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DIET: Cholesterol gallstones (shown here) are common in populations consuming a diet rich in calories, cholesterol, saturated fatty acids, refined carbohydrates, proteins, salts, and low in fiber.

LIPID ABNORMALITIES: Hypertriglyceridemia is associated with increased prevalence of gallstones. HDL cholesterol has a protective effect. High plasma total cholesterol and LDL cholesterol are not considered to be risk factors for the formation of gallstones.

OBESITY/METABOLIC SYNDROME: A group of conditions known as metabolic syndrome, including obesity, dyslipidemia (especially hypertriglyceridemia), type 2 diabetes and insulin resistance, and hyperinsulinemia are considered to be risk factors for gallstones.

DRUGS: Agents including prednisolone, cyclosporine, azathioprine, octreotide, clofibrate, nicotinic acid and third-generation cephalosporin ceftriazone increase the risk of forming cholesterol stones. Alcohol intake, ascorbic acid, and coffee appear to have a protective effect.

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