Hart, A.R.; Luben, R.; Jakes, R.; Oakes, S.; Camus, J.; Wareham, N.; Welch, A.; Bingham, S.A.; Khaw, K.-T.; Day, N.E.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA109
Academic Journal
Background: The aetiology of gall stones is unknown, although it is plausible that increased physical activity may protect against stone formation by reducing bile stasis. No prospective studies have investigated this hypothesis using a physical activity questionnaire which has been validated against physiological measurements. Methods: 25 623 men and women aged 45-79 years were recruited into EPIC-Norfolk (European Prospective Investigation Into Cancer). Participants completed a short questionnaire at recruitment that asked about physical activity at work and as recreation. This questionnaire was validated against both energy expenditure, as assessed by 4 day heart rate monitoring, and cardio-respiratory fitness, assessed by sub-maximal oxygen uptake. Based on their responses to the questionnaire, subjects' physical activity was classed into one of four categories, namely: inactive, moderately inactive, moderately active, or active. Participants were followed up for the development of symptomatic gall stones. Each case was matched with four controls for age and sex. Results: 175 persons (67% women) developed symptomatic gall stones at a median age of 65.8 years. Increased physical activity was inversely associated with the development of symptomatic stones in a linear manner across the four categories of physical activity (OR across categories: 0.78, 95% CI = 0.66 to 0.92, p = 0.003). The odds ratio for an active vs inactive level of physical activity was 0.38 (95% CI = 0.21 to 0.71). The trends of the protective effect of physical activity were similar in both men and women when they were adjusted for possible confounding factors, including BMI, alcohol, parity, and HRT. Conclusions: Increased physical activity was associated with a decreased risk of gall stones. Encouraging the inactive and moderately inactive groups to participate in between half to one hour of recreational activity per day might potentially reduce the number of cholecystectomies in this...


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