practical dietary recommendations

Related Resources

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Dr. Madden's univeristy page
Cochrane Review: Madden et al., 2024 – Modified dietary fat intake for treatment of gallstone disease in people of any age
Related episode: 513: Kidney Stones & Diet – Deepa Kariyawasam, RD

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