An explanation for gallstones in normal-weight women: slow intestinal transit.

Many cases of gallstones can be explained in terms of the established risk factors, especially obesity. However, gallstones develop in some women who are not obese, and the causes are unknown. Biochemical studies have shown that slow intestinal transit is associated with lithogenic bile. We have tested the hypothesis that intestinal transit is abnormally slow in normal-weight women with gallstones. In a population survey, 1058 women aged 25-69 years, registered with general practitioners in Bristol, UK, underwent cholecystosonography. Gallstones were identified in 48 women, of whom 15 were of normal weight (body mass index < or = 25 kg/m2). These women and age-matched controls with healthy gallbladders then underwent measurement of whole-gut transit time (WGTT); the measurement was done directly when possible, or calculated from records of three defaecations. The mean WGTT was significantly longer in the women with gallstones than in the controls (82 vs 63 h; mean difference 19, 95% CI 2-37 h). Stool output was also lower in the women with gallstones (74 [SD 54] vs 141 [56] g per 24 h, p = 0.015). There was no significant difference between cases and controls in body mass index, waist-hip circumference ratio, parity, plasma triglyceride concentration, or alcohol intake. Normal-weight women with gallstones tend to have slow intestinal transit and this feature could explain why they have gallstones.

Dietary intake and sources of non-starch polysaccharide in English men and women.

Up-to-date information is unavailable on intakes of non-starch polysaccharide (NSP) in Britain. We surveyed 739 men aged 40-69 years and 976 women aged 25-69 years using a validated food-frequency questionnaire focused on carbohydrates. Mean NSP intake in the three decades of men was 15.5-16.4 g/day and in the five decades of women it was 14.3-15.3 g/day, with no clear effect of age. These NSP intakes are higher than those from a 1977 survey but well short of the recent government-recommended population mean of 18 g/day. However, nine people consumed over 32 g/day. The relative contribution of food groups to NSP intake varied with age and sex. Women obtained more NSP from raw fruit and salad, brown breads and breakfast cereals. Their preference for these foods probably explains why, overall, their NSP intakes were close to those of men. Younger people and men obtained relatively more of their NSP from potatoes cooked with fat and from pulses and less from raw fruit. The largest single source of soluble NSP was potatoes and half of this came from potatoes cooked with fat. In older women raw fruit and salad were equally important. Pulses provided about 10% of soluble NSP in younger women, cooked vegetables about 10% in older women. Increased potato consumption deserves attention as a means of obtaining the metabolic benefits of a high soluble NSP intake.