title: A prospective study of hospitalization with gallstone disease among women: role of dietary factors, fasting period, and dieting.
abstract: BACKGROUND
  Dietary risk factors for the development of gallstones have not been clearly established. We analyzed data from a population-based prospective study to determine dietary risk factors for hospitalization with gallstone disease.
  
  
  METHODS
  We evaluated the role of dietary constituents, fasting, and dieting on subsequent hospitalization with gallstone disease among 4,730 women, ages 25 to 74 years, who participated in the first follow-up of the first National Health and Nutrition Examination Survey. Baseline dietary variables were established through a 24-hour dietary recall and a medical history. Proportional hazards models were used to calculate the effects of dietary variables while controlling for baseline risk factors.
  
  
  RESULTS
  After an average of 10 years follow-up, gallstone disease was confirmed by hospital records among 216 women who denied gallstone disease at the baseline examination. The hazard rate of hospitalization with gallstone disease increased with increasing overnight fasting period and with dieting. Intake of fiber showed a small protective effect. The effect of energy intake was significant only among women younger than age 50 years at baseline. Results were not affected by adjustment for known risk factors for gallstone disease or other dietary factors.
  
  
  CONCLUSIONS
  A long overnight fasting period, dieting, and low fiber intake may increase the risk of hospitalization with gallstone disease.
authors.affiliation: Epidemiology and Data Systems Program, NIH/NIDDK, Bethesda, MD 20892.
authors.forename: R
authors.initials: R
authors.lastname: Sichieri
authors.forename: J E
authors.initials: JE
authors.lastname: Everhart
authors.forename: H
authors.initials: H
authors.lastname: Roth
mesh_terms: D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D004034:Diet Surveys; D004038:Diet, Reducing / Q000009:adverse effects*; D004043:Dietary Fiber / Q000008:administration & dosage*; D004734:Energy Metabolism; D005215:Fasting / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology