Abstract
In this chapter I first consider the evidence that the prevalence of gallstones in a population is not immutable, a proposition which implies that gallstones are preventable. I then look at the scope for prevention in terms of modifiable risk factors, and in terms of those eating and drinking habits which have been linked with gallstones themselves or with lithogenic bile.
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References
Marinovic, I., Guerra, C. and Larach, G. (1972). Incidencia de litiasis biliar en material de autopsias y analisis de composicion de los calculos. Revista Méd. Chile, 100, 1320–7
Zähor, Z., Sternby, N.H., Kagan, A., Uemera, K., Vanecek, R. and Vichert, A.M. (1974). Frequency of cholelithiasis in Prague and Malmö. An autopsy study. Scand. J. Gastroenterol., 9, 3–7
Domellöf, L., Lowenfels, A.B. and Sipponen, P. (1984). Prevalence of gallstones in Finland: an autopsy study in the Helsinki area. Scand. J. Gastroenterol., 19, 761–4
Newman, H.F. and Northup, J.D. (1959). The autopsy incidence of gallstones. Int. Abst. Surg., 109, 1–13
Rodewald, H. (1957). Zur Pathologie der Gallenblase. II Mitteilung. Über die Häufigkeit der Gallensteine. Zentbl. Allg. Path., 96, 300–2
Cleland, J.B. (1953). Gallstones in seven thousand post-mortem examinations. Med. J. Austr., 2, 488–9
Torvik, A. and Høivik, B. (1960). Gallstones in an autopsy series. Incidence, complications, and correlations with carcinoma of the gallbladder. Acta Chir. Scand., 120, 168–74
Douss, T.W. and Castleden, W.M. (1973). Gallstones and carcinoma of the large bowel. N.Z. Med. I., 11, 162–5
Watkinson, G. (1967). The autopsy incidence of gallstones in England and Scotland. Proc 3rd World Congress Gastroenterol, Tokyo, 4, 157–62
Bateson, M.C. (1984). Gallbladder disease and cholecystectomy rate are independently variable. Lancet, 2, 621–4
Acalovschi, M., Dumitrascu, D., Caluser, I. and Ban, A. (1987). Comparative prevalence of gallstone disease at 100-year interval in a large Romanian town, a necropsy study. Dig. Dis. Sci., 32, 354–7
Galväo, H., Menezes, M.L. and Correia, J.P. (1981). The prevalence of gallstones in the Portuguese population: a necrops study. Ital. J. Gastroenterol, 13, 100–4
Kalos, A., Delidou, A., Kordosis, T., Archimandritis, A., Gananis, A. and Angelopoulos, B. (1977). The incidence of gallstones in Greece; an autopsy study. Acta Hep- Gastroenterol, 24, 20–3
Stitnimankarn, T. (1960). The necroscopy incidence of gallstones in Thailand. Am. J. Med. Sci., 240, 349–52
Owor, R. (1964). Gallstones in the autopsy population at Mulago Hospital, Kampala. E. Afr. Med. J., 41, 251–3
Edington, G.M. (1957). Observations on hepatic disease in the Gold Coast: with special reference to cirrhosis. Trans. R. Soc. Trop. Med. Hyg., 51, 48–55
Sampliner, R.E., Bennett, P.H., Comess, L.J., Rose, F.A. and Burch, T.A. (1970). Gallbladder disease in Pima Indians. Demonstration of high prevalence and early onset by cholecystography. N. Engl I. Med., 283, 1358–64
Williams, C.N., Johnston, J.L. and Weldon, K.L.M. (1977). Prevalence of gallstones and gallbladder disease in Canadian Micmac Indian women. Can. Med. Assoc. J., 117, 758–60
Yagi, T. (1960). Some observations on chemical components of gallstones in the Sendai district of Japan. Tohoku. /. Exp. Med., 12, 117–30
Maki, T. (1961). Cholelithiasis in the Japanese. Arch. Surg., 82, 599–612
Malhotra, S.L. (1968). Epidemiological study of cholelithiasis among railroad workers in India with special reference to causation. Gut, 9, 290–5
Progetto Distretto Sezze Controllo Comunitario (DISCO), the National Research Council and the Rome Group for Epidemiology and Prevention of Cholelithiasis (GREPCO) (1987). Epidemiology of gallstone disease in Italy: comparison between a rural and urban female population. Ital. J. Gastroenterol, 19, 129–33
Hills, L.L. (1971). Cholelithiasis and immigration. Med. J. Austr., 2, 94–5
Trotman, B.W. and Soloway, R.D. (1973). Influence of age, race or sex on pigment and cholesterol gallstone incidence. Gastroenterology, 65, 573
Brett, M. and Barker, D.J.P. (1976). The world distribution of gallstones. Int. I. Epidemiol, 5, 335–41
Kameda, H. (1967). Gallstones, compositions, structural characteristics and geographical distribution. In: Proc 3rd World Congress Gastroenterol, Tokyo 1966, 4, 117–24
Pixley, F. (1986). Epidemiology. In: Bateson, M.C. (ed), Gallstone Disease and its Management, pp. 1–23. (Lancaster: MTP Press)
Balzer, K., Goebell, H., Breuer, N., Ruping, K.W. and Leder, L.D. (1986). Epidemiology of gallstones in a German industrial town (Essen) from 1940–1975. Digestion, 33, 189–97
Pixley, F., Wilson, D., McPherson, K. and Mann, J. (1985). Effect of vegetarianism on development of gallstones in women. Br. Med. I., 291, 11–2
Scragg, R.K.R. (1984). Diet, obesity, plasma lipids and insulin in gallstone disease. PhD Thesis, University of Adelaide
Scragg, R.K.R. (1986). Aetiology of cholesterol gallstones. In: Bateson, MC (ed), Gallstone Disease and its Management, pp. 25–55. (Lancaster: MTP Press)
Bennion, L.J. and Grundy, S.M. (1978). Risk factors for the development of cholelithiasis in man. N. Engl I. Med., 299, 1161–7 and 1221–7
Scragg, R.K.R., McMichael, A J. and Baghurst, P.A. (1984). Diet, alcohol, and relative weight in gallstone disease: a case-control study. Br. Med. I., 288, 1113–9
Garn, S.M., La Velle, M., Rosenberg, K.R. and Hawthorne, V.M. (1986). Maturational timing as a factor in female fatness and obesity. Am. J. Clin. Nutr 43, 879–83
Jorgensen, T. (1988). Gallstones in a Danish population: fertility period, pregnancies, and exogenous female sex hormones. Gut, (In press)
Bennion, L.J. and Grundy, S.M. (1975). Effects of obesity and caloric intake on biliary lipid metabolism in man. J. Clin. Invest., 56, 996–1011
Angelin, B., Einarsson, K., Ewerth, S. and Leijd, B. (1981). Biliary lipid composition in obesity. Scand. I. Gastroenterol, 16, 1015–9
Angelico, F. and the GREPCO group (1984). Factors associated with gallstone disease: observations in the GREPCO study. In: Capocaccia, L., Ricci, G., Angelico, F., Angelico, M. and Attili, A.F. (eds). Epidemiology and Prevention of Gallstone Disease, pp.185–92. (Lancaster: MTP Press)
Reuben, A., Qureshi, Y., Murphy, G.M. and Dowling, R.H. (1985). Effect of obesity and weight reduction on biliary cholesterol saturation and the response to chenodeoxycholic acid. Eur. J. Clin. Invest., 16, 133–42
Schlierf, G., Schellenberg, B., Stiehl, A., Czygan, P. and Oster, P. (1981). Biliary cholesterol saturation and weight reduction-effects of fasting and low calorie diet. Digestion, 21, 44–9
Einarsson, K., Hellstròm, K. and Kallner, M. (1975). Gallbladder disease in hyperlipoproteinemia. Lancet, i, 484–7
Ahlberg, J., Angelin, B., Einarsson, K., Hellstròm, K. and Leijd, B. (1979). Prevalence of gallbladder disease in hyperlipoproteinemia. Dig. Dis. Sci., 24, 459–64
