Gallstone disease (GSD) is a prevalent condition worldwide, characterized by the formation of solid deposits in the gallbladder or biliary tract due to bile composition imbalances. Key contributing factors include obesity, rapid weight loss, glucose intolerance and dietary habits. FODMAPs, short-chain fermentable carbohydrates, serve as prebiotics that promote the growth of beneficial gut microbiota. This study aimed to examine the association between dietary FODMAP intake and the risk of gallstone formation.
In this case–control study, 189 adults with ultrasonography-confirmed gallstones and 342 controls were enrolled. Dietary intake was assessed using a validated 168-item food frequency questionnaire, and FODMAP components were quantified accordingly. Logistic regression models were used to estimate odds ratios and 95% confidence intervals across tertiles of FODMAP intake.
Higher total FODMAP intake was associated with a substantially lower risk of gallstone disease. In crude analyses, individuals in the highest tertile of total FODMAP intake had 71% lower odds of gallstones (OR: 0.29; 95% CI: 0.18–0.46). After adjustment for age, sex, energy intake, BMI, physical activity, smoking and alcohol consumption, the inverse association remained strong (adjusted OR: 0.21; 95% CI: 0.12–0.36). Similar inverse associations were observed for fructan, galacto-oligosaccharides, lactose and polyols, whereas fructose showed no significant association with gallstone risk.
This study suggests an inverse association between higher dietary FODMAP intake and gallstone disease. Given the case-control design, these findings indicate a potential protective relationship but do not establish causality. Further prospective and interventional studies are needed to confirm these associations.
