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Cited by 89Gallbladder and Bile Duct DisordersBariatric Surgery and OutcomesDiet and metabolism studies

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index; 2 of the 20 sources its claims cite were checked for support.

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

Open access
Johansson, K, Sundström, J, Marcus, C, Hemmingsson, E, Neovius, M·2014·International Journal of Obesity
DOI 10.1038/ijo.2013.83PMC PMC3921672
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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.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In a 1-year matched cohort in a Swedish commercial weight-loss program, VLCD (500 kcal/day) produced greater weight loss than LCD (1200–1500 kcal/day) but about a 3-fold higher risk of symptomatic gallstones requiring hospital care and/or cholecystectomy. The absolute risk remained low, and adjustment for 3-month weight loss attenuated but did not eliminate the excess gallstone risk.

Key findings

  • One-year weight loss was greater with VLCD than LCD: −11.1 vs −8.1 kg; adjusted difference −2.8 kg (95% CI −3.1 to −2.4; P<0.001).
  • During 6361 person–years, 48 vs 14 gallstones requiring hospital care occurred in VLCD vs LCD (152 vs 44 per 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).
  • Of 62 gallstone events, 38 (61%) resulted in cholecystectomy (29 vs 9; hazard ratio 3.2, 95% CI 1.5–6.8; P=0.003; number-needed-to-harm 151, 95% CI 94–377).
  • Adjusting for 3-month weight loss attenuated the risks: gallstones hazard ratio 2.5 (95% CI 1.3–5.1; P=0.009 in abstract) and cholecystectomy hazard ratio 2.2 (95% CI 0.9–5.2; P=0.08).

Methods

  • One-year matched cohort of consecutively enrolled adults in a commercial weight-loss program at 28 Swedish centers, 2006–2009; VLCD 500 kcal/day for 6–10 weeks vs LCD 1200–1500 kcal/day for up to 3 months, followed by the same 9-month maintenance phase.
  • Matching was 1:1 by age, sex, BMI, waist circumference, and gallstone history, yielding 3320 participants per group; outcomes were retrieved from the Swedish National Patient Register.
  • Main analysis used conditional Cox regression over 1-year follow-up, intention-to-treat; sensitivity analysis excluded participants with gallstones requiring hospital care in the prior 5 years, and exploratory multivariable Cox regression examined predictors.

Limitations

  • The paper states the main limitation was the nonrandomized design; matching and multivariable adjustment handled some baseline differences, but residual confounding may exist.
  • Participants selected and paid for treatment themselves, possibly limiting generalizability to the wider overweight and obese population.
  • The National Patient Register captures inpatient and nonprimary outpatient gallstones, not primary-care visits or undetected asymptomatic gallstones, so results may not generalize to mild or asymptomatic gallstones.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/ijo.2013.83

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

2 of 20 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    In a previous study of VLCD as a treatment for sleep apnea, all 3 gallstones were reported during the maintenance phase.

    “This was also the case in a previous study of VLCD as a treatment for sleep apnea (3/3 gallstones reported during the maintenance phase).28, 29”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [28] Johansson K, Hemmingsson E, Harlid R, Trolle Lagerros Y, Granath F, Rossner S et al. Longer term effects of very low energy diet on obstructive sleep apnoea in cohort derived from randomised controlled trial: prospective observational follow-up study. BMJ 2011; 342: d3017. source
    • cites [29] Johansson K, Neovius M, Lagerros YT, Harlid R, Rossner S, Granath F et al. Effect of a very low energy diet on moderate and severe obstructive sleep apnoea in obese men: a randomised controlled trial. BMJ 2009; 339: b4609. source

      Methods > Intervention identifies this as a VLCD study of sleep apnoea and says patients were offered a one-year weight-maintenance programme. Results > Safety reports adverse events through week 9 but does not report three gallstones or their timing during maintenance; Methods > Safety mentions gallstones only as a possible VLCD adverse event. No page numbers are available in our copy. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Findingown data

    The conditional hazard ratio for cholecystectomy was 3.2 (95% CI 1.5-6.8; P=0.003) comparing VLCD with LCD.

