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What to Eat After a Gallbladder Removal
David L. Katz, MD
Photo: Mackenzie Stroh
Q: I've had my gallbladder removed. I've been feeling bloated and think I might be gaining weight as a result. Should I be changing my diet or taking supplements to help my body compensate?
— Veronica Reynolds, Arvada, Colorado

A: Removal of the gallbladder, usually because of gallstones, is among the most common surgical procedures in the United States: More than 500,000 such procedures are performed annually.

Those numbers might make a person believe she could get by quite nicely without a gallbladder, but the organ does in fact serve an important purpose in digestion. It stores and releases bile, a substance that helps the body process fat.

When the gallbladder is removed, bile still flows from the liver (where it originates) into the small intestine. However, the release is more haphazard and can result in discomfort after a meal—particularly one that is high in fat.

My first recommendation is to consider eating smaller meals evenly spaced throughout the day and to reduce your intake of dietary fat. You may find these minor changes are all you need.

If that doesn't work, try slowly increasing your intake of fiber—from whole grains, fruits, vegetables, beans, and lentils—which helps speed the movement of food through your system. More efficient digestion can also help reduce bloating.

Another useful practice is to take a daily probiotic supplement, such as Culturelle. Research suggests that the friendly bacteria in these supplements can help break down food, increasing the efficiency of digestion.

A few gradual adjustments should ensure that you and food get along just fine, even without your gallbladder there to referee.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.



Do Diet Drinks Actually Cause Weight Gain?
David L. Katz, MD
Photo: Mackenzie Stroh
Q: I've heard recent reports that diet drinks can cause weight gain. Is this true?
— Charlie Tipton, Lincolnton, North Carolina

A: I believe they can, but the science is not decisive. The studies suggesting diet sodas, or anything containing sugar substitutes, can contribute to weight gain are based almost entirely on animal research. What scientists have found is that a rodent's brain relies on the link between taste and calories to keep track of just how much eating has occurred. Sugar substitutes—saccharin, sucralose, aspartame, neotame, and acesulfame-K—unbundle the taste of sweetness from calories: The taste buds tell the brain that food is coming in, but the body doesn't get the energy it's expecting. This, apparently, undermines the ability of rats to judge how much they've consumed, and, over time, they begin to overeat and gain weight.

The same mechanism may occur in people, too, but we don't yet know for sure. Though some human studies indicate sugar substitutes help with short-term weight loss, an equal number suggest they don't. My particular concern is that artificial sweeteners are 200 to 13,000 times as sweet as sugar, and that is a potent stimulus for turning a sweet tooth into a fang. Other research suggests that the taste of sweetness is mildly addictive—the more you eat, the more you need to feel fully satisfied. If artificially sweetened sodas increase your cravings, the calories they take out of your diet are apt to sneak back in later when you, for instance, need a larger or sweeter dessert to feel satisfied.

I do make one exception for diet drinks: They can be a great substitute for people who drink a lot of regular soda and are trying to cut down. Just be sure to take the next step—toward the water cooler.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.



"How Did I Let This Happen Again?"
Four years ago, when Oprah managed to get down to a trim and fit 160 pounds, she thought she'd hit on a foolproof formula for permanent weight loss. Then life—in the form of a thyroid problem and a killer schedule—intervened. Last year she was back up to the 200-pound mark and knew something had to change. After a desperately needed time-out to reflect and recharge, here's what she's learned, what she's doing differently, and what's next.
January 2009 cover
Photo: Matthew Rolston
You know how bad you feel when you have a special event, a reunion, a wedding, a bar mitzvah, and you wanted to lose that extra 10 to 40 pounds, and you didn't do it? So the day comes and now you've got to try to find something to wear that makes you feel halfway decent, and you have to figure out how to hold in your stomach all night and walk backward out of the room so no one sees that your butt keeps moving even when you stop. Multiply that feeling by a million—make that more than 2.4 million for every O reader—and you'll know how I've felt over the past year every time I had to shoot a cover for O. If you're a regular subscriber, you'll notice you've not seen a head-to-toe shot all year. Why? Because I didn't want to be seen. "

O Magazine January 2005 cover In 1992 I reached my heaviest, 237 pounds. I was 38. Then, four years ago, I made it a goal to lose weight, and I appeared on the January 2005 cover (left) at a toned 160 pounds. I thought I was finished with the weight battle. I was done. I'd conquered it. I was so sure, I was even cocky. I had the nerve to say to friends who were struggling, "All you have to do is work out harder and eat less! Get your 10,000 steps in! None of that starchy stuff!"

Bam! Karma is a bear of a thing.

So here I stand, 40 pounds heavier than I was in 2006. (Yes, you're adding correctly; that means the dreaded 2-0-0.) I'm mad at myself. I'm embarrassed. I can't believe that after all these years, all the things I know how to do, I'm still talking about my weight. I look at my thinner self and think, "How did I let this happen again?"

It happened slowly. In February 2007, at 53, I started to have some health issues. At first I was unable to sleep for days. My legs started swelling. My weight started creeping up, first 5 pounds, then 10 pounds. I was lethargic and irritable. My internal clock seemed totally out of whack. I began having rushing heart palpitations every time I worked out. Okay, I've never loved daily exercise, but this was different. I actually developed a fear of working out. I was scared that I would pass out. Or worse. I felt as if I didn't know my own body anymore.
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Oprah Talks to Jay-Z
The Exclusive O Interview
At 13 he was selling crack. By 30 he was a hip-hop legend—having gone, in his words, "from grams to Grammys." Now Jay-Z charts his escape from the hard-knock life, describes the reunion that healed the wounds of his childhood—and even reveals the standing Sunday date he has with what's her name.
Jay-Z and Oprah
Photo: Rob Howard
The first time the hip-hop artist and record executive Jay-Z witnessed a murder, he was 9 years old. It was 1978, and in those days, he was known as Shawn Carter—a quiet kid who lived with his mother and three siblings in a sprawling housing project in the Bedford-Stuyvesant section of Brooklyn.

"That was my apartment right there—5C," Jay-Z told me one afternoon in August as we strolled the sidewalks of the Marcy Houses. "Navigating this place was life-or-death." He wasn't exaggerating; as the crack epidemic took hold in the 1980s, 13-year-old Jay-Z began selling drugs. His father had abandoned the family when Jay-Z was 11. And like many of his friends, he found his role models in the neighborhood dealers. "On the streets, you had to operate with integrity," he told me. "If you broke your word to someone, he wasn't going to take you to court—he was going to deal with you himself. So it was here in the projects that I learned loyalty."

It was in the projects, too, that he began rapping. Around the neighborhood Shawn became known as Jazzy—a reference, he says, to the way he carried himself: "like an older guy, like an older spirit." He gained a local following after he started selling his own records out of his car. And in 1996—disenchanted with the small-time label that finally signed him—he launched his own label, Roc-A-Fella Records. Later that year, Reasonable Doubt hit stores nationwide, and Jay-Z (the play on Jazzy he'd adopted after that name started to feel "too glittery") was on his way.

Since then, Jay-Z has released ten solo studio albums (the most recent, The Blueprint 3, debuted on September 11, 2009). He has sold more than 30 million records, won seven Grammys, and built a business empire that includes the Rocawear clothing line and Roc Nation entertainment company. In 2004 he became a part owner of the NBA's New Jersey Nets.

In December he will turn 40, and in recent years his focus has been on more than just his career. In 2003 he reconciled with his father, Adnes Reeves, shortly before Reeves's death. That same year, he began to put his wealth to good use, founding the Shawn Carter Scholarship Fund for disadvantaged and formerly incarcerated youth who hope to attend college (though Jay-Z never did time himself, in 2001 he pleaded guilty to stabbing a record executive at a Manhattan nightclub and was sentenced to three years' probation). In 2006 he teamed up with the United Nations to raise awareness of the worldwide water shortage. And in 2008, after six years of dating, he married the singer Beyoncé Knowles.

After our walk through the Marcy projects, Jay-Z and I visit a three-story row house a few blocks away. The house used to belong to his grandmother, and until he was 5, Jay-Z lived here with his parents, three siblings, and extended family. As we sit on the front stoop chatting (the same spot where, Jay-Z says, he spent long summer evenings "just chillin'"), the passersby who spot him form a crowd on the sidewalk; several boys climb the iron fence that surrounds the property. "Is that really Jay-Z?" one boy says to another. "Yep—and he's from here," the other responds.

Sitting on this stoop, it's stunning to think about how far Jay-Z has come. Not only is he an entirely self-made man, he's found his great success doing exactly what he loves. He is thoughtful and intelligent, a reader and a seeker. And in between telling me how he survived life on the streets, how a scolding from his mother helped him fall in love, and even how he and Beyoncé managed to keep their wedding small and private, he explains why he cares so much about connecting with kids who remind him of him—kids he hopes will point to his photo and say, "I can make it, too."
Start reading Oprah's interview with Jay-Z

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Are Your Friends Making You Fat?
Woman eating toast
Photo: © 2009 Jupiterimages Corporation
It's hard enough watching your own diet . Now research suggests you might want to watch other people's, too. Humans are social mimics, meaning we mirror the behavior of those around us, says Gavan Fitzsimons, PhD, professor of marketing and psychology at Duke University. "With more Americans overweight, scientists are very interested in the subconscious cues that influence our eating habits." There's no need to blow off dinner dates with your wire-thin BFF, but it may help to know why her presence could encourage you to order dessert. A look at how different people can impact the number on your scale:

The influencer: Your svelte friend
People tend to eat 1.5 times more in the company of a thin person who eats a lot than an overweight one, reports a study out of the University of British Columbia.

The influencer: Your date
Women consume 100 fewer calories when dining with a male date than with a female companion, according to research from McMaster University in Ontario.

The influencer: Your glass-half-full pal
Researchers from Doshisha University in Kyoto, Japan, theorize that optimists are more likely to give in to temptation: They may nudge you to "live a little," too.

The influencer: Your husband
Married women are more than twice as likely to be obese as those who are single or dating, reports a University of North Carolina at Chapel Hill study.

The influencer: Your friend's friends
Research from Harvard Medical School suggests that your risk of becoming obese increases 20 percent if a friend of a friend is also obese.

Next: The truth about fat cells



Mixed Grain Risotto with Squash, Tomatoes, and Basil
Think of mixed grain risotto as your culinary blank canvas, adaptable to any season; this summery version has ripe tomatoes, zucchini, and basil. The grains deliver vitamins (E, thiamin, folate, B6) and minerals (zinc, iron, magnesium, phosphorus, potassium) year-round.

This recipe is from The Real-Food Diet Mix-and-Match Meal Plan .
Mixed Grain Risotto with Squash, Tomatoes, and Basil
Recipe created by Laura Pensiero
Servings: Serves 6-8
  • 2 Tbsp. extra-virgin extra-virgin olive oil
  • 1/3 cup chopped onion
  • 1 small yellow squash , quartered lengthwise and thinly sliced
  • 1 small zucchini , quartered lengthwise and thinly sliced
  • 1/2 cup each brown rice and pearl barley and wild rice
  • 1/4 cup dry dry white wine (optional)
  • 6 cups low-sodium chicken low-sodium chicken or vegetable vegetable broth
  • 1/2 cup grated Parmesan , plus more for garnish (optional)
  • 1/4 cup chopped fresh fresh basil , plus some whole leaves for garnish (optional)
  • 1 large tomato , seeded and diced
  • Salt and freshly ground pepper
Note: Instead of using three different grains, try 1 1/2 cups of a whole grain rice mix.

Heat oil in a medium pot over medium-high heat. Add onion and cook, stirring occasionally, until softened, 2 to 3 minutes. Add 3/4 of squash and zucchini, and cook, stirring occasionally, until just softened, 2 to 3 minutes. Add brown rice, barley, and wild rice; toast, stirring often, for 2 minutes. Add wine (if using) and cook 1 minute more. Add broth; bring to a boil. Partially cover pot, reduce heat to medium-low, and simmer, stirring occasionally, until rice and barley are tender and risotto is thick and slightly soupy, about 45 minutes.

Stir in rest of squash and zucchini and corn (if using); cook, uncovered, until tender, 3 to 4 minutes. Remove from heat; stir in cheese, basil, and tomatoes. Add salt and pepper to taste, and basil garnish (if using).

Recipe variations:

Replace vegetables with...

  • Spring: Peas, asparagus, and watercress or spinach leaves.
  • Fall: Shiitake mushrooms, bok choy, radicchio, and flat-leaf parsley.
  • Winter: Acorn or butternut squash, dried fruit (such as apricots, cranberries, golden raisins, and cherries), and brussels sprouts (add them near the end of cooking).
All year round: Add cooked chicken, pork, sausage, or beef toward the end of cooking. To spice things up, add chopped jalapeños when cooking the onions.

From Hudson Valley Mediterranean: The Gigi Good Food Cookbook, by Laura Pensiero. Copyright (c) 2009 by Laura Pensiero. Published by William Morrow Cookbooks, an imprint of HarperCollins Publishers. Reprinted by permission.