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The Relation of Physical Activity to Risk for Symptomatic Gallstone Disease in Men

Michael F. Leitzmann, MD, MPH; Edward L. Giovannucci, MD, ScD; Eric B. Rimm, ScD; Meir J. Stampfer, MD, DrPH; Donna Spiegelman, ScD; Alvin L. Wing, MBA; and Walter C. Willett, MD, DrPH
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From the Harvard School of Public Health, Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts. Acknowledgments: The authors thank Mira Koyfman, Mildred Wolff, Elizabeth Frost-Hawes, Kerry Pillsworth, and Jill Arnold. Current Author Addresses: Drs. Leitzmann, Rimm, and Willett: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;128(6):417-425. doi:10.7326/0003-4819-128-6-199803150-00001
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Background: Gallstone disease is a major source of morbidity in the United States. Gallstones are twice as common in women as in men, but severe biliary events leading to surgery occur with equal frequency in the two sexes.

Objective: To determine whether physical activity decreases risk for symptomatic gallstone disease in men.

Design: Prospective cohort study.

Setting: U.S. male health professionals.

Patients: 45 813 men 40 to 75 years of age were followed from 1986 to 1994.

Measurements: Questionnaires mailed in 1986, 1988, 1990, 1992, and 1994 asked about physical activity, incidence of gallstone disease, age, body weight, dietary and alcohol intake, smoking habits, use of medications, and occurrence of diagnosed medical conditions other than gallstone disease.

Results: 828 men reported having newly symptomatic gallstones (diagnosed by ultrasonography or radiography) or undergoing cholecystectomy for recent symptoms. After adjustment for multiple confounders, increased physical activity was inversely related to risk for symptomatic gallstone disease. When extreme quintiles were compared, men younger than 65 years of age had a stronger inverse association (multivariate relative risk, 0.58 [95% CI, 0.44 to 0.78]) with risk than did men 65 years of age or older (relative risk, 0.75 [CI, 0.52 to 1.09]). In contrast, sedentary behavior was positively related to risk for symptomatic gallstone disease. Men who watched television more than 40 hours per week had a higher risk for symptomatic gallstones than men who watched less than 6 hours per week (relative risk for older men, 3.32 [CI, 1.51 to 7.27]; relative risk for younger men, 1.58 [CI, 0.38 to 6.48]).

Conclusions: Physical activity may play an important role in the prevention of symptomatic gallstone disease in men even beyond its benefit for control of body weight. The results of this study indicate that 34% of cases of symptomatic gallstone disease in men could be prevented by increasing exercise to 30 minutes of endurance-type training five times per week.





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