The Effect of Long-Term Intake of cis Unsaturated Fats on the Risk for Gallstone Disease in Men

The Effect of Long-Term Intake of cis Unsaturated Fats on the Risk for Gallstone Disease in Men

A Prospective Cohort Study

Chung-Jyi Tsai, MD, ScD;
Michael F. Leitzmann, MD, DrPH;
Walter C. Willett, MD, DrPH; and
Edward L. Giovannucci, MD, ScD

From Channing Laboratory, Harvard Medical School, Brigham and Women's Hospital, and Harvard School of Public Health, Boston, Massachusetts.

Abstract

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.

For definitions of terms used in the text, see Glossary.

Article and Author Information

Acknowledgments: The authors thank the participants of the Health Professionals Follow-up Study for their continued cooperation and participation. They also thank all the research staff in the study for their expert help.
Grant Support: By research grants (CA55075 and DK46200) from the National Institutes of Health.
Potential Financial Conflicts of Interest: None disclosed.
Corresponding Author: Chung-Jyi Tsai, MD, ScD, Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, 800 Rose Street, MN649, Lexington, KY 40536-0298; e-mail, hpcjt{at}channing.harvard.edu.
Current Author Addresses: Dr. Tsai: Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, 800 Rose Street, MN649, Lexington, KY 40536-0298.
Dr. Leitzmann: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Boulevard, Bethesda, MD 20892.
Drs. Willett and Giovannucci: Harvard Medical School, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115.
Author Contributions: Conception and design: C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.
Analysis and interpretation of the data: C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.
Drafting of the article: C.-J. Tsai, M.F. Leitzmann.
Critical revision of the article for important intellectual content: C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.
Final approval of the article: C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.
Provision of study materials or patients: M.F. Leitzmann, W.C. Willett.
Statistical expertise: C.-J. Tsai, M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.
Obtaining of funding: W.C. Willett.
Administrative, technical, or logistic support: W.C. Willett.
Collection and assembly of data: M.F. Leitzmann, W.C. Willett, E.L. Giovannucci.