Weight, diet, and the risk of symptomatic gallstones in middle-aged women

Volume 321:563-569		August 31, 1989		Number 9

Weight, diet, and the risk of symptomatic gallstones in middle-aged women

KM Maclure, KC Hayes, GA Colditz, MJ Stampfer, FE Speizer, and WC Willett

Add to Personal Archive

Add to Citation Manager

Notify a Friend

E-mail When Cited

PubMed Citation

Abstract

To assess the risk factors for symptomatic gallstones, 88,837 women in the Nurses' Health Study cohort (age range, 34 to 59 years) were followed for four years after completing a detailed questionnaire about food and alcohol intake in 1980. A total of 433 cholecystectomies and 179 cases of newly symptomatic, unremoved gallstones, diagnosed by ultrasonographic examination or x-ray films, were reported during the four-year follow-up. The age-adjusted relative risk for very obese women, who had a Quetelet index of relative weight (weight in kilograms divided by the square of the height in meters) of more than 32 kg per square meter, was 6.0 (95 percent confidence interval, 4.0 to 9.0), as compared with women whose relative weight was less than 20 kg per square meter. For slightly overweight women (relative weight, 24 to 24.9 kg per square meter), the relative risk was 1.7 (95 percent confidence interval, 1.1 to 2.7). Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (greater than 8200 J per day), as compared with a low energy intake (less than 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of at least 5 g per day was associated with a decreased incidence as compared with abstention (relative risk, 0.6; 95 percent confidence interval, 0.4 to 0.8). Parity did not appear to be an important risk factor after an adjustment was made for relative weight. These data support a strong association between obesity and symptomatic gallstones and suggest that even moderate overweight may increase the risk.

Source Information

Department of Epidemiology, Harvard School of Public Health, Boston, Mass.

This article has been cited by other articles:

