Gallstones - Prevention

By David Perlmutter, MD, FACN

It has been estimated that in the United States gallstones exist in about 20% of women and 8% of men over the age of 40 years. Typically, gallstones may remain unnoticed throughout an individual’s lifetime. Occasionally, however, these stones may obstruct the outflow of bile from the gallbladder leading to severe abdominal pain.

The classic medical teaching with respect to those most likely to get gallstones has been described as the "3 F’s," that is fat, female, and fertile. Thus, the highest risk group has been women who have been pregnant, overweight, and in addition, typically eating a diet high in animal products and over the age of 60 years. Thus, most of the medical research being published concerning gallstones has focused primarily on therapy rather than on modifiable risk factors. A recent article appearing in the American Journal of Clinical Nutrition in 1999 (Volume 69, page 120), drew some very significant conclusions concerning factors which could be modified to directly reduce risk of gallstones. The study, performed in Castellana, Italy, evaluated 100 patients who were recently diagnosed as having gallstones and compared their diets to 290 randomly selected patients who were proven by ultrasound evaluation to be free of gallstones. In addition, physical activity for the preceding 12 months prior to the ultrasound examination was also evaluated.

The results of the study demonstrated that the most significant factors related to the risk of developing gallstones were body-mass index (obesity) and intake of refined sugar. In addition, intake of saturated fats was also a direct risk factor and found to be more likely associated in men than in women. Those factors which were inversely related to the risk of developing gallstones included consumption of monounsaturated fats, fiber, and physical activity.