title: Long-term intake of dietary fiber and decreased risk of cholecystectomy in women.
abstract: BACKGROUND
  Epidemiologic studies on the relationship between dietary fiber and gallstone disease are inconclusive, and the effects of different types of dietary fiber are not clear.
  
  
  METHODS
  We examined the association between long-term intake of dietary fiber as well as fiber from different sources and risk of cholecystectomy in a cohort of 69,778 women who were aged from 35 to 61 years in 1984 and had no history of gallstone disease. As part of the Nurses' Health Study, the women reported on questionnaires mailed to them every two years both their fiber intake and whether they had undergone cholecystectomy.
  
  
  RESULTS
  During 16 yr of follow-up, we documented 5,771 cases of cholecystectomy. After adjusting for age and other known or suspected risk factors in a multivariate model, compared with women in the lowest quintile of total dietary fiber intake, the relative risk of choleystectomy for those in the highest quintile was 0.87 (95% CI, 0.78-0.96, p for trend = 0.005). For a 5-g increase in total fiber intake, the multivariate relative risk was 0.94 (95% CI, 0.90-0.98). Insoluble fiber, taking soluble fiber into account in the multivariate model, was significantly associated with a reduced risk. The multivariate relative risk was 0.83 (95% CI, 0.73-0.94, p for trend = 0.009) for insoluble fiber, and was 1.01 (95% CI, 0.89-1.15, p for trend = 0.9) for soluble fiber, when extreme quintiles were compared. For a 5-g increase in intake, the relative risk was 0.90 (95% CI, 0.84-0.97) for insoluble fiber, and was 1.01 (95% CI, 0.83-1.23) for soluble fiber.
  
  
  CONCLUSIONS
  Our results suggest that increased long-term consumption of dietary fiber, particularly insoluble fiber, can reduce risk of cholecystectomy in women.
authors.affiliation: Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Chung-Jyi
authors.initials: CJ
authors.lastname: Tsai
authors.forename: Michael F
authors.initials: MF
authors.lastname: Leitzmann
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Edward L
authors.initials: EL
authors.lastname: Giovannucci
mesh_terms: D000328:Adult; D002763:Cholecystectomy / Q000706:statistics & numerical data*; D004043:Dietary Fiber; D005260:Female; D042882:Gallstones / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires