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Ladeira LLC, Nascimento GG, Leite FRM, Alves-Costa S, Thomaz EBAF, Alves CMC, Cury JA, Ribeiro CCC. Sugar intake above international recommendations and oral disease burden: A population-based study. Oral Dis 2024; 30:615-623. [PMID: 36504466 DOI: 10.1111/odi.14464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/19/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the association between added sugar intake above the daily limit for the risk of noncommunicable diseases (NCDs) and the Chronic Oral Disease Burden in adolescents. METHODS This was a population-based study using cross-sectional data nested to RPS Cohorts Consortium, São Luís, Brazil, from the 18-19-year-old follow-up (n = 2515). High consumption of added sugars was estimated according to the limits of the World Health Organization guidelines (WHO) (≥5% of total energy/day) and the American Heart Association statement (AHA) (≥25 g/day). The Chronic Oral Disease Burden was a latent variable (number of decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing). Models were adjusted for Socioeconomic Status, sex, obesity, and plaque index and analyzed through structural equation modeling. RESULTS Adolescents had high sugar consumption according to the WHO (78.6%) and AHA (81.4%) recommendations. High sugar intake, according to WHO (SC = 0.096; p = 0.007) and AHA (SC = 0.056; p = 0.027), was associated with a heavier Chronic Oral Disease Burden. Even half of the recommended dose was sufficient to affect some oral disease indicators. CONCLUSION Sugar intake over international statements to prevent NCDs is associated with higher Chronic Oral Disease Burden among adolescents.
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Affiliation(s)
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health ACP, Health Services and Systems Research Programme Duke-NUS Medical School, Singapore, Singapore
| | - Fabio Renato Manzolli Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health ACP, Health Services and Systems Research Programme Duke-NUS Medical School, Singapore, Singapore
| | - Silas Alves-Costa
- Postgraduate Program of Dentistry, Federal University of Maranhão, São Luís, Brazil
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Costa SA, Ribeiro CCC, de Oliveira KR, Alves CMC, Thomaz EBAF, Casarin RCV, Souza SDFC. Low bone mineral density is associated with severe periodontitis at the end of the second decade of life: A population-based study. J Clin Periodontol 2021; 48:1322-1332. [PMID: 34288024 DOI: 10.1111/jcpe.13525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the association between low bone mineral density (BMD) and severe periodontitis at the end of the second decade of life. MATERIALS AND METHODS This population-based study analysed 2032 youngers (18-19 years old) of the RPS cohort. BMD of lumbar spine (BMD-LS) and of the whole body (BMD-WB) were assessed by dual x-ray emission densitometry. Low BMD-LS (Z-score ≤ -2) and low BMD-WB (Z-score ≤ -1.5) were correlated with severe periodontitis. The extent of periodontal disease was also evaluated as the following outcomes: proportions of teeth affected by clinical attachment loss ≥5 mm and probing depth ≥5 mm. Multivariate models by sex, education, family income, risk of alcohol dependence, smoking, plaque, bleeding index, and body mass index were estimated through logistic regression (binary outcomes) and Poisson regression (continuous outcomes). RESULTS The prevalence of severe periodontitis was 10.97%. Low BMD-LS (odds ratio [OR] = 2.08, confidence interval [CI] = 1.12-3.85, p = .01) and low BMD-WB (OR = 1.34, CI = 1.001-1.81, p = .04) were associated with severe periodontitis in the final multivariate models. Low BMD-LS and BMD-WB were also associated with a greater extent of periodontitis (p < .05). CONCLUSIONS Low BMD was found to be associated with the severity and extent of periodontitis in adolescents. Adolescents at peak bone mass age presenting low BMD are more likely to be affected by severe periodontitis.
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Confortin SC, Ribeiro MRC, Barros AJD, Menezes AMB, Horta BL, Victora CG, Barros FC, Gonçalves H, Bettiol H, Santos ISD, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Silveira MFD, Domingues MR, Lima NP, Rocha PRH, Cavalli RC, Batista RFL, Cardoso VC, Simões VMF, Silva AAMD. RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. CAD SAUDE PUBLICA 2021; 37:e00093320. [PMID: 33950086 DOI: 10.1590/0102-311x00093320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/20/2020] [Indexed: 01/11/2023] Open
Abstract
This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.
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Moreira ARO, Batista RFL, Ladeira LLC, Thomaz EBAF, Alves CMC, Saraiva MC, Silva AAM, Brondani MA, Ribeiro CCC. Higher sugar intake is associated with periodontal disease in adolescents. Clin Oral Investig 2020; 25:983-991. [PMID: 32519237 DOI: 10.1007/s00784-020-03387-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/28/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Analyze the association between higher added sugar exposure and periodontal disease in adolescents (18-19 years old). MATERIALS AND METHODS This was a cross-sectional study nested to RPS Cohorts Consortium, São Luís, Brazil (n = 2515). The exposure was percentage of daily calories from added sugar (≥ 10%), estimated from a quantitative food frequency. The outcome was periodontal disease estimated by the number of teeth affected by bleeding on probing, periodontal probing depth ≥ 4 mm, and clinical attachment level ≥ 4 mm at the same site. A theoretical model was depicted in a directed acyclic graph to identify the minimal sufficient adjustment set: household income, adolescent's educational level, sex, alcohol use, and smoking. Periodontal disease was categorized into < 2 teeth affected, 2 to 3 teeth affected, and ≥ 4 teeth affected to estimate prevalence ratios (PR) by multinomial logistic regression. To test for consistency, means ratio (MR) were estimated using zero-inflated Poisson. RESULTS High sugar intake was associated with ≥ 4 teeth affected by periodontal disease (PR = 1.42; 95% confidence interval (CI) = 1.03-1.94; p = 0.030); consistency Poisson analysis reinforced these results (MR = 1.15; 95% CI = 1.03-1.29; p = 0.011). CONCLUSION High level of added sugar intake was associated with greater extent of periodontal disease in adolescents. CLINICAL RELEVANCE High sugar intake was associated with periodontal disease in adolescents, supporting the integrated hypothesis of dental caries and periodontal disease and giving impetus to future clinical investigation on the effect of restriction of added sugar consumption in periodontal parameters, which potentially may change traditional treatment protocols of periodontal disease.
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Affiliation(s)
- Ana R O Moreira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Rosangela F L Batista
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Lorena L C Ladeira
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
| | - Erika B A F Thomaz
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Claudia M C Alves
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Maria C Saraiva
- Department of Pediatric Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio A M Silva
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Mario A Brondani
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Cecilia C C Ribeiro
- Postgraduate Program of Dentistry, Federal University of Maranhão, Av. dos Portugueses 1966, Cidade Universitária Bacanga, São Luís, MA, 65080-805, Brazil.
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil.
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