Tsai C-J et al. (2005) Glycemic load, glycemic index, and carbohydrate intake in relation to risk of cholecystectomy in women. Gastroenterology 129: 105–112

The effect of high-carbohydrate diets on insulin-resistant individuals has been widely investigated; however, the effect of such diets and their associated high glycemic response on the risk of developing gallstone disease is less well documented. Tsai and colleagues have reported the results of a 16-year prospective study, which investigated the association between carbohydrate intake, glycemic load and index, and the incidence of cholecystectomy in a large cohort of American women.

In 1984, 70,408 women with no prior diagnosis of gallstone disease, who were involved in The Nurses' Health Study and aged 35–61 years, were mailed semiquantitative food-frequency questionnaires regarding their intake of carbohydrate-containing foods. Biennial follow-up questionnaires were completed until the year 2000, and calculations of total carbohydrate intake, glycemic load and glycemic index were compared with the self-reported occurrence of cholecystectomy.

In total, 5,771 cholecystectomy cases were reported over the 16 years of follow-up. A positive association was found between higher intakes of carbohydrates and cholecystectomy. For glycemic load and index, the relative risks of cholecystectomy for the highest compared with the lowest quintiles were 1.50 and 1.32, respectively.

The authors conclude that the quality and quantity of carbohydrate intake in women can be predictive of the risk of cholecystectomy, and highlight the need for more clinical studies to substantiate their findings.