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Alves-Costa S, Nascimento GG, Peres MA, Li H, Costa SA, Ribeiro CCC, Leite FRM. Sugar-sweetened beverage consumption and periodontitis among adults: A population-based cross-sectional study. J Clin Periodontol 2024; 51:712-721. [PMID: 38454156 DOI: 10.1111/jcpe.13961] [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: 05/22/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
AIM Investigating the association between sugar-sweetened beverages (SSