Rural–Urban Differences in Dietary and Lifestyle Factors Contributing to Gallbladder Stones.

Abstract

Gallbladder stones (cholelithiasis) are a common gastrointestinal disorder arising from an imbalance in biliary constituents, primarily cholesterol, bile salts, and bilirubin. The development of gallstones is influenced by modifiable factors such as diet, obesity, and physical activity, as well as non-modifiable factors including age, gender, and genetics. This cross-sectional study investigates how dietary and lifestyle differences between rural and urban populations contribute to gallstone risk.Methods- We recruited 200 adults, 100 from rural areas and 100 from urban settings. Participants completed structured questionnaires capturing dietary patterns, physical activity, hydration, meal regularity, alcohol and tobacco use, and demographic information. Anthropometric measurements were recorded to assess obesity (BMI > 25). All participants underwent abdominal ultrasonography to detect gallstones. Data were analyzed to compare prevalence and associated risk factors between rural and urban groups.Result- Urban residents exhibited a significantly higher prevalence of gallstones than rural residents. The urban group also showed riskier dietary and lifestyle profiles, including higher intake of fatty and fried foods (urban 72% vs rural 28%), greater consumption of fast foods (urban 65% vs rural 18%), irregular meal patterns (urban 54% vs rural 26%), and a more sedentary lifestyle with substantial job-related inactivity (urban sedentary work 76% vs rural 30%). Obesity (BMI > 25) was more prevalent in urban participants (49% vs 22%). Conversely, rural participants reported higher fiber intake (74% vs 36%) and greater regular physical activity (64% vs 22%), which are protective factors against gallstone formation. Hydration status and alcohol use differed by setting, with rural males showing slightly higher alcohol/smoking exposure. Gender-specific analyses indicated a female predominance in gallstone prevalence across both settings, with urban women disproportionately affected (approximately a 3:1 female-to-male ratio in urban areas).Discussion- Findings align with existing evidence that urbanization and modernization drive lifestyle changes increasing gallstone risk. High-fat, low-fiber diets, coupled with physical inactivity and rising obesity, appear to create a lithogenic milieu in urban populations. Rural areas retain protective attributes from traditional diets and active lifestyles but exhibit vulnerabilities related to hydration and irregular meals, especially under hot climates and demanding labor. The pronounced female predominance in urban gallstone prevalence underscores hormonal and metabolic interactions warranting gender-sensitive prevention strategies.Conclusion- The study demonstrates a clear urban–rural disparity in gallstone risk, driven by divergent dietary and activity patterns. Urban residents face heightened risk due to obesogenic diets and sedentary behavior, while rural populations maintain protective dietary and activity profiles but face context-specific challenges. Public health interventions should promote high-fiber, low-saturated-fat diets, regular meal timing, increased physical activity, and adequate hydration across both settings, with targeted, gender-sensitive messaging in urban areas..