    “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).”
    • Also stated in: § Risk of cholecystectomy · plain
      “Including only participants who did not undergo a cholecystectomy preceding program start (n=3159 in the VLCD group and 3159 in the LCD group), 38 cases of cholecystectomy were performed during 6067 person–years of follow-up, of which 29 were in the VLCD group and 9 in the LCD group (96 versus 30 per 10 000 person–years; conditional hazard ratio, 3.2, 95% CI 1.5–6.8; P=0.003; number-needed-to-harm”
    Quote in the paperSubstantial claim
  • Findingown data

    In multivariable analysis, the risk of developing gallstones requiring hospital care was higher in those with a higher baseline BMI.

    “In multivariable analysis, the risk of developing gallstones requiring hospital care was higher in women than in men, in younger than in older participants, in those with a higher baseline BMI, among those who lost the most weight and in those with a history of gallstones (irrespective of cholecystectomy status; Supplementary Table 2).”
    Quote in the paperNot a substantial claim
  • Findingown data

    In multivariable analysis, the risk of developing gallstones requiring hospital care was higher in younger than in older participants.

    “In multivariable analysis, the risk of developing gallstones requiring hospital care was higher in women than in men, in younger than in older participants, in those with a higher baseline BMI, among those who lost the most weight and in those with a history of gallstones (irrespective of cholecystectomy status; Supplementary Table 2).”
    Quote in the paperNot a substantial claim
  • Findingown data

    The risk difference for gallstones requiring hospital care was 108 per 10 000 person-years (95% CI 59-157; P<0.001).

    “The risk difference was 108 per 10 000 person–years (95% CI 59–157; P<0.001), resulting in a number-needed-to-harm of 92 (95% CI 63–168; P<0.001).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. 21
  • It may state two separate claims as one. 19

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    After matching, 3320 participants remained in each group.

    “After matching LCD participants (n=4588) with replacement to VLCD participants (n=3773) 1:1 by age, sex, BMI, waist circumference, and previous gallstones, 3320 participants remained in each group (Figure 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    There were fewer users in the VLCD than in the LCD group of antihypertensives (16.7% versus 19.4%; mean difference, −2.7%, 95% CI −0.8 to −4.5%; P=0.005).

    “and antihypertensives (16.7% versus 19.4% mean difference, −2.7%, 95% CI −0.8 to −4.5% P=0.005; Table 1).”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Findingown data

    Adjusting the main analysis for weight loss during the first 3 months attenuated the hazard ratio, but the hazard ratio for gallstones requiring hospital care remained higher with VLCD than LCD (2.5, 95% CI 1.3-5.1; P<0.001).

    “Adjusting the main analysis for weight loss during the first 3 months attenuated the hazard ratio, but the hazard ratio remained higher with VLCD than LCD (2.5, 95% CI 1.3–5.1; P<0.001).”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Findingown data

    Eighty-two percent of the VLCD group and 78% of the LCD group completed the 1-year program (odds ratio, 1.3, 95% CI 1.2-1.5; P<0.001).

    “Eighty-two percent of the VLCD group and 78% in the LCD group completed the 1-year program (odds ratio, 1.3, 95% CI 1.2–1.5; P<0.001).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Findingown data

    There were fewer users in the VLCD than in the LCD group of antidiabetes drugs (1.8 versus 3.3%; mean difference, −1.4%, 95% CI −0.7 to −2.2%; P<0.001).

    “There were fewer users in the VLCD than in the LCD group of antidiabetes drugs (1.8 versus 3.3% mean difference, −1.4%, 95% CI −0.7 to −2.2% P<0.001)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Findingown data

    At baseline, 0.9% (58/6640) had a history of gallstones requiring hospital care, of which 74% (43/58) had been cholecystectomized.

    “At baseline, 0.9% (n=58/6640) had a history of gallstones requiring hospital care, of which 74% (n=43/58) had been cholecystectomized (Table 1).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    Increased risk of gallstone formation during and after VLCD-induced rapid weight loss is incorporated in clinical recommendations as an adverse event, advising physicians to inform patients about this risk, but the risk magnitude has been unclear.

    “Increased risk of gallstone formation during and after VLCD-induced rapid weight loss is incorporated in clinical recommendations as an adverse event, advising physicians to inform patients about this risk, but the risk magnitude has been unclear.7, 16, 20”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] National Task Force on the Prevention and Treatment of Obesity NIoH. Very low-calorie diets. JAMA 1993; 270: 967–974. source
    • cites [16] SCOOP-VLCD. SCOOP-VLCD Task 7.3. Scientific Co-operation on Questions Relating to Food: Directorate-General Health and Consumer Protection, European Union. In 2002.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [20] Everhart JE . Contributions of obesity and weight loss to gallstone disease. Ann Intern Med 1993; 119: 1029–1035. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    Multivariable adjustment was used for handling remaining baseline imbalances.

    “Multivariable adjustment was used for handling remaining baseline imbalances.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Interpretationown data

    After adjusting for weight loss during the first 3 months, the risk was attenuated but remained higher with VLCD than LCD, suggesting a direct effect of VLCD on gallstone disease.

    “After adjusting for weight loss during the first 3 months, the risk was attenuated but remained higher with VLCD than LCD, suggesting a direct effect of VLCD on gallstone disease.”
    • Also stated in: § Conclusion · hedged
      “After adjusting for weight loss during the first 3 months, the risk was attenuated but remained higher with VLCD than LCD, suggesting a direct effect of VLCD on gallstone disease.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Using VLCD in commercial weight loss programs is a particular concern given the risk of adverse events as well as weight regain.

    “using VLCD in commercial weight loss programs is a particular concern given the risk of adverse events as well as weight regain.7, 8, 9”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] National Task Force on the Prevention and Treatment of Obesity NIoH. Very low-calorie diets. JAMA 1993; 270: 967–974. source
    • cites [8] Saris WH . Very-low-calorie diets and sustained weight loss. Obes Res 2001; 9 (Suppl 4): 295S–301S. source

      Checked before — its earlier verdict is held back until a new check runs.

    • cites [9] Tsai AG, Wadden TA . The evolution of very-low-calorie diets: an update and meta-analysis. Obesity (Silver Spring) 2006; 14: 1283–1293. source

  • Probably not a substantial claim.

    Study design and conductown data

    Matching was performed 1:1 by age, sex, body mass index, waist circumference and gallstone history.

    “Matching (1:1) was performed by age, sex, body mass index, waist circumference and gallstone history (n=3320:3320).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Study design and conductown data

    Mortality was not analyzed due to few cases, with one death due to unknown cause occurring in the VLCD group after the weight loss phase.

    “Mortality was not analyzed due to few cases (one death due to unknown cause occurred in the VLCD group after the weight loss phase).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim.

    Premisecitation

    Rapid weight loss, either by VLCD or bariatric surgery, is a known risk factor for gallstone formation.

    “Rapid weight loss, either by VLCD or bariatric surgery, is a known risk factor for gallstone formation.20”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Everhart JE . Contributions of obesity and weight loss to gallstone disease. Ann Intern Med 1993; 119: 1029–1035. source

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    A sensitivity analysis was conducted restricting the study population to participants without gallstones requiring hospital care during the 5 years preceding program start.

    “A sensitivity analysis was conducted restricting the study population to participants without gallstones requiring hospital care during the 5 years preceding program start.”
    Quote in the paperNot a substantial claim

  • It may state two separate claims as one.

    Study design and conductnone given

    The outcomes were prospectively reported and data were collected routinely on a nationwide level in the universally accessible Swedish health-care system, with virtually complete follow-up.

    “Further, the outcomes were prospectively reported and data were collected routinely on a nationwide level in the universally accessible Swedish health-care system, with virtually complete follow-up.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Premisecitation

    Previous studies of VLCD-induced rapid weight loss have generally been small, of short duration, lacked control groups and used formulations with lower amounts of fat compared with formulations used today.

