Simon J A et al Ascorbic acid supplement use and the prevalence of gallbladder disease. J CLIN EPIDEMIOL 1998;51:257-65.

La Vecchia et al (see Fall 1996 SMFW Bulletin,  Vol. 38, No. 2 and following below) demonstrated the prevalence of gallstones was less in Italians who drank more than 500 ml of wine daily. This study found a decreased prevalence of clinical gallbladder disease and  cholecystectomy among postmenopausal women who drank alcohol and consumed ascorbic acid supplements.

The Heart and Estrogen-progestin Replacement Study (HERS) is a secondary coronary heart disease prevention  trial. Baseline data from 2744 postmenopausal women aged 44-79 years were available for cross-sectional analysis. History of alcohol use (not divided into types), ascorbic acid supplement use (not dietary intake), gallbladder disease or cholecystectomy and a number of other potential confounding factors which are known to affect gallstone formation were entered into multivariate logistic regression models. "In bivariate  analyses, alcohol consumption was associated with a 30% decreased prevalence of clinical gallbladder disease and cholecystectomy (p< 0.001). In multivariate models stratified by ascorbic acid supplement use, alcohol consumption was associated with a reduction in the prevalence of clinical gallbladder disease (OR = 0.46; 95% CI, 0.26 - 0.83) and cholecystectomy (OR = 0.32; 95% CI, 0.17 - 0.63), but only among women who consumed ascorbic acid supplements." After adjustment for potential confounding factors, among drinkers (amount not specified) use of Vitamin C was associated with an adjusted OR = 0.50 (95% CI, 0.31 - 0.81) for the prevalence of clinical gallbladder disease and 0.38 (95% CI, 0.21 - 0.67) for cholecystectomy. Among non-drinkers, ascorbic acid supplement use was not associated with prevalence of gallbladder  disease or cholecystectomy.

The authors theorize: "alcohol and ascorbic acid may reduce biliary cholesterol saturation and, thus when combined together, be particularly effective in decreasing the prevalence of cholesterol gallstone formation."

La Vecchia C et alAlcohol drinking and prevalence of self-reported gallstonedisease in the 1983 Italian National Health Survey. EPIDEMIOL 1994;5:533-6.

The prevalence of gallstones is less in Italians who consume alcohol.

Interviews were conducted on 58,462 Italian adults (27,912 males and 30,550 females) and gallstone disease was self-reported by subjects recall. Questions on drinking included average daily consumption of wine, beer and spirits but all the information was pooled for analysis. Since the households were randomly selected "to  be representative of the general Italian population" one presumes the most common alcohol intake was wine with meals which would be typical of a Mediterranean culture. Compared with alcohol abstainers, the relative  risk of diagnosed (clinically relevant) gallstone disease was 0.83 (95% confidence interval 0.73-0.92) at wine intake equivalent to <250 ml/day, 0.67 (95% confidence interval, 0.59-0.77) for 250-500 ml/day and 0.58 (95% confidence interval 0.47-0.70) for >500 ml per day.

The authors conclude: "the present study confirms that alcohol consumption is inversely related to the risk of gallstones."

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