DIET AND LIFESTYLE FACTORS ASSOCIATED WITH THE RISK OF GALLSTONE DISEASE: A REVIEW OF THE CURRENT LITERATURE

Jakub Hamouta; Wiktor Doroszuk; Dawid Sewruk; Magdalena Próchnicka; Michał Siwek; Natalia Strumnik; Jan Noskowicz; Jan Urban; Kamila Derlatka; Julia Konat

doi:10.31435/ijitss.3(47).2025.3929

Jakub Hamouta 1st Military Clinical Hospital with the Outpatient Clinic SPZOZ in Lublin, Lublin, Poland https://orcid.org/0009-0003-6368-223X
Wiktor Doroszuk 1st Military Clinical Hospital with the Outpatient Clinic SPZOZ in Lublin, Lublin, Poland https://orcid.org/0009-0004-2446-726X
Dawid Sewruk Provincial Specialist Hospital in Lublin, Lublin, Poland https://orcid.org/0009-0008-4153-7126
Magdalena Próchnicka University Clinical Hospital No. 4 in Lublin, Lublin, Poland https://orcid.org/0000-0002-0641-2079
Michał Siwek University Clinical Hospital No. 4 in Lublin, Lublin, Poland https://orcid.org/0000-0002-0930-9333
Natalia Strumnik Independent Public Health Care Facility in Puławy, Puławy, Poland https://orcid.org/0009-0009-9634-3502
Jan Noskowicz Independent Public Healthcare Institution of the Ministry of Internal Affairs and Administration named after Sergeant Grzegorz Załoga in Katowice, Katowice, Poland https://orcid.org/0009-0009-6578-0398
Jan Urban Independent Public Healthcare Institution of the Ministry of Internal Affairs and Administration named after Sergeant Grzegorz Załoga in Katowice, Katowice, Poland https://orcid.org/0009-0004-8583-6970
Kamila Derlatka Medical University of Lublin, Lublin, Poland https://orcid.org/0009-0002-8528-4550
Julia Konat Provincial Specialist Hospital in Lublin, Lublin, Poland https://orcid.org/0009-0008-6607-6725

DOI: https://doi.org/10.31435/ijitss.3(47).2025.3929

Keywords: Gallstone Disease, Cholelithiasis, Diet, Lifestyle, Physical Activity, Risk Factors

Abstract

Background: Gallstone disease (GSD) is a prevalent gastrointestinal disorder, particularly in developed countries, with a global adult prevalence ranging between 10% and 20%. Although often asymptomatic, GSD may lead to serious complications including acute pancreatitis, cholecystitis, and biliary obstruction.

Aim: This review aims to summarize current evidence on dietary and lifestyle factors associated with the risk of gallstone disease and explore modifiable risk factors relevant for prevention.

Material and Methods: A narrative review of recent literature was conducted using peer-reviewed articles published in PubMed and Google Scholar. Prospective cohort studies, meta-analyses, and Mendelian randomization analyses were included to evaluate associations between dietary patterns, lifestyle behaviors, and gallstone disease risk.

Results: High intake of ultra-processed foods, sugar-sweetened beverages, and refined carbohydrates was consistently associated with an increased risk of GSD. Conversely, plant-based diets emphasizing whole and minimally processed foods, high fruit and vegetable consumption, and anti-inflammatory dietary patterns showed protective effects. Vegetarian diets appeared particularly beneficial for women. Additionally, obesity, type 2 diabetes, and smoking were confirmed as causal risk factors, while moderate coffee consumption may reduce GSD risk. Rapid weight loss and weight cycling were also identified as risk enhancers. Additionally, increased physical activity appears to reduce the risk of GSD.

Conclusions: The findings highlight the importance of dietary quality and healthy lifestyle choices in the prevention of gallstone disease. Modifiable factors such as diet composition, physical activity, and body weight management play a pivotal role in reducing GSD incidence. Preventive strategies should focus on long-term adherence to plant-based, low-processed diets and healthy lifestyle practices.

References

Di Ciaula, A., Garruti, G., Frühbeck, G., De Angelis, M., de Bari, O., Wang, D. Q., Lammert, F., & Portincasa, P. (2019). The Role of Diet in the Pathogenesis of Cholesterol Gallstones. Current medicinal chemistry, 26(19), 3620–3638. https://doi.org/10.2174/0929867324666170530080636.

Dupont, B., Dejardin, O., Bouvier, V., Piquet, M. A., & Alves, A. (2022). Systematic Review: Impact of Social Determinants of Health on the Management and Prognosis of Gallstone Disease. Health equity, 6(1), 819–835. https://doi.org/10.1089/heq.2022.0063.

Gutt, C., Schläfer, S., & Lammert, F. (2020). The Treatment of Gallstone Disease. Deutsches Arzteblatt international, 117(9), 148–158. https://doi.org/10.3238/arztebl.2020.0148.

Madden, A. M., Smeeton, N. C., Culkin, A., & Trivedi, D. (2024). Modified dietary fat intake for treatment of gallstone disease in people of any age. The Cochrane database of systematic reviews, 2(2), CD012608. https://doi.org/10.1002/14651858.CD012608.pub3.