Liu, B., Beral, V., Balkwill, A., on behalf of the Million Women Study Collaborators, (2009). Childbearing, breastfeeding, other reproductive factors and the subsequent risk of hospitalization for gallbladder disease. Int J Epidemiol 38: 312-318 [Abstract] [Full Text]
Liu, B., Balkwill, A., Spencer, E., Beral, V., on behalf of the Million Women Study Collaborators, (2008). Relationship between body mass index and length of hospital stay for gallbladder disease. J Public Health (Oxf) 30: 161-166 [Abstract] [Full Text]
Wang, H. H., Afdhal, N. H., Wang, D. Q-H. (2006). Overexpression of estrogen receptor {alpha} increases hepatic cholesterogenesis, leading to biliary hypersecretion in mice. J. Lipid Res. 47: 778-786 [Abstract] [Full Text]
Leitzmann, M. F., Tsai, C.-J., Stampfer, M. J., Willett, W. C., Giovannucci, E. (2005). Thiazide Diuretics and the Risk of Gallbladder Disease Requiring Surgery in Women. Arch Intern Med 165: 567-573 [Abstract] [Full Text]
Tsai, C.-J., Leitzmann, M. F, Willett, W. C, Giovannucci, E. L (2004). Prospective study of abdominal adiposity and gallstone disease in US men. Am. J. Clin. Nutr. 80: 38-44 [Abstract] [Full Text]
Tsai, C.-J., Leitzmann, M. F, Hu, F. B, Willett, W. C, Giovannucci, E. L (2004). Frequent nut consumption and decreased risk of cholecystectomy in women. Am. J. Clin. Nutr. 80: 76-81 [Abstract] [Full Text]
Cuevas, A., Miquel, J. F., Reyes, M. S., Zanlungo, S., Nervi, F. (2004). Diet as a Risk Factor for Cholesterol Gallstone Disease. J. Am. Coll. Nutr. 23: 187-196 [Abstract] [Full Text]
Leitzmann, M. F, Tsai, C.-J., Stampfer, M. J, Rimm, E. B, Colditz, G. A, Willett, W. C, Giovannucci, E. L (2003). Alcohol consumption in relation to risk of cholecystectomy in women. Am. J. Clin. Nutr. 78: 339-347 [Abstract] [Full Text]
O'Brien, P. E., Dixon, J. B. (2003). A Rational Approach to Cholelithiasis in Bariatric Surgery: Its Application to the Laparoscopically Placed Adjustable Gastric Band. Arch Surg 138: 908-912 [Abstract] [Full Text]
Lazcano-Ponce, E. C., Miquel, J. F., Munoz, N., Herrero, R., Ferrecio, C., Wistuba, I. I., Alonso de Ruiz, P., Aristi Urista, G., Nervi, F. (2001). Epidemiology and Molecular Pathology of Gallbladder Cancer. CA Cancer J Clin 51: 349-364 [Abstract] [Full Text]
Simon, J. A., Hunninghake, D. B., Agarwal, S. K., Lin, F., Cauley, J. A., Ireland, C. C., Pickar, J. H., for the Heart and Estrogen/progestin Replacement S, (2001). Effect of Estrogen plus Progestin on Risk for Biliary Tract Surgery in Postmenopausal Women with Coronary Artery Disease: The Heart and Estrogen/progestin Replacement Study. ANN INTERN MED 135: 493-501 [Abstract] [Full Text]
Field, A. E., Coakley, E. H., Must, A., Spadano, J. L., Laird, N., Dietz, W. H., Rimm, E., Colditz, G. A. (2001). Impact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period. Arch Intern Med 161: 1581-1586 [Abstract] [Full Text]
Acalovschi, M (2001). Cholesterol gallstones: from epidemiology to prevention. Postgrad. Med. J. 77: 221-229 [Full Text]
Bateson, M C (2000). Gallstones and cholecystectomy in modern Britain. Postgrad. Med. J. 76: 700-703 [Abstract] [Full Text]
Fine, J. T., Colditz, G. A., Coakley, E. H., Moseley, G., Manson, J. E., Willett, W. C., Kawachi, I. (1999). A Prospective Study of Weight Change and Health-Related Quality of Life in Women. JAMA 282: 2136-2142 [Abstract] [Full Text]
Leitzmann, M. F., Rimm, E. B., Willett, W. C., Spiegelman, D., Grodstein, F., Stampfer, M. J., Colditz, G. A., Giovannucci, E. (1999). Recreational Physical Activity and the Risk of Cholecystectomy in Women. NEJM 341: 777-784 [Abstract] [Full Text]
Willett, W. C., Dietz, W. H., Colditz, G. A. (1999). Guidelines for Healthy Weight. NEJM 341: 427-434 [Full Text]
Niemi, M, Kervinen, K, Rantala, A, Kauma, H, Paivansalo, M, Savolainen, M J, Lilja, M, Kesaniemi, Y A (1999). The role of apolipoprotein E and glucose intolerance in gallstone disease in middle aged subjects. Gut 44: 557-562 [Abstract] [Full Text]
Syngal, S., Coakley, E. H., Willett, W. C., Byers, T., Williamson, D. F., Colditz, G. A. (1999). Long-Term Weight Patterns and Risk for Cholecystectomy in Women. ANN INTERN MED 130: 471-477 [Abstract] [Full Text]
Misciagna, G., Centonze, S., Leoci, C., Guerra, V., Cisternino, A. M., Ceo, R., Trevisan, M. (1999). Diet, physical activity, and gallstones�a population-based, case-control study in southern Italy. Am. J. Clin. Nutr. 69: 120-126 [Abstract] [Full Text]
Halpern, N. B. (1998). Access Problems in Laparoscopic Cholecystectomy: Postoperative Adhesions, Obesity, and Liver Disorders. SURG INNOV 5: 92-106 [Abstract]
Dietz, W. H. (1998). Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease. Pediatrics 101: 518-525 [Abstract] [Full Text]
Ferguson, T. K., Anderson, J. C., Fisher, C. R., Harned, R. K. (1994). Cholelithiasis in Pregnant Women: Prevalence and Risk Factors. Journal of Diagnostic Medical Sonography 10: 104-107 [Abstract]
Carson, J. L., Ruddy, M. E., Duff, A. E., Holmes, N. J., Cody, R. P., Brolin, R. E. (1994). The Effect of Gastric Bypass Surgery on Hypertension in Morbidly Obese Patients. Arch Intern Med 154: 193-200 [Abstract]
Aucott, J. N., Cooper, G. S., Bloom, A. D., Aron, D. C. (1993). Management of Gallstones in Diabetic Patients. Arch Intern Med 153: 1053-1058 [Abstract]
Pastides, H., Tzonou, A., Trichopoulos, D., Katsouyanni, K., Trichopoulou, A., Kefalogiannis, N., Manousos, O. (1990). A Case-Control Study of the Relationship Between Smoking, Diet, and Gallbladder Disease. Arch Intern Med 150: 1409-1412 [Abstract]
(1989). STRONG ASSOCIATION BETWEEN OBESITY AND GALLSTONES. JWatch General 1989: 2-2 [Full Text]

Comments and questions? Please contact us.