Kadziolka, R., Nilsson, S. and Schersten, T. (1977). Prevalence of hyperlipoproteinemia in men with gallstone disease. Scand. J. Gastroenterol, 12, 353–5
Bell, G.D., Lewis, B., Petrie, A. and Dowling, R.H. (1973). Serum lipids in cholelithiasis: effect of chenodeoxycholic acid therapy. Br. Med. J., 3, 520–3
Ahlberg, J. (1979). Serum lipid levels and hyperlipoproteinemia in gallstone patients. Acta Chir. Scand., 145, 373–7
Barbara, L., Sama, L., Labate, A.M.M. et al. (1987). A population study on the prevalence of gallstone disease. The Sirmione study. Hepatology, 7, 913–7
Scragg, R.K.R., Calvert, G.D. and Oliver, J.R. (1984). Plasma lipids and insulin in gallstone disease: a case-control study. Br. Med. J., 289, 521–5
Ahlberg, J., Angelin, B., Einarsson, K., Hellstròm, K. and Leijd, B. (1980). Biliary lipid composition in normo- and hyperlipoproteinemia. Gastroenterology, 79, 90–4
Thornton, J.R., Heaton, K.W. and Macfarlane, D.G. (1981). A relation between high-density-lipoprotein cholesterol and bile cholesterol saturation. Br. Med. I., 283, 1352–4
Alvaro, D., Angelico, F., Attili, A.F. et al. (1986). Plasma lipid lipoproteins and biliary lipid composition in female gallstone patients. Biomed. Biochem. Acta, 45, 761–8
Marks, J.W., Cleary, P.A. and Albers, J.J. (1984). Lack of correlation between serum lipoproteins and biliary cholesterol saturation in patients with gallstones. Dig. Dis. Sci., 29, 1118–22
Sodhi, H.S. and Kudchodkar, B.J. (1973). Correlating metabolism of plasma and tissue cholesterol with that of plasma-lipoproteins. Lancet, 1, 513–9
Angelin, B. (1977). Cholesterol and bile acid metabolism in normo- and hyperlipoproteinemia. Acta Med. Scand., Suppl. 610, 1–40
Lewis, B. (1976). Influence of diet, energy balance and hormones on serum lipids. In: Lewis, B., The Hyperlipidaemias. Clinical and Laboratory Practice, pp. 131–80. (Oxford: Blackwell Scientific Publications)
Anderson, J.W., Chen, W.-J.L. and Sieling, B. (1980). Hypolipidemic effects of high-carbohydrate, high-fiber diets. Metabolism, 29, 551–8
Reiser, S., Hallfrisch, J., Michaelis, O.E., Lazar, F.L., Martin, R.E. and Prather, E.S. (1978). Isocaloric exchange of dietary starch and sucrose in humans. I Effects on levels of fasting lipids. Am. J. Clin. Nutr., 32, 1659–69
Simpson, H.C.R., Simpson, R.W., Lousley, S., Carter, R.D., Geekie, M., Hockaday, T.D.R. and Mann, J.I. (1981). A high carbohydrate leguminous fibre diet improves all aspects of diabetic control. Lancet, i, 1–5
Coronary Drug Project Research Group (1977). Gallbladder disease as a side effect of drugs influencing lipid metabolism. N. Engl. I. Med., 296, 1185–90
Sturdevant, R.A.L., Pearce, M.L. and Dayton, S. (1973). Increased prevalence of cholelithiasis in men ingesting a serum cholesterol lowering diet. N. Engl. I. Med., 288, 24–7
Miettinen, M., Turpeinen, O., Karvonen, M.J., Paavilainen, E. and Elosuo, R. (1976). Prevalence of cholelithiasis in men and women ingesting a serum-cholesterol-lowering diet. Ann. Clin. Res., 8, 111–6
Angelico, M. and the GREPCO group (1984). Relationship between serum lipids and cholelithiasis: observations in the GREPCO study. In: Capocaccia, L., Ricci, G., Angelico, F., Angelico, M. and Attili, A.F. (eds), Epidemiology and Prevention of Gallstone Disease, pp.77–84. (Lancaster: MTP Press)
Petitti, D.B., Friedman, G.D. and Klatsky, A.L. (1981). Association of a history of gallbladder disease with a reduced concentration of high-density-lipoprotein cholesterol. N. Engl I. Med., 304, 1396–8
Thornton, J., Symes, C. and Heaton, K. (1983). Moderate alcohol intake reduces bile cholesterol saturation and raises HDL cholesterol. Lancet, 2, 819–22
Stubbe, I., Eskilsson, J. and Nilsson-Ehle, P. (1982). High-density lipoprotein concentrations increase after stopping smoking. Br. Med. J., 284, 1511–3
Werner, D., Emmett, P.M. and Heaton, K.W. (1984). The effects of dietary sucrose on factors influencing cholesterol gallstone formation. Gut, 25, 269–74
Reiser, S., Handler, H.B., Gardner, L.B., Hallfrisch, J.G., Michaelis, O.E. and Prather, E.S. (1979). Isocaloric exchange of dietary starch and sucrose in humans. II Effect on fasting blood insulin, glucose, and glucagon and on insulin and glucose response to a sucrose load. Am. J. Clin. Nutr., 32, 2206–16
Willett, W. (1987). Nutritional epidemiology: issues and challenges. Int. J. Epidemiol, 16, 312–7
Alessandrini, A., Fusco, M.A., Gatti, E. and Rossi, P.A. (1982). Dietary fibres and cholesterol gallstones: a case control study. Ital I. Gastroenterol, 14, 156–8
Attili, A.F. and the GREPCO group (1984). Dietary habits and cholelithiasis. In: Capocaccia, L., Ricci, G., Angelico, F., Angelico, M. and Attili, A.F. (eds), Epidemiology and Prevention of Gallstone Disease, pp. 175–81. (Lancaster: MTP Press)
Attili, A.F. and the Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO) (1987). Diet and gallstones: result of an epidemiologic study performed in male civil servants. In: Barbara, L., Bianchi Porro, G., Cheli, R. and Lipkin, M. (eds), Nutrition in Gastrointestinal Disease, pp. 225–31. (New York: Raven Press)
Heaton, K.W. (1987). Effect of dietary fiber on biliary lipids. In: Barbara, L., Bianchi Porro, G., Cheli, R. and Lipkin, M. (eds), Nutrition in Gastrointestinal Disease, pp. 213–22. (New York: Raven Press)
Eastwood, M.A. (1986). What does the measurement of dietary fibre mean? Lancet, 1, 1487–8
Bloch, H.M., Thornton, J.R. and Heaton, K.W. (1980). Effects of fasting on the composition of gallbladder bile. Gut, 21, 1087–9
Messing, B., Bories, C., Kunstlinger, F. and Bernier, J.J. (1983). Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology, 84, 1012–9
Bolondi, L., Gaiani, S., Testa, S. and Labo, G. (1985). Gallbladder sludge formation during prolonged fasting after gastrointestinal tract surgery. Gut, 26, 734–8
Capron, J.P., Delamarre, J., Herve, M.A., Dupas, J.L., Poulain, P. and Descombes, P. (1981). Meal frequency and duration of overnight fast: a role in gallstone formation? Br. Med. J., 283, 1435
Bouchier, I.A.D. (1987). Nutrition and gallstone disease. In: Barbara, L., Bianchi Porro, G., Cheli, R. and Lipkin, M. (eds), Nutrition in Gastrointestinal Disease, pp. 205–12. (New York: Raven Press)
Marcus, S.N. and Heaton, K.W. (1986). Intestinal transit, deoxycholic acid and the cholesterol saturation of bile-three inter-related factors. Gut, 21, 550–8
Marcus, S.N. and Heaton, K.W. (1988). Deoxycholic acid and the pathogenesis of gallstones. Gut, 29, 522–33
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© 1988 Kluwer Academic Publishers
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Heaton, K.W. (1988). Clues from Epidemiology. In: Northfield, T., Jazrawi, R., Zentler-Munro, P. (eds) Bile Acids in Health and Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1249-6_10
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DOI: https://doi.org/10.1007/978-94-009-1249-6_10
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