GALLSTONES
RECREATIONAL PHYSICAL ACTIVITY AND THE RISK OF CHOLECYSTECTOMY
IN WOMEN
Gallstones affect 10 to 15 percent of adults in the United
States. In most Western countries an estimated 75% of gallstones
are of the cholesterol type. Cholesterol gallstones have
many causes, but biliary hypersecretion of cholesterol is
an important determinant. This condition is profoundly exacerbated
by obesity. Physical activity may be an important determinant
of the risk of gallstone disease, both independently and
as a result of its role in maintaining body weight. Therefore,
a study was carried out in a cohort of 60,290 women who
were 40 to 65 years of age and had no history of gallstone
disease. Recreational physical activity (such as jogging,
running, and bicycling) and sedentary behaviour (such as
spending hours watching television) were studied in relation
to the risk of cholecystectomy. During a 10-year follow-up
period, 3257 cases of cholecystectomy were documented. It
was found that recreational physical activity was inversely
related to the risk of cholecystectomy. The multivariate
relative risk for women in the highest as compared to the
lowest quintile of physical activity was 0.69. In contrast,
sedentary behaviour was independently related to an increased
risk of cholecystectomy. As compared with women who spent
less than 6 hours per week sitting while at work or driving,
women who spent 41 to 60 hours per week sitting had a multivariate
relative risk of 1.42, and women who spent more than 60
hours per week sitting or driving had a multivariate relative
risk of 2.32. Thus, in women recreational physical activity
is associated with a decreased risk of cholecystectomy.
Leitzmann, M.F. et al
N.ENGL.J.MED. 1999, 341 (11) 777-84
A PROSPECTIVE STUDY OF COFFEE CONSUMPTION AND THE RISK
OF SYMPTOMATIC GALLSTONE DISEASE IN MEN
Coffee has several metabolic effects that could reduce
the risk of gallstone formation, an association with potential
clinical and public health relevance. The objective of the
study was to examine the association between coffee consumption
and the risk of symptomatic gallstone disease in men. Data
came from The Health Professionals Follow-up Study, a prospective
cohort study that commenced in 1986 with follow up through
1996. The consumption of coffee and other caffeinated drinks
was assessed as part of the 131 item food frequency questionnaire
given to US male health professionals. 46,008 men, aged
40-75 years without history of gallstone disease participated
in the study.
The main outcome measures were newly symptomatic gallstone
disease or a cholecystectomy. 1,081 subjects reported symptomatic
gallstone disease, 885 of these required cholecystectomy.
After adjusting for other known/suspected risk factors,
it was found that compared with men who did not consume
regular coffee in 1986 and 1990, the adjusted relative risk
(RR) for those drinking 2 to 3 cups of regular coffee daily
was 0.60 and for those drinking 4 or more cups daily the
RR was 0.55.
All coffee brewing methods showed decreased risk and risk
also declined with increasing caffeine intake. Decaffeinated
coffee was not associated with a decreased risk.
Leitzmann, M.F. et al
J.A.M.A. 1999, 281 (22) 2106-2112
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