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CME Released: 8/7/2003
Valid for credit through: 8/7/2004
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Aug. 7, 2003 — Alcohol consumption is linked to lower incidence of symptomatic gallstones in women, according to the results of the Nurses' Health Study published in the August issue of the American Journal of Clinical Nutrition. Although prospective evaluation revealed an inverse association, the authors suggest that benefits of moderate consumption be weighed against potential health hazards.
"The results of most, but not all, epidemiologic investigations that addressed the relation between alcohol intake and gallstone disease suggest that alcohol confers protection against gallstone development," write Michael F. Leitzmann, from the Harvard School of Public Health in Boston, Massachusetts, and colleagues. "However, controversy exists regarding the magnitude of the inverse association between alcohol intake and cholelithiasis. Alternative explanations for the observed risk reduction include confounding by factors such as socioeconomic status or diet and bias from the inclusion of ill former drinkers in the reference group of nondrinkers."
Of 80,898 women from the Nurses' Health Study who had no history of gallstone disease in 1980, there were 7,831 cases of cholecystectomy during 20-year follow-up.
Compared with subjects who had no alcohol intake based on food-frequency questionnaires, subjects who had alcohol intakes of 0.1 to 4.9, 5.0 to 14.9, 15.0 to 29.9, 30.0 to 49.9, and 50.0 g/day had multivariate relative risks of cholecystectomy of 0.95, 0.86, 0.80, 0.67, and 0.62 (95% confidence interval [CI], 0.49 - 0.79), respectively. Compared with subjects who never consumed alcohol, subjects who consumed alcohol 1 to 2, 3 to 4, 5 to 6, and 7 days per week had multivariate relative risks of cholecystectomy of 0.94, 0.88, 0.87, and 0.73 (95% CI, 0.63 - 0.84 for 7 days per week), respectively.
Independent of consumption patterns for quantity of alcohol consumed and frequency of alcohol consumption, all alcoholic beverage types (wine, beer, and liquor) were inversely associated with cholecystectomy risk. Controlling for established or suspected independent risk factors for gallstone disease, including body mass index, weight change, and parity, did not affect these associations.
Study limitations include possible alcohol avoidance among women with preclinical gallstone disease and potential measurement error in assessment of alcohol intake.
"Our findings suggest that frequent, moderate alcohol intake is associated with a decreased risk of cholecystectomy in women," the authors write." All types of alcoholic beverages were inversely associated with the risk of cholecystectomy. Despite the inverse association between regular, moderate alcohol intake and gallstone disease, interested patients should discuss the health effects of alcohol consumption with their health care providers, who can help determine the patients' overall health risks and benefits, as well as provide an individual clinical recommendation."
The National Institutes of Health, the National Institute on Alcohol Abuse and Alcoholism, and the National Cancer Institute supported this study. None of the authors reported any conflict of interest in connection with this article.
Am J Clin Nutr. 2003;78(2):339-347
