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Preventive medecine: about gall-stones PREVENTIVE MEDECINE: ABOUT GALL-STONES
The most common type of gall-stone is made of cholesterol and is the result of altered bile metabolism produced by dietary changes in the West. It is difficult to be sure exactly how common gall-stones are because many produce no symptoms at all and are discovered by chance on X-ray or at autopsy. However, accurate enough figures enable us to say that the proneness to gall-stones of westernized countries varies between 30 and 60 per cent-the highest figures being from Chile, Sweden and Czechoslovakia. Third World countries have much lower figures, for example: Uganda 3 per cent; Thailand 4.4 per cent; and Ghana 0 per cent. A survey of hospitals in Africa, India, Arabia and New Guinea confirmed that gall-stones are extremely rare in the rural parts of these countries. On the other hand, in the urbanized black population of Johannesburg, gall-stones are quite common (12 per cent in elderly women).
Since World War II there has been a worldwide increase in the number of people undergoing surgery for gall-stones. The increase has been between 2.5 and 6 times, depending on the country. There has been an increase not just among older women -the most susceptible section of the population-but also among young people and in men. This suggests that whatever is causing gall-stones has increased its influence since the last war.
All this evidence suggests that gall-stones are directly related to a western way of life. It is also interesting that people with one of four other western diseases are much more likely to have gall-stones. These other conditions are obesity, diabetes, diverticular disease and hiatus hernia. A woman with gall-stones has on average put on more weight since maturity than one without, even if she is not seriously overweight.
The common factor between all these conditions is the over-consumption of refined foods and of high-energy foods. A reduced calorie intake is the best treatment for maturity onset (Type II) diabetes as we have seen; it also reduces harmful blood fats and is slimming. But-more to the point when it comes to gallstones-it results in a lowered concentration of cholesterol in the bile and so in fewer gall-stones. Wild animals rarely have gall-stones but they can be made to have them by being fed artificial diets such as our western diet. Of all the dietary factors that have been studied in the laboratory and clinical trials the lack of dietary fibre and too much sugar and white flour are the main culprits. Increasing the intake of these reduces the likelihood of an individual forming gall-stones.
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GENERAL HEALTH
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