Diet and gallstones in italy: The cross-sectional MICOL results

Abstract

Fifteen thousand nine hundred ten men and 13,674 women (age, 30-69 years) were enrolled in an epidemiological survey of the general population, between December 1984 and April 1987. Each participant was submitted to ultrasonography (US) of the gallbladder and completed a food-frequency questionnaire, covering 38 food items. A common portion size was identified and subjects were asked how often each item was consumed. Nutrient intake was computed by multiplying the intake frequency and nutrient content per portion for each item, and then by summing the product over all foods. Each nutrient intake was adjusted for energy intake. Alcohol intake was calculated by summing the consumption of wine, beer, and liquor. Having excluded subjects aware of having gallstones (GS) or previously submitted to cholecystectomy (to avoid prothopatic bias), 787 males and 1,014 females with GS and 14,272 males and 10,836 females without GS were available for analysis. Relative risks (RR) of GS were computed by quintiles of nutrient intake. The overnight fasting period was calculated as the difference between the specified time of dinner and the time of the next meal (breakfast or lunch). A significant negative association was found between RR of GS and total energy intake for males ( 2 for trend ‫؍‬ 8.37; P ‫؍‬ .004), fiber intake for females ( 2 ‫؍‬ 5.45; P ‫؍‬ .02), and daily alcohol consumption for males ( 2 ‫؍‬ 10.86; P ‫؍‬ .001). A positive association was observed between RR of GS and carbohydrate ( 2 ‫؍‬ 5.95; P ‫؍‬ .01 for males; 2 ‫؍‬ 9.39; P ‫؍‬ .002 for females) and protein intake only for males ( 2 ‫؍‬ 10.92; P ‫؍‬ .01). Prevalence of GS was higher among subjects who had an overnight fasting period of over 12 hours than subjects with that of less than 12 hours. (RR: 1.35; 95% CI: 1.01-1.80 for males; RR: 1.28; 95% CI: 1.03-1.60 for females). These data do not confirm that high energy intake is associated with an increased risk of GS. Factors protecting against GS comprise: low carbohydrate (males and females) and protein (males) intakes, high fiber (females) and moderate alcohol intake (males) consumption, and a shorter overnight fasting period for both sexes. (HEPATOLOGY 1998;27:1492-1498.)Diet may influence the formation of gallstones (GS) either by modifying gallbladder motility or by altering the biliary lipid composition. The relationships between GS disease and the dietary habits in an Italian free-living population sample are analyzed and discussed in this article. The importance of diet in the pathogenesis of GS has been much debated. Information on this issue can be obtained from experimental, 1-18 clinical, 19-26 and epidemiological studies. [27][28][29][30][31][32][33][34][35] These latter studies have mainly investigated symptomatic GS subjects who were aware of having GS or subjects who had been previously submitted to cholecystectomy. Thus, it could be supposed that they accordingly modified their dietary habits. The present study only included subjects with asymptomatic, previously undiagnosed GS and compar...

Cigarette Smoking, Alcohol Use, and Gallstone Risk in Japanese Men

“…On the other hand, both case-control [12, 18]and prospective [6, 8, 19, 20]studies consistently showed that alcohol consumption was related to a decreased risk of clinical gallstone or gallbladder disease. A protective association between alcohol and gallstone disease was also observed in several [16, 21, 22, 23, 24], but not all [14], cross-sectional studies based on screening ultrasonography and in an ultrasonography-based prospective study [17]. It is, however, suspected that gastrointestinal symptoms leading to the clinical diagnosis of gallstones may cause a reduction of alcohol use, thereby spuriously resulting in a protective association between alcohol and gallstones [25].…”

“…Alcohol use was unrelated to gallstone disease in men and women combined in Germany [14]. In the Italian multicenter study [24], the investigators addressed the association with newly diagnosed gallstones only and reported a protective association between alcohol use and prevalent gallstones in men, but not in women. In a prospective study based on population screening in southern Italy [17], wine consumption was related to a substantial decrease in gallstone risk among men and women combined, whereas beer and spirits were unrelated to the risk.…”

Dietary carbohydrates and glycaemic load and the incidence of symptomatic gall stone disease in men

“…17 In a population study in Italy, a positive association was observed between high carbohydrate intake and an increased risk of gall stones diagnosed in an ultrasonographic survey. 20 The inconsistency among these studies may be due to lack of long term dietary information, imprecise or non-validated assessment of nutrients, suboptimal study design, small sample size, or different definitions of disease end points.…”

“…14 15 Epidemiological studies of carbohydrate consumption and gall stone disease have shown mixed results. [16][17][18][19][20] Although the available evidence indicates that insulin resistance, chronic hyperglycaemia, and associated disorders of lipid metabolism are important predictors of gall stone disease, the relationship between dietary glycaemic load and glycaemic index and the risk of gall stone disease have not been examined.…”

Fatores de risco sociodemográficos e clínicos associados à colecistectomia no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

“…As dietas ricas em proteínas e fibras têm o efeito oposto, protegendo contra o desenvolvimento de cálculos biliares (Kritchevsky & Dlurfeld, 1983;Attili et al, 1998 Vecchia et al, 1994;Kono et al, 2002) enquanto outras mostram associação com a formação de cálculos biliares (Singh et al, 2001;Timmer A et al, 2000).…”