# Replacing red and processed meat, poultry, or fish with legumes and the risk of gallbladder diseases in a large British cohort

## TL;DR

Replacing red and processed meat with legumes may lower the risk of gallbladder disease, but replacing poultry or fish with legumes does not show the same benefit.

## Contribution

This study is the first to show that substituting legumes for red and processed meat is linked to a reduced risk of gallbladder disease in a large British cohort.

## Key findings

- Replacing 80g/week of red and processed meat with legumes was associated with a 3% lower risk of gallbladder disease.
- No significant association was found when legumes replaced poultry or fish.
- Adjusting for BMI did not change the observed associations.

## Abstract

Legumes are promoted as climate-friendly and healthy protein sources. This study evaluated the association between replacing red and processed meat, poultry, or fish with equal amounts of legumes and the risk of gallbladder disease.

Participants from the UK Biobank Cohort who completed two or more 24 h dietary assessments and had complete information on covariates were included. Information on age, sex, and socioeconomic and lifestyle factors were collected at recruitment, while information on dietary intake was collected using multiple 24 h dietary assessments. Information on incident gallbladder disease (defined as cholelithiasis, cholecystectomy, or cholecystitis) was collected from health registries based on ICD10-diagnosis or operation codes. The rate of developing gallbladder diseases when replacing red and processed meat, poultry, or fish with legumes was estimated using multivariable-adjusted Cox Proportional Hazards regression analyses adjusted for potential confounders.

Over a median follow-up time of 10.5 (interquartile range: 10.4–10.9) years, 121,593 eligible participants provided 1,246,913 person-years of follow-up during which 3772 individuals developed gallbladder disease. Replacing 80 g/week of red and processed meat with legumes was associated with a lower rate of gallbladder disease (HR: 0.97, 95% CI 0.95; 0.98, p < 0.001). No association was found when replacing poultry or fish with legumes. Adjusting for BMI did not change the magnitude or direction of associations.

Replacing red and processed meat with legumes was associated with lower rates of gallbladder disease. Further research in populations with higher legume intake is warranted to confirm these findings.

The online version contains supplementary material available at 10.1007/s00394-025-03828-1.