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August 19, 1992

Fat Content of Very Low-Calorie Diets and Gallstone Formation

Author Affiliations

Harvard School of Public Health Boston, Mass

JAMA. 1992;268(7):873. doi:10.1001/jama.1992.03490070051035

To the Editor.  —Causal mechanisms have not been fully clarified to date in several studies that highlight the occurrence of gallstones in obese individuals during weight loss on very low-calorie diets (VLCDs) (Table).1-3 The incidence of new gallstone formation, as detected by ultrasound, ranged from 10% to 26% over 8-week to 16-week periods. Of note is the fact that the diet in each of these studies contained only 1 g of fat. In line with other authors, Liddle et al2 called attention to the possibility of gallbladder stasis as a possible causal factor.The possibility of gallbladder stasis as a primary factor in gallstone formation during weight loss on VLCDs is consistent with the results of a recent study by Festi et al.4 In that study, researchers provided a 500-calorie (2100-J) diet for 13 weeks to 34 obese individuals (mean body mass index, 40.3 kg/m2), followed