    “Previous studies of VLCD-induced rapid weight loss have generally been small, of short duration, lacked control groups and used formulations with lower amounts of fat compared with the formulations used today.10, 11, 12, 13, 14”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [10] Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ et al. Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 1988; 319: 1567–1572. source
    • cites [11] Kamrath RO, Plummer LJ, Sadur CN, Adler MA, Strader WJ, Young RL et al. Cholelithiasis in patients treated with a very-low-calorie diet. Am J Clin Nutr 1992; 56 (1 Suppl): 255S–257S. source
    • cites [12] Liddle RA, Goldstein RB, Saxton J . Gallstone formation during weight-reduction dieting. Arch Intern Med 1989; 149: 1750–1753. source

  • It may state two separate claims as one.

    Interpretationown data

    The absolute risk of gallstones and cholecystectomy was low but approximately three times higher in the VLCD than in the LCD group during the 1-year commercial weight loss program.

    “In our analysis of symptomatic gallstones requiring hospital care or cholecystectomy in participants using either VLCD or LCD for the first 3 months of a 1-year commercial weight loss program, we found the absolute risk of gallstones as well as cholecystectomy to be low but approximately three times higher in the VLCD than in the LCD group.”
    • Also stated in: § Conclusion · plain
      “The absolute risk of gallstones as well as cholecystectomy was found to be low but approximately three times higher in the VLCD than in the LCD group during the 1-year commercial weight loss program.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Study design and conductnone given

    The National Patient Register contains data on inpatient and nonprimary outpatient visits for gallstones, not visits in primary care or undetected asymptomatic gallstones.

    “Finally, the National Patient Register contains data on inpatient and nonprimary outpatient visits for gallstones, not visits in primary care, or undetected asymptomatic gallstones.”
    Quote in the paperSubstantial claim

  • It may state two separate claims as one.

    Interpretationreasoning

    Increased risk for gallstone formation during VLCDs could be explained by inadequate fat content of the diet and/or the rapid weight loss associated with VLCDs.

    “Increased risk for gallstone formation during VLCDs could be explained by inadequate fat content of the diet and/or the rapid weight loss associated with VLCDs.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation

    A fat intake of 7-10 g per day has been reported as a threshold for maintaining an efficient gallbladder emptying.

    “However, as described previously, a fat intake of 7–10 g per day has been reported as a threshold for maintaining an efficient gallbladder emptying.16, 26”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [16] SCOOP-VLCD. SCOOP-VLCD Task 7.3. Scientific Co-operation on Questions Relating to Food: Directorate-General Health and Consumer Protection, European Union. In 2002.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [26] Festi D, Colecchia A, Larocca A, Villanova N, Mazzella G, Petroni ML et al. Review: low caloric intake and gall-bladder motor function. Aliment Pharmacol Ther 2000; 14 (Suppl 2): 51–53. source

  • It may state two separate claims as one.

    Study design and conductown data

    The two treatment groups were balanced regarding circulatory disease, malignancy history and the use of lipid-lowering drugs and antidepressants.

    “The two treatment groups were balanced regarding circulatory disease, malignancy history and the use of lipid-lowering drugs and antidepressants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Study design and conductnone given

    The strengths of the study include the large sample of weight loss participants in a real-life setting, with a direct VLCD and LCD comparison.

    “The strengths of the current study include the large sample of weight loss participants in a real-life setting, with a direct VLCD and LCD comparison.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.

    Premisenone given

    To the best of the authors' knowledge, this is the largest controlled study of VLCD and of the risk of severe gallstone problems and the first large-scale safety analysis of a commercial program.

    “To the best of our knowledge, this is the largest controlled study of VLCD and of the risk of severe gallstone problems and the first large-scale safety analysis of a commercial program.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. It may state two separate claims as one.

    Premisecitation

    The majority of gallstones found in previous VLCD studies were asymptomatic, and few led to symptoms.

