I went to the GP two days ago about recurring episodes of very nasty stomach pain. He listed three possibilities, but the top one was gallstones, and he's sending me for an ultrasound. I said rather proudly that I was eating 27% of my calories from fat, and he said that it was very high and I should be eating 10% instead, along with a high-protein diet. I was a bit too doped from painkillers to ask how exactly I should do this on a vegan diet, but once I got home and started tinkering in FitDay I realised that this was a pretty tall order.
Nevertheless, I tried. I added extra protein powder to my morning porridge, experimented with sautéing in broth instead of a teaspoon of olive oil, replaced half the soya milk in my morning porridge with water, found the fatfreevegan.com website, and had to add huge quantities of pulses and extra veg in order to get up past 1000 calories. My insides have been completely unimpressed with this new regime, with constant gurgling, noises and smells so bad I honestly don't know what I'll do when my partner gets home from work tonight. After two days of this I thought I'd check, so I rang and spoke to another GP. I mentioned that 10% is very low and basically means no added fats, no nuts or seeds, no tofu, no avocado, very little soya milk, no EFA supplements. She was surprised and said that they always recommend 10% fat for healthy eating, that I should be fine with my usual diet (which is blindingly healthy, quite frankly), and that her colleague had meant that I shouldn't be living on fried and greasy foods, something I'm very far from doing. Then she muttered something about saturated fat, and I got the impression that the 10% figure may have been about saturated fat, not total fat intake. After describing my diet a bit more, she ended up telling me to eat what I do normally, though we compromised on 20% fat, to be lowered if I get suspected gallstone attacks again. (I had actually had a couple of higher-fat meals before the last attack, I'd had a big block of tofu to use up.) I asked what proportion of protein I should get and she said she didn't know about that sort of thing.
She also recommended the British Dietetic Association website for general guidelines. Once the phone call was over, I moseyed over to have a look. Guess what, they recommend 70g fat daily for a woman on a 2000 calorie diet. I'm on 1100 (sensible for my height and low activity levels, and okayed by my usual GP who's currently on holiday), and for me the equivalent would be 39g fat, whereas I've been averaging about 33g. How exactly have I been eating a high-fat diet?! Not to mention that I've looked up gallstones, and apparently they can be caused by insufficient fat in the diet, although they can also be caused by a host of things from genetics (don't think mine are great there) to high cholesterol, including rapid weight loss (they mention crash dieting) and hormonal disruption. I don't think 1lb/week counts as rapid, even at my height, but I have experienced hormonal disruption since starting dieting and the CFIDS/ME always complicates matters, so maybe that set something off.
Anyway, I am relieved that I can get back to a normal diet, just with slightly lower fat levels. (There goes that nice avocado that's probably overripened by today anyway.) Meanwhile, I am still rather confused by the whole thing. It's generally an excellent practice, my local GP surgery. Should I just assume that GPs may not know the first thing about nutrition?