Physical activity reduces the risk of symptomatic gallstones: a prospective cohort study

Banim, Paul; Luben, Robert; Wareham, Nicholas J.; Sharp, Stephen J.; Khaw, Kay‐Tee; Hart, Andrew

doi:10.1097/meg.0b013e32833732c3

Cited by 53 publications

(44 citation statements)

References 36 publications

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“…Visceral fat index levels were above normal values for 39.5% where a cut-off of 12 differentiates normal from elevated levels. Most patients were moderately inactive (42.5%) or moderately active (37.5%), as classified per the physical activity index groups [30,31]. The remaining 20% were active.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Body composition was assessed with bioelectrical impedance analysis (Tanita, Sindelfingen). A self-report questionnaire based on the European Prospective Investigation into Cancer and Nutrition (EPIC) study captured physical activity and classified patients into the following physical activity index groups: inactive, moderately inactive, moderately active, and active [30,31].…”

Section: Biochemical Measurements and Clinical Assessmentsmentioning

confidence: 99%

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Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Papapostoli

Lammert

Stokes

2016

JGLD

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Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. A meta-analysis has confirmed decreased serum 25-hydroxyvitamin D levels in NAFLD patients. This intervention study investigates whether vitamin D correction ameliorates hepatic steatosis. Methods: We prospectively recruited 40 patients from an outpatient liver clinic with vitamin D deficiency (serum 25-hydroxyvitamin D < 20 ng/ml). Controlled attenuation parameter (CAP) during transient elastography quantified hepatic steatosis. Patients with significant liver fat accumulation were included, which was defined by a CAP value ≥ 280 dB/m. Patients received 20,000 IU vitamin D/week for six months, while vitamin D status, liver function tests (LFTs), CAP and body composition were monitored. Results: The cohort comprised 47.5% women (age 54.9 ± 12.1 years; BMI 29.5 ± 3.0 kg/m2). Mean serum vitamin D level was 11.8 ± 4.8 ng/ml. CAP decreased significantly from baseline (330 ± 32 vs. 307 ± 41 dB/m) during supplementation (P = 0.007). A mean CAP reduction relative to baseline was demonstrated at four weeks and three and six months: -5.3 ± 13.8%; -6.0 ± 14.6% and -6.4 ± 13.0%, respectively. During these time points, restoration of serum vitamin D levels was observed (34.6 ± 12.9, 36.3 ± 10.2, 34.8 ± 9.8 ng/ml; P < 0.0001). Liver function tests and body composition remained unchanged. Conclusions: Hepatic steatosis, as assessed by CAP, significantly improves after only 4 weeks of vitamin D correction. Hepatic steatosis is a dynamic process, that can be monitored in the short-term using such non-invasive methods. Abbreviations: ALT: alanine aminotransferase; ANOVA: analysis of variance; AP: alkaline phosphatase; AST: aspartate aminotransferase; CAP: controlled attenuation parameter; CRP: C-reactive protein; FFA: free fatty acids; γ-GT: gamma-glutamyl transpeptidase; ITT: intention-to-treat; LFT: liver function test; LSM: liver stiffness measurement; NAFLD: non-alcoholic fatty liver disease; PPAR-γ: peroxisome proliferator-activated receptor gamma; PP: per protocol; PTH: parathyroid hormone; VDR: vitamin D receptor

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Section: Patient Characteristicsmentioning

confidence: 99%

Section: Biochemical Measurements and Clinical Assessmentsmentioning

confidence: 99%

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Papapostoli

Lammert

Stokes

2016

JGLD

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“…Banim et al [61] recently found physical activity to reduce the risk of gallstones (fig. 1) in subjects from the European Prospective Investigation of Cancer (EPIC) cohort.…”

Section: Lifestyle Factorsmentioning

confidence: 99%

“…1) in subjects from the European Prospective Investigation of Cancer (EPIC) cohort. The authors suggest that a 70% reduced risk of symptomatic gallstones could be attained in the population after 5 years of physical activity equivalent to the ‘active’ category [61]. …”

Section: Lifestyle Factorsmentioning

confidence: 99%

“…1 The EPIC cohort was followed up for a total of 14 years in this study, n = 25,639 (age range 40–74). Banim et al [61] assessed physical activity via a questionnaire and categorised subjects into four activity levels which have been validated against physiological markers of exercise. At 5 years, a HR for gallstone occurrence depending on level of physical activity was assessed.…”

Section: Lifestyle Factorsmentioning

confidence: 99%

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Gallstones: Environment, Lifestyle and Genes

Stokes

Krawczyk

Lammert³

2011

Dig Dis

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Gallstone disease represents one of the most common and costly gastroenterological disorders. In Germany, 0.25% of the population undergo cholecystectomy per year, and cholelithiasis incurs annual medical expenses of more than USD 6.5 billion in the United States. The paradigm of environmental risk factors for gallstones has lately been challenged by genetic studies in experimental models and humans. The analysis of more than 40,000 Swedish twin pairs with gallstones demonstrated that genetic factors account for 25% of the phenotypic variance. Since then, studies employing genome-wide association analysis, case-control cohorts and analysis of sib-pairs in families with gallstones have expanded our knowledge of ‘gallstone genes’. Indeed, gallstone disease phenotypes are likely to result from the complex interaction of genetic factors, chronic overnutrition with carbohydrates, depletion of dietary fibre and other not fully defined environmental factors including physical inactivity and infections. This hypothesis is supported by the profound increases of cholesterol gallstone prevalence rates in Native Americans, post-war European countries and current urban centres in East Asia, all of which were associated with ‘westernized’ nutrition. Herein, we summarise the spectrum of environmental and genetic risk factors which should pave the way to ‘personalised’ strategies for the prevention and therapy of gallstones.

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Non-pharmacological and pharmacological interventions for primary prevention of gallbladder stones in adults

Stokes

Lammert

2012

Cochrane Database of Systematic Reviews

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Physical activity reduces the risk of symptomatic gallstones: a prospective cohort study

Cited by 53 publications

References 36 publications

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Effect of Short-Term Vitamin D Correction on Hepatic Steatosis as Quantified by Controlled Attenuation Parameter (CAP)

Gallstones: Environment, Lifestyle and Genes

Non-pharmacological and pharmacological interventions for primary prevention of gallbladder stones in adults

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