    “However, the majority of the gallstones found in these studies were asymptomatic, and few led to symptoms.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    The two most commonly suggested mechanisms for gallstone formation are supersaturation of bile with cholesterol, leading to cholesterol crystallization and stone formation, and insufficient gallbladder emptying due to impaired motility.

    “The two most commonly suggested mechanisms for gallstone formation are supersaturation of bile with cholesterol, leading to cholesterol crystallization and stone formation, and the insufficient gallbladder emptying due to impaired motility.25”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [25] Maddrey WC, Schiff ER, Sorrell MF . Ovid. Schiff's diseases of the liver. In: Chapter 22 Gallstone Disease: Pathogenesis and Treatment 10th ed. Lippincott Williams & Wilkins: Philadelphia, 2007. pp p.640–663.

  • Probably not a substantial claim. It may state two separate claims as one.

    Study design and conductnone given

    Analyses included all matched patients and were analyzed by intention to treat.

    “Analyses included all matched patients and were analyzed by intention to treat.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductreasoning

    Residual confounding may exist.

    “However, residual confounding may exist.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation

    Rapid weight loss induced by VLCDs is believed to affect both mechanisms: supersaturation is believed to be caused by decreased bile salt levels and increased cholesterol levels, and impaired motility due to reduced gallbladder stimulation because of the low-fat content.

    “Rapid weight loss induced by VLCDs is believed to affect both the mechanisms: Supersaturation is believed to be caused by decreased bile salt levels and increased cholesterol levels, and impaired motility due to reduced gallbladder stimulation because of the low-fat content.26, 27”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [26] Festi D, Colecchia A, Larocca A, Villanova N, Mazzella G, Petroni ML et al. Review: low caloric intake and gall-bladder motor function. Aliment Pharmacol Ther 2000; 14 (Suppl 2): 51–53. source
    • cites [27] Erlinger S . Gallstones in obesity and weight loss. Eur J Gastroenterol Hepatol 2000; 12: 1347–1352. source

  • Probably not a substantial claim.

    Premisenone given

    A commonly described adverse event after rapid weight loss, including very-low-calorie diets, is gallstones.

    “A commonly described adverse event after rapid weight loss (including VLCD) is gallstones.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductnone given

    The main limitation of the study was the nonrandomized design.

    “The main limitation was the nonrandomized design.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Study design and conductown data

    The results appeared to be robust in the sensitivity analyses.

    “The results appeared to be robust in our sensitivity analyses.”
    Quote in the paperNot a substantial claim
31 of 31

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting P-values for the weight-loss-adjusted gallstone result

    Minor

    The abstract reports P=0.009 for the adjusted gallstone hazard ratio, while the Results section reports P<0.001 for the same hazard ratio and confidence interval.

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Metadata

Authors
Johansson, K., Sundström, J., Marcus, C., Hemmingsson, E., & Neovius, M.
Affiliations
  • Karolinska Institutet (SE)
  • Uppsala University (SE)
Corresponding author
Johansson, K
ORCID
Venue
International Journal of Obesity
Publisher
Springer Science and Business Media LLC
Published
2013-05-22
Volume
38
Issue
2
Pages
279-284
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
DOI
10.1038/ijo.2013.83
PMC
PMC3921672
OpenAlex
W2031993190
Semantic Scholar
cb8deb94cdf2444d23a691703f7648c08ca68705
Cited by
89
References
29
Citations by year
2026: 6 · 2025: 15 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 8 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 4 · 2014: 5 · 2013: 1
FWCI
4.07
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Obesity (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gallbladder and Bile Duct Disorders
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
Keywords
very low calorie diet, hypocaloric diet, symptomatic gallstones, cholecystectomy, weight loss, commercial weight loss programs, adverse events, weight maintenance, bariatric surgery, gallstone risk, matched cohort, number needed to harm, obesity treatment
MeSH terms
Adult, Energy Intake, Cholecystectomy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Risk Factors, Sweden, Time Factors, Cohort Studies, Weight Loss, Case-Control Studies, Treatment Outcome, Risk Assessment, Caloric Restriction, Gallstones, Weight Reduction Programs

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