Fewer Gallbladder Surgeries with Mediterranean Diets

Shereen Lehman wrote . . . . . .

Eating foods high in fiber, such as those found in a Mediterranean diet, was tied to a lower risk of gallbladder surgery in a recent French study.

Compared to people who didn’t follow a Mediterranean diet pattern, those who adhered to it most closely had a significantly lower likelihood of needing a cholecystectomy, which is the medical term for an operation to remove the gallbladder, say the authors.

“We found that higher intakes of legumes, fruit, vegetable oil, and (whole grain) bread were associated with decreased cholecystectomy risk, and a higher intake of ham was associated with higher risk of cholecystectomy,” wrote the authors in the American Journal of Gastroenterology.

About 700,000 cholecystectomies are performed every year in the United States, according to the American College of Surgeons. Most are the result of blockage due to gallstones.

“Gallstones are very common, but most of them are asymptomatic, meaning people have no symptoms. If you don’t have any symptoms from your gallstones, there’s no reason to have your gallbladder removed,” said Dr. James Lewis, a gastroenterologist at the University of Pennsylvania in Philadelphia who was not part of the study.

The vast majority of people with gallstones never have problems from them, Lewis said in a phone interview.

“When they do cause problems, then having your gallbladder removed is completely appropriate,” he said.

The new study, led by Dr. Amelie Barre at the University of Paris Sud in Orsay, used information on nearly 64,000 women who were born between 1925 and 1950 and covered by a national insurance plan. Every two years, they answered questions about their health status, medical history, and lifestyle.

Over the course of 18 years, 2,778 of the women had their gallbladder removed.

Women who ate the most legumes, fruits, vegetable oil, and whole grain bread were anywhere from 13 to 27 percent less likely to have gallbladder surgery than were women who ate the least of those foods.

A western dietary pattern – including high consumption of processed meat, canned fish, eggs, rice, pasta, appetizers, pizza, potatoes, cakes, and alcohol – was not linked with either a higher or lower risk for the surgery. There was, however, an association of ham intake with cholecystectomy risk.

But when researchers assigned a Mediterranean diet score to all participants, they found that women with the highest scores were 11 percent less likely to have the surgery compared to women with the lowest scores.

This type of observational study can’t prove that a Mediterranean diet was the reason for women’s lower risk of gallbladder surgery, or that ham intake caused a higher risk. Furthermore, dietary intakes were self-reported at just one point in time. The reports may not have been accurate, and women’s diets may have changed over time.

Still, Lewis said, the Mediterranean-style diet has consistently been shown to be associated with living longer.

“If people really want to think about what they should be eating in order to increase their longevity, it’s very easy for me to recommend to them that they should try and follow a Mediterranean-style diet,” he said.

In fact, the U.S. Department of Agriculture recently advised Americans to follow a diet that is very similar to a Mediterranean-style diet, Lewis noted. (bit.ly/2vHSL8h)

“This is just one of many reasons that we should be following that style diet. If you look at the published literature on dietary patterns, what you’ll see is that Mediterranean-style diet has been associated with a reduced overall mortality but also reduced cardiovascular mortality (and) reduced risks of cancer,” he said.

Source: Reuters


Today’s Comic

Gallstone Disease May Increase Heart Disease Risk

A history of gallstone disease may increase your risk of coronary heart disease, according to new research in the American Heart Association’s journal Arteriosclerosis, Thrombosis and Vascular Biology.

Gallstone disease is one of the most common and costly gastrointestinal disorders in the United States. Gallstone disease and coronary heart disease have similar risk factors, including diabetes, obesity, high cholesterol, high blood pressure and poor diet.

In a meta-analysis of seven studies consisting of a total of 842,553 participants and 51,123 cases of coronary heart disease, researchers analyzed the relationship between history of gallstones and the development of coronary heart disease. They found that a history of gallstone disease was linked with a 23 percent increased risk of developing coronary heart disease.

“Our results suggest that patients with gallstone disease should be monitored closely based on a careful assessment of both gallstone and heart disease risk factors,” said Lu Qi, M.D., Ph.D., study senior author and professor of epidemiology at Tulane University in New Orleans, Louisiana. “Preventing gallstone disease may also benefit heart health.”

In a separate analysis of 269,142 participants from three different studies, the researchers found coronary heart disease occurred more often with a history of gallstone disease because of the shared risk factors. Moreover, the increased risk was similar between women and men.

Interestingly, in the three studies, participants with a history of gallstone disease who were otherwise healthy — were not obese, diabetic or had high blood pressure — had a greater risk of coronary heart disease than participants that had these conditions.

Previous studies have reported an increased risk of cardiovascular disease with history of gallstone disease, but these studies lacked U.S. populations, were conducted over short periods, did not confirm the cases of gallstones or did not account for significant risk factors for gallstone diseases such as lifestyle and diet, researchers said.

The researchers did not identify why gallstone disease and coronary heart disease were linked in this study, but one theory is that gallstones may affect bile acid secretion, which has been related to cardiovascular risk factors. In addition, gut microbiota has been related to cardiovascular disease. “Patients with gallstones also have abnormal abundance and metabolism in their gut microbiota”, Qi said.

Understanding the factors that link gallstones and coronary heart disease and clinical trials to assess the effects of the factors on cardiovascular health are essential for applying the research findings to clinical practice, Qi said.

Source: American Heart Association

Higher BMI Increases Risk of Gallstones, Especially in Women

New research reveals a causal association between elevated body mass index (BMI) and increased risk of gallstone disease. Results published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show women are at greater risk of developing gallstones.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) describe gallstones as pebble-like material, which can develop when there is excess cholesterol—accounting for 80% of all gallstones—bile salts or bilirubin in bile stored in the gallbladder. Gallstone disease is one of the most common and costly gastrointestinal diseases—accounting for $5.8 billion (Sandler et al., May 2002). Prior studies have shown that greater BMI is associated with increased risk of gallstone disease; however it is unclear if it is the cause of the disease.

To further understanding of the connection between BMI and gallstone risk, a team led by Dr. Anne Tybjærg-Hansen from Rigshospitalet, Copenhagen University Hospital in Denmark studied 77,679 participants from the general population, employing a Mendelian randomization approach—a method using genetic variation to study the impact of modifiable risk factors as the cause of a disease. There were 4,106 participants who developed symptomatic gallstone disease during the 34 years of follow-up.

Participants with gallstone disease were more likely to be older, female, and less physically active. Researchers found that those with gallstones often used hormone replacement therapy and drank less alcohol than those without the disease. Analyses show that increased BMI was associated with gallstone disease risk with an overall hazard ratio (HR) of 2.84. When looking at BMI and gender, the team found that women had a higher risk of developing gallstone disease than men (HR=3.36 and 1.51, respectively).

Findings indicate that gallstone disease risk increased 7% for every 1 kg/M2 increase in BMI. “Obesity is a known risk factor for gallstone disease and our study suggests that elevated BMI likely contributes to the development of this disease,” concludes Dr. Tybjærg-Hansen. “These data confirm that obesity adversely affects health, and lifestyle interventions that promote weight loss in overweight and obese individuals are warranted.”

Source: Wiley