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Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study.
Int J Obes (Lond). 2014 Feb; 38(2):279-84.IJ

Abstract

BACKGROUND

Concern exists regarding gallstones as an adverse event of very-low-calorie diets (VLCDs; <800 kcal per day).

OBJECTIVE

To assess the risk of symptomatic gallstones requiring hospital care and/or cholecystectomy in a commercial weight loss program using VLCD or low-calorie diet (LCD).

DESIGN

A 1-year matched cohort study of consecutively enrolled adults in a commercial weight loss program conducted at 28 Swedish centers between 2006 and 2009. A 3-month weight loss phase of VLCD (500 kcal per day) or LCD (1200-1500 kcal per day) was followed by a 9-month weight maintenance phase. Matching (1:1) was performed by age, sex, body mass index, waist circumference and gallstone history (n=3320:3320). Gallstone and cholecystectomy data were retrieved from the Swedish National Patient Register.

RESULTS

One-year weight loss was greater in the VLCD than in the LCD group (-11.1 versus -8.1 kg; adjusted difference, -2.8 kg, 95% CI -3.1 to -2.4; P<0.001). During 6361 person-years, 48 and 14 gallstones requiring hospital care occurred in the VLCD and LCD groups, respectively, (152 versus 44/10 000 person-years; hazard ratio, 3.4, 95% CI 1.8-6.3; P<0.001; number-needed-to-harm, 92, 95% CI 63-168; P<0.001). Of the 62 gallstone events, 38 (61%) resulted in cholecystectomy (29 versus 9; hazard ratio, 3.2, 95% CI 1.5-6.8; P=0.003; number-needed-to-harm, 151, 95% CI 94-377; P<0.001). Adjusting for 3-month weight loss attenuated the hazard ratios, but the risk remained higher with VLCD than LCD for gallstones (2.5, 95% CI 1.3-5.1; P=0.009) and became borderline for cholecystectomy (2.2, 95% CI 0.9-5.2; P=0.08).

CONCLUSION

The risk of symptomatic gallstones requiring hospitalization or cholecystectomy, albeit low, was 3-fold greater with VLCD than LCD during the 1-year commercial weight loss program.

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Authors+Show Affiliations

Johansson K
Clinical Epidemiology Unit, Department of Medicine (Solna) Karolinska Institutet, Stockholm, Sweden.
Sundström J
Uppsala University, Department of Medical Sciences, Uppsala, Sweden.
Marcus C
Karolinska Institutet, Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm, Sweden.
Hemmingsson E
Karolinska Institutet, Obesity Center, Department of Medicine, Stockholm, Sweden.
Neovius M
Clinical Epidemiology Unit, Department of Medicine (Solna) Karolinska Institutet, Stockholm, Sweden.

MeSH

AdultCaloric RestrictionCase-Control StudiesCholecystectomyCohort StudiesEnergy IntakeFemaleFollow-Up StudiesGallstonesHumansMaleMiddle AgedObesityRisk AssessmentRisk FactorsSwedenTime FactorsTreatment OutcomeWeight LossWeight Reduction Programs

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23736359

Citation

Johansson, K, et al. "Risk of Symptomatic Gallstones and Cholecystectomy After a Very-low-calorie Diet or Low-calorie Diet in a Commercial Weight Loss Program: 1-year Matched Cohort Study." International Journal of Obesity (2005), vol. 38, no. 2, 2014, pp. 279-84.
Johansson K, Sundström J, Marcus C, et al. Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study. Int J Obes (Lond). 2014;38(2):279-84.
Johansson, K., Sundström, J., Marcus, C., Hemmingsson, E., & Neovius, M. (2014). Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study. International Journal of Obesity (2005), 38(2), 279-84. https://doi.org/10.1038/ijo.2013.83
Johansson K, et al. Risk of Symptomatic Gallstones and Cholecystectomy After a Very-low-calorie Diet or Low-calorie Diet in a Commercial Weight Loss Program: 1-year Matched Cohort Study. Int J Obes (Lond). 2014;38(2):279-84. PubMed PMID: 23736359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of symptomatic gallstones and cholecystectomy after a very-low-calorie diet or low-calorie diet in a commercial weight loss program: 1-year matched cohort study. AU - Johansson,K, AU - Sundström,J, AU - Marcus,C, AU - Hemmingsson,E, AU - Neovius,M, Y1 - 2013/05/22/ PY - 2012/10/09/received PY - 2013/03/05/revised PY - 2013/03/23/accepted PY - 2013/6/6/entrez PY - 2013/6/6/pubmed PY - 2014/11/5/medline SP - 279 EP - 84 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 38 IS - 2 N2 - BACKGROUND: Concern exists regarding gallstones as an adverse event of very-low-calorie diets (VLCDs; <800 kcal per day). OBJECTIVE: To assess the risk of symptomatic gallstones requiring hospital care and/or cholecystectomy in a commercial weight loss program using VLCD or low-calorie diet (LCD). DESIGN: A 1-year matched cohort study of consecutively enrolled adults in a commercial weight loss program conducted at 28 Swedish centers between 2006 and 2009. A 3-month weight loss phase of VLCD (500 kcal per day) or LCD (1200-1500 kcal per day) was followed by a 9-month weight maintenance phase. Matching (1:1) was performed by age, sex, body mass index, waist circumference and gallstone history (n=3320:3320). Gallstone and cholecystectomy data were retrieved from the Swedish National Patient Register. RESULTS: One-year weight loss was greater in the VLCD than in the LCD group (-11.1 versus -8.1 kg; adjusted difference, -2.8 kg, 95% CI -3.1 to -2.4; P<0.001). During 6361 person-years, 48 and 14 gallstones requiring hospital care occurred in the VLCD and LCD groups, respectively, (152 versus 44/10 000 person-years; hazard ratio, 3.4, 95% CI 1.8-6.3; P<0.001; number-needed-to-harm, 92, 95% CI 63-168; P<0.001). Of the 62 gallstone events, 38 (61%) resulted in cholecystectomy (29 versus 9; hazard ratio, 3.2, 95% CI 1.5-6.8; P=0.003; number-needed-to-harm, 151, 95% CI 94-377; P<0.001). Adjusting for 3-month weight loss attenuated the hazard ratios, but the risk remained higher with VLCD than LCD for gallstones (2.5, 95% CI 1.3-5.1; P=0.009) and became borderline for cholecystectomy (2.2, 95% CI 0.9-5.2; P=0.08). CONCLUSION: The risk of symptomatic gallstones requiring hospitalization or cholecystectomy, albeit low, was 3-fold greater with VLCD than LCD during the 1-year commercial weight loss program. SN - 1476-5497 UR - https://www.unboundmedicine.com/medline/citation/23736359/full_citation L2 - https://doi.org/10.1038/ijo.2013.83 DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓37 ↑27]

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