Pak, M., & Lindseth, G. (2016). Risk Factors for Cholelithiasis. Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates, 39(4), 297–309. https://doi.org/10.1097/SGA.0000000000000235.

Wang, X., Yu, W., Jiang, G., Li, H., Li, S., Xie, L., Bai, X., Cui, P., Chen, Q., Lou, Y., Zou, L., Li, S., Zhou, Z., Zhang, C., Sun, P., & Mao, M. (2024). Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 22(8), 1586–1595. https://doi.org/10.1016/j.cgh.2024.01.051.

Liu, S., Yi, M., Qin, J., Lei, F., Lin, L., Li, Y., Zhuo, M., Liu, W., Huang, X., Cai, J., Zhang, X., Zhang, P., Ji, Y., Ye, J., & Li, H. (2022). The increasing incidence and high body mass index-related burden of gallbladder and biliary diseases-A results from global burden of disease study 2019. Frontiers in medicine, 9, 1002325. https://doi.org/10.3389/fmed.2022.1002325.

Li, Z. Z., Guan, L. J., Ouyang, R., Chen, Z. X., Ouyang, G. Q., & Jiang, H. X. (2023). Global, regional, and national burden of gallbladder and biliary diseases from 1990 to 2019. World journal of gastrointestinal surgery, 15(11), 2564–2578. https://doi.org/10.4240/wjgs.v15.i11.2564.

Unalp-Arida, A., & Ruhl, C. E. (2024). Burden of gallstone disease in the United States population: Prepandemic rates and trends. World journal of gastrointestinal surgery, 16(4), 1130–1148. https://doi.org/10.4240/wjgs.v16.i4.1130.

Salari, N., Hasheminezhad, R., Heidarisharaf, P., Khaleghi, A. A., Azizi, A. H., Shohaimi, S., & Mohammadi, M. (2023). The global prevalence of gallstones in pregnancy: A systematic review and meta-analysis. European journal of obstetrics & gynecology and reproductive biology: X, 19, 100237. https://doi.org/10.1016/j.eurox.2023.100237.

Portincasa, P., Di Ciaula, A., Bonfrate, L., Stella, A., Garruti, G., & Lamont, J. T. (2023). Metabolic dysfunction-associated gallstone disease: expecting more from critical care manifestations. Internal and emergency medicine, 18(7), 1897–1918. https://doi.org/10.1007/s11739-023-03355-z.

Di Ciaula, A., & Portincasa, P. (2018). Recent advances in understanding and managing cholesterol gallstones. F1000Research, 7, F1000 Faculty Rev-1529. https://doi.org/10.12688/f1000research.15505.1.

Dan, W. Y., Yang, Y. S., Peng, L. H., Sun, G., & Wang, Z. K. (2023). Gastrointestinal microbiome and cholelithiasis: Current status and perspectives. World journal of gastroenterology, 29(10), 1589–1601. https://doi.org/10.3748/wjg.v29.i10.1589.

Yang, T., Zhong, J., Zhang, R., Xiao, F., Wang, Y., Tao, H., & Hong, F. (2024). Different types and numbers metabolic abnormalities and risk of gallbladder stone disease in adults. Frontiers in nutrition, 11, 1443575. https://doi.org/10.3389/fnut.2024.1443575.

Uche-Anya, E., Ha, J., Khandpur, N., Rossato, S. L., Wang, Y., Nguyen, L. H., Song, M., Giovannucci, E., & Chan, A. T. (2024). Ultraprocessed food consumption and risk of gallstone disease: analysis of 3 prospective cohorts. The American journal of clinical nutrition, 120(3), 499–506. https://doi.org/10.1016/j.ajcnut.2024.07.002.

Wu, W., Pei, Y., Wang, J., Liang, Q., & Chen, W. (2025). Association of dietary quality indicators with gallstones in the US: NHANES 2017-2020. BMC public health, 25(1), 976. https://doi.org/10.1186/s12889-025-21783-8.

Li, L., Liu, C., Xia, T., Li, H., Yang, J., Pu, M., Zhang, S., Ma, Y., & Zhang, T. (2024). Association between plant-based dietary index and gallstone disease: A cross sectional study from NHANES. PloS one, 19(6), e0305822. https://doi.org/10.1371/journal.pone.0305822.

Chang, C. M., Chiu, T. H. T., Chang, C. C., Lin, M. N., & Lin, C. L. (2019). Plant-Based Diet, Cholesterol, and Risk of Gallstone Disease: A Prospective Study. Nutrients, 11(2), 335. https://doi.org/10.3390/nu11020335.

Nordenvall, C., Oskarsson, V., & Wolk, A. (2018). Fruit and vegetable consumption and risk of cholecystectomy: a prospective cohort study of women and men. European journal of nutrition, 57(1), 75–81. https://doi.org/10.1007/s00394-016-1298-6.

Bin, C., & Zhang, C. (2025). The association between vitamin D consumption and gallstones in US adults: A cross-sectional study from the national health and nutrition examination survey. Journal of the Formosan Medical Association = Taiwan yi zhi, 124(3), 212–217. https://doi.org/10.1016/j.jfma.2024.09.010.

