Association between Sugar-sweetened beverage consumption and gallstones: A cross-sectional analysis from NHANES 2017–2023

Sugar-sweetened beverages (SSBs) are a major source of added sugars and may be related to gallstones, yet the quantitative relationship has not been well characterized. To evaluate the association between SSB consumption and gallstone prevalence, assess potential non-linear dose–response patterns, and exploratorily examine subgroup differences. We analyzed 9001 U.S. adults in National Health and Nutrition Examination Survey (NHANES) 2017–2023. SSB exposure was derived from two 24-h dietary recalls; gallstones were ascertained by self-report. Survey-weighted logistic regression estimated odds ratios (ORs) with progressive covariate adjustment. Non-linearity was tested using restricted cubic splines (RCS). Subgroup and sensitivity analyses were also performed. Every 100 kcal/day increment in SSBs was associated with 10% higher odds of gallstones (adjusted OR = 1.10; 95% CI: 1.05, 1.15). Compared with non-consumers, ≥300 kcal/day related to an 81% higher odds (OR = 1.81; 95% CI: 1.37, 2.40). RCS indicated a significant non-linear relationship ( P nonlinearity = 0.04). Subgroup and sensitivity analyses yielded directionally consistent results with the primary analysis. Higher SSB intake was positively and non-linearly associated with gallstone prevalence in this cross-sectional analysis. Longitudinal studies are warranted to confirm temporality and clarify underlying mechanisms. • Higher sugar-sweetened beverage intake was associated with gallstones. • Higher intake was associated with higher odds of gallstones after adjustment. • A non-linear association pattern was observed in spline analyses. • Results were consistent across multiple sensitivity analyses.