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. Metho...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 multivariatemodels, 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 inmen. These results add to the concern that low fat high carbohydrate diets may not be an optimal dietary recommendation.展开更多
Background & Aims: High- carbohydrate diets with a high glycemic response may exacerbate the metabolic consequences of the insulin- resistance syndrome. The effect on the incidence of gallstone disease is not clea...Background & Aims: High- carbohydrate diets with a high glycemic response may exacerbate the metabolic consequences of the insulin- resistance syndrome. The effect on the incidence of gallstone disease is not clear. Methods: We examined the associations between high- carbohydrate diets with a high glycemic response and the risk of cholecystectomy in a cohort of women who were aged from 35 to 61 years in 1984 and had no history of gallstone disease. As part of the Nurses’ Health Study, the women reported on questionnaires mailed to them every 2 years both their carbohydrate intake and whether they had undergone cholecystectomy. Results: During 16 years of follow- up, we ascertained 5771 new cases of cholecystectomy. After adjusting for age and other known or suspected risk factors in a multivariate model, the relative risk for the highest compared with the lowest quintile of dietary carbohydrate was 1.35 (95% CI: 1.17- 1.55,P for trend < .0001). The relative risks for the highest compared with the lowest quintile were 1.50 for glycemic load (95% CI: 1.32- 1.71,P for trend < .0001) and 1.32 for glycemic index (95% CI: 1.20- 1.45, P for trend < .0001). Independent positive associations were also seen for intakes of starch and sucrose. Conclusions: Our findings suggest that a higher intake of carbohydrate, dietary glycemic load, and glycemic index may enhance risk of cholecystectomy in women.展开更多
Background: Monounsaturated and polyunsaturated fats act as inhibitors of cholesterol cholelithiasis in animal experiments. Objective: To examine the association between long term intake of cis unsaturated fats and th...Background: Monounsaturated and polyunsaturated fats act as inhibitors of cholesterol cholelithiasis in animal experiments. Objective: To examine the association between long term intake of cis unsaturated fats and the incidence of gallstone disease in humans. Design: Prospective population based cohort study. Setting: The Health Professional Follow up Study. Participants: 45 756 men, age 40 to 75 years in 1986, who were free of gallstone disease. Measurements: Consumption of cis unsaturated fats was assessed starting in 1986 as part of the 131 item semi quantitative food frequency questionnaires. Questionnaires were mailed to participants every 2 years. The main outcome measure was self reported newly diagnosed symptomatic gallstone disease. Results: During 14 years of follow up, 2323 new cases of gallstone disease were documented. After adjustment for age and other potential risk factors, the relative risk for gallstone disease among men in the highest quintile of dietary intake of cis unsaturated fats compared with men in the lowest quintile was 0.82 (95%CI, 0.69 to 0.96; P for trend = 0.006). The relative risk among men in the highest quintile of polyunsaturated fat consumption compared with men in the lowest quintile was 0.84 (CI, 0.73 to 0.96; P for trend = 0.01), and the relative risk among men in the highest quintile of monounsaturated fat consumption compared with men in the lowest quintile was 0.83 (CI, 0.70 to 1.00; P for trend = 0.01). Limitations: Outcomes were restricted to men with cholecystectomy or diagnostically confirmed but unremoved symptomatic gallstones. Conclusions: A high intake of polyunsaturated and monounsaturated fats in the context of an energy balanced diet is associated with a reduced risk for gallstone disease in men.展开更多
文摘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 multivariatemodels, 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 inmen. These results add to the concern that low fat high carbohydrate diets may not be an optimal dietary recommendation.
文摘Background & Aims: High- carbohydrate diets with a high glycemic response may exacerbate the metabolic consequences of the insulin- resistance syndrome. The effect on the incidence of gallstone disease is not clear. Methods: We examined the associations between high- carbohydrate diets with a high glycemic response and the risk of cholecystectomy in a cohort of women who were aged from 35 to 61 years in 1984 and had no history of gallstone disease. As part of the Nurses’ Health Study, the women reported on questionnaires mailed to them every 2 years both their carbohydrate intake and whether they had undergone cholecystectomy. Results: During 16 years of follow- up, we ascertained 5771 new cases of cholecystectomy. After adjusting for age and other known or suspected risk factors in a multivariate model, the relative risk for the highest compared with the lowest quintile of dietary carbohydrate was 1.35 (95% CI: 1.17- 1.55,P for trend < .0001). The relative risks for the highest compared with the lowest quintile were 1.50 for glycemic load (95% CI: 1.32- 1.71,P for trend < .0001) and 1.32 for glycemic index (95% CI: 1.20- 1.45, P for trend < .0001). Independent positive associations were also seen for intakes of starch and sucrose. Conclusions: Our findings suggest that a higher intake of carbohydrate, dietary glycemic load, and glycemic index may enhance risk of cholecystectomy in women.
文摘Background: Monounsaturated and polyunsaturated fats act as inhibitors of cholesterol cholelithiasis in animal experiments. Objective: To examine the association between long term intake of cis unsaturated fats and the incidence of gallstone disease in humans. Design: Prospective population based cohort study. Setting: The Health Professional Follow up Study. Participants: 45 756 men, age 40 to 75 years in 1986, who were free of gallstone disease. Measurements: Consumption of cis unsaturated fats was assessed starting in 1986 as part of the 131 item semi quantitative food frequency questionnaires. Questionnaires were mailed to participants every 2 years. The main outcome measure was self reported newly diagnosed symptomatic gallstone disease. Results: During 14 years of follow up, 2323 new cases of gallstone disease were documented. After adjustment for age and other potential risk factors, the relative risk for gallstone disease among men in the highest quintile of dietary intake of cis unsaturated fats compared with men in the lowest quintile was 0.82 (95%CI, 0.69 to 0.96; P for trend = 0.006). The relative risk among men in the highest quintile of polyunsaturated fat consumption compared with men in the lowest quintile was 0.84 (CI, 0.73 to 0.96; P for trend = 0.01), and the relative risk among men in the highest quintile of monounsaturated fat consumption compared with men in the lowest quintile was 0.83 (CI, 0.70 to 1.00; P for trend = 0.01). Limitations: Outcomes were restricted to men with cholecystectomy or diagnostically confirmed but unremoved symptomatic gallstones. Conclusions: A high intake of polyunsaturated and monounsaturated fats in the context of an energy balanced diet is associated with a reduced risk for gallstone disease in men.