Yuan, S., Gill, D., Giovannucci, E. L., & Larsson, S. C. (2022). Obesity, Type 2 Diabetes, Lifestyle Factors, and Risk of Gallstone Disease: A Mendelian Randomization Investigation. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 20(3), e529–e537. https://doi.org/10.1016/j.cgh.2020.12.034.

Marschall, H. U., & Einarsson, C. (2007). Gallstone disease. Journal of internal medicine, 261(6), 529–542. https://doi.org/10.1111/j.1365-2796.2007.01783.x.

Alyahyawi, K. O., Jareebi, M. A., Iskander, O. A., Othman, J. A., Alagsam, A. A., Borik, W. S., Qaarie, M. Y., & Gosadi, I. M. (2023). Exploration of the Causal Association Between Behavioral Risk Factors and Gallstone Disease Development in Two European Ancestry Populations. Cureus, 15(4), e37110. https://doi.org/10.7759/cureus.37110.

Xie, L., Xu, M., Lei, Y., Li, J., & Xie, J. (2024). The causal relationship between diet habits and cholelithiasis: a comprehensive Mendelian randomization (MR) study. Frontiers in nutrition, 11, 1377631. https://doi.org/10.3389/fnut.2024.1377631.

Tehrani, A. N., Saadati, S., Yari, Z., Salehpour, A., Sadeghi, A., Daftari, G., Ghorbani, M., & Hekmatdoost, A. (2023). Dietary fiber intake and risk of gallstone: a case-control study. BMC gastroenterology, 23(1), 119. https://doi.org/10.1186/s12876-023-02752-0.

Gutiérrez-Díaz, I., Molinero, N., Cabrera, A., Rodríguez, J. I., Margolles, A., Delgado, S., & González, S. (2018). Diet: Cause or Consequence of the Microbial Profile of Cholelithiasis Disease?. Nutrients, 10(9), 1307. https://doi.org/10.3390/nu10091307.

Wirth, J., Joshi, A. D., Song, M., Lee, D. H., Tabung, F. K., Fung, T. T., Chan, A. T., Weikert, C., Leitzmann, M., Willett, W. C., Giovannucci, E., & Wu, K. (2020). A healthy lifestyle pattern and the risk of symptomatic gallstone disease: results from 2 prospective cohort studies. The American journal of clinical nutrition, 112(3), 586–594. https://doi.org/10.1093/ajcn/nqaa154.

Ye, Z., Xie, J., Ni, X., Yang, J., Li, J., Xuan, Y., & Gu, H. (2024). Physical activity and risk of cholelithiasis: a narrative review. Frontiers in medicine, 11, 1485097. https://doi.org/10.3389/fmed.2024.1485097.

Gao, C., Li, Y., Ren, X., & Han, W. (2025). Association between relative fat mass and gallstones: a cross-sectional study based on NHANES 2017-2020. Frontiers in nutrition, 12, 1554659. https://doi.org/10.3389/fnut.2025.1554659.

Li, J., & Bai, S. J. (2025). Cardiometabolic index as a predictor of gallstone incidence in U.S. adults: insights from NHANES 2017-2020. BMC gastroenterology, 25(1), 45. https://doi.org/10.1186/s12876-025-03642-3.

Yu, W., Xia, J., Chen, F., Jiao, P., Cui, P., Zhang, C., Wang, Y., Shan, X., & Wang, X. (2024). 胆结石患病风险预测模型的构建和多中心验证研究 [Establishment and Validation of a Predictive Model for Gallstone Disease in the General Population: A Multicenter Study]. Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition, 55(3), 641–652. https://doi.org/10.12182/20240560501.

Wang, Y., Lu, J., Wen, N., Nie, G., Peng, D., Xiong, X., Cheng, N., & Li, B. (2022). The role of diet and nutrition related indicators in biliary diseases: an umbrella review of systematic review and meta-analysis. Nutrition & metabolism, 19(1), 51. https://doi.org/10.1186/s12986-022-00677-1.

Hu, H., Shao, W., Liu, Q., Liu, N., Wang, Q., Xu, J., Zhang, X., Weng, Z., Lu, Q., Jiao, L., Chen, C., Sun, H., Jiang, Z., Zhang, X., & Gu, A. (2022). Gut microbiota promotes cholesterol gallstone formation by modulating bile acid composition and biliary cholesterol secretion. Nature communications, 13(1), 252. https://doi.org/10.1038/s41467-021-27758-8.

Li, W., Ren, A., Qin, Q., Zhao, L., Peng, Q., Ma, R., & Luo, S. (2023). Causal associations between human gut microbiota and cholelithiasis: a mendelian randomization study. Frontiers in cellular and infection microbiology, 13, 1169119. https://doi.org/10.3389/fcimb.2023.1169119.

DIET AND LIFESTYLE FACTORS ASSOCIATED WITH THE RISK OF GALLSTONE DISEASE: A REVIEW OF THE CURRENT LITERATURE

Abstract

References

Most read articles by the same author(s)