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

Abstract

Background: Diets with a high glycaemic response exacerbate the metabolic consequences of the insulin resistance syndrome. Their effects on the incidence of gall stone disease are not clear, particularly in men. Methods: Dietary information was collected as part of the Health Professionals Follow up Study starting in 1986 using a semiquantitative food frequency questionnaire with follow up until 1998. On biennial questionnaires participants reported new symptomatic gall stone disease, diagnosed by radiology, and whether they had undergone cholecystectomy. Results: During 12 years of follow up, we documented 1810 new cases of symptomatic gall stones. After adjusting for age and other known or suspected risk factors in multivariate models, the relative risk (RR) for the highest compared with the lowest quintile of carbohydrate intake was 1.59 (95% confidence interval (CI) 1.25, 2.02; p for trend = 0.002). The RR for the highest compared with the lowest quintile of dietary glycaemic load was 1.50 (95% CI 1.20, 1.88; p for trend = 0.0008), and 1.18 for dietary glycaemic index (95% CI 1.01, 1.39; p for trend = 0.04). Independent positive associations were also seen for intakes of starch, sucrose, and fructose. Conclusions: Our findings suggest that a high intake of carbohydrate, glycaemic load, and glycaemic index increases the risk of symptomatic gall stone disease in men. These results add to the concern that low fat high carbohydrate diets may not be an optimal dietary recommendation.

Gallstones: Environment, Lifestyle and Genes

“…Indeed, all the above have been associated as risk factors for cholesterol gallstones in large epidemiological data sets from the USA, Europe, Japan, and China [11,12,13,14,15,16]. In a Japanese cohort of 1,264 patients, Tsunoda et al [16] reported a strong positive correlation between calories consumed and gallstone formation.…”

“…Data from two large US prospective epidemiological association studies using cohorts from the Health Professionals Follow-Up Study (men) and the Nurses’ Health Study (women) found a high intake of carbohydrate, coupled with an increased dietary glycaemic load, to enhance the risk of symptomatic gallstone disease and cholecystectomy in men and women, respectively [13,14]. In particular, refined sugar is often positively correlated with gallstone risk, as evidenced in these two cohorts in addition to several other studies [17,18,19,20].…”

Should animal fats be back on the table? A critical review of the human health effects of animal fat

“…Low fat high carbohydrate diets of a high glycemic index have been associated with symptomatic gall bladder disease (Tsai et al 2005) likely due to reduced cycling of cholesterol through bile salt release. Although fat or oil are often stated as affecting gastrooesophagial reflux disease, a systematic review of the literature failed to find an effect of fat consumption (Dent et al 2005).…”

Research needs and prioritizations for studies linking dietary sugars and potentially related health outcomes

“…Over a third (36%) of these trials were studies with a duration of <1 day. All 11 cohort studies [16][17][18][19][20][21][22][23][24][25][26] were conducted in adults, of which eight were in healthy populations, one in pregnant women, one in diabetics, and one in a study population with mixed health status. The sample sizes of these cohorts were large (mean sample size = 35,738) with a wide range of follow-up time (4 to 48 years).…”

“…None lasted for more than one year. Of the 11 cohort studies [16][17][18][19][20][21][22][23][24][25][26], one study in adults investigated the relationship between simple or added sugars and change in waist circumference after five years [20].…”