Mgr. Ing. Jitka Jirků, nutritional therapist at Canadian MedicalArticle
25. 11. 2021 Nutrition consultancy
With the low-fat or fat restricted diet (diet no.4), sometimes referred to as the gallbladder diet, it is important to know that the recommended amount of fats in the diet is dependent on the severity or type of the illness a patient has. This diet is generally recommended to patients with chronic cholecystitis (inflammation of the gallbladder), cholelysiasis (gallbladder stones), or those that have undergone a cholecystectomy (gallbladder removal). It is often recommended following the acute stage of any gallbladder or pancreas related diseases.
A fat restricted diet can be classified as:
- Very low-fat diet <20 grams (is prescribed for 3-4 days, usually while still inpatient; diet no. D4 S)
- Low-fat diet < 40 grams (is recommended for a maximum duration of a week, usually following the acute phase of a disease, for example during recovery from pancreatitis or a gallbladder infection.
- Fat restricted diet < 60 grams is suitable as a longer term option, see recipes available below; diet no D4.
The following food groups should be avoided (or consumed in very small quantities) when following a fat restricted diet:
- Fried foods and burnt fats,
- Fatty foods, especially meats and processed foods (lean ham is alright), full-fat milk products, or mayonnaise
- Vegetables that cause bloating, especially cabbage, cauliflower, raw onion, kohlrabi, mushrooms, etc.
- Legumes, but red lentils are often well tolerated
- Eggs as a meal on their own
- Fresh yeast dough
- Spicy foods and strong flavorings
It is recommended to add the allowed amount of fats (butter or a good quality oil) to the finished meal, preferably less than 10g per portion. The meal plan can be considered quite frugal, both in the choice of food groups, and in the cooking methods (we recommend boiling, steaming, dry-pan frying (Teflon), baking in aluminum foil, baking in a hot air oven.
Buckwheat with Chinese vegetables and sweet corn
Recipe makes 3 portions:
- WOK Chinese vegetable mix (frozen) 450 g
- Canned sweet corn (e.g. Bonduelle) 140 g
- Buckwheat uncooked (e.g. Menu Gold) 300 g
- Butter 20 grams (not necessary)
Rinse the buckwheat thoroughly with hot water, leave it to soak in warm water for about 15 minutes. Drain the buckwheat and cook in fresh water for about 4-5 minutes, drain, season and set aside. Add the Chinese vegetable mix and a little water into a pan and simmer lightly until soft. When the vegetables are soft, we can add 20 grams of butter, then add boiled buckwheat mixed with corn (drain the brine). Heat the whole mixture lightly and season with your favorite spices as needed (try to avoid pepper, chilli, or curry spices).
Nutritional values for 3 portions: 1 492 kcal
Total protein 50 g / total carbohydrates 250 g /Total fats 32 g / Total fiber 17 g
Pork tenderloin with tomatoes and cheese baked in aluminum foil
Recipe makes 3 servings:
- Pork tenderloin (or boneless pork roast) 400 g = 3 slices
- 3 potatoes (approx.200 g), can also be sweet potatoes
- 3 large tomatoes without skin and seeds (can also be canned)
- Small zucchini
- 150g hard cheese with a max. 30% fat content (light mozzarella or camembert)
Peel the potatoes and cut into thick slices and salt. Salt the pork tenderloin, cut the edges slightly, tenderize and dry fry on a pan (let the meat tighten) and then cover with a little water or a low fat broth. Peel and coarsely grate the zucchini, removing the seeds, and simmer lightly before it softens. If we are using fresh tomatoes,remove the seeds and skins and then stew them together with the zucchini. If we are using canned tomatoes, add them to the already cooked zucchini, season and simmer together for a little while. Prepare 3 larger pieces of foil, lightly cover with vegetable oil and place your sliced potatoes on top of it, then place the meat on the potatoes, add the vegetable mixture (tomatoes and zucchini) on top of the meat and make a larger hole in the middle of the vegetable mixture, where we can place a cube of our cheese. At this stage, we can also add various herbs or spices to taste. Wrap everything in foil and put on a baking dish and pour water over it (only to cover the bottom of the baking tray). Bake at 180C for about 45-60 minutes, or until the meat softens.
Nutritional values for 3 portions: 1 587 kcals
Total protein 144 g / total carbohydrates 140 g / total fats 48 g / total fiber 17 g
Chicken roll with peas, eggs and ham
Recipe makes 3 portions:
- Chicken or turkey breast, cut into thicker slices (450 g =3 slices)
- 1 whole egg and 2 egg whites
- Small can of peas
- Lean ham 150 g
- 3 teaspoons full-fat mustard
- 30g of butter (not necessary)
Cut the chicken/turkey slice in half, but do not cut it all the way through, so that you can spread it open and tenderize it into a thin sheet. Add salt and lightly coat with mustard. Cut the ham into cubes, lightly fry in a pan and pour in the egg mixture. Add canned peas without the brine, mix well and spread the prepared mixture in a thin layer onto the poultry sheet and season well. Wrap up the chicken and filling into a roll and fasten it together with string. Place the roulade into a baking dish, cover it with a little water (or broth) and cover with foil. Bake for 15 minutes at 200 degrees, then reduce to 180 degrees, and bake until the meat softens. Rotate the roulade ever so often and drizzle with its own juices. Once the meat is soft, place a couple of slices of butter on top and bake lightly to allow the butter to melt, serve with a side dish of choice (potatoes, mashed potatoes, rice).
Nutritional content for 3 portions: 1 121 kcal
Total protein 157 g /Total carbohydrates 15 g /Total fats 47 g / Total fiber 9 g
Bulgur wheat with tuna and spinach
Recipe makes 3 portions:
- Mozzarella light Galbani 3 x 125g packets (or any other low-fat cheese)
- Uncooked bulgur wheat 240 g
- Tuna chunks in their own brine 2 x 185 g; it also possible to use cod fillets baked in foil, or under a lid in the oven with a pour a little water
- Chopped frozen spinach, Albert 1 x pack (400 g)
Rinse the bulgur with boiling water and cook according to the instructions on the packet. Stew the spinach lightly, cover with a little water (or broth),and season with salt. Drain the excess water from the bulgur and in the spinach and tuna (drain most of the juice, leave only a little), season. Pour everything into a baking dish and bake for about 30 minutes at 170 degrees. Finally, cover the dish with slices of mozzarella and let them bake slowly (so that the mozzarella melts). You can also just add grated cheese (<30% fat) once served.
Nutritional contents for 3 portions: 1 858 kcal
Total protein 179 g /Total carbohydrates 190 g /Total fats 43 g / Total fiber 32 g
In conclusion, it is important to note that a person’s tolerance to the amount and type of fat is completely individual and often gradually improves thanks to the body's ability to adapt. Diet no. 4 helps to prevent possible complications of the disease, especially the gallbladder (abdominal pain, diarrhoea, bloating), but sometimes it also helps to achieve often desired weight loss associated with these diseases (in cases where weight loss is indicated/recommended by the doctor).
SVAČINA, S. a kol. KLINICKÁ DIETOLOGIE. Grada Publishing, a.s., 2008. Vydání 1. ISBN 978-80-247-2256-6.
KOHOUT, P. a kol. KLINICKÁ VÝŽIVA. Galén. 2021. ISBN 978-80-7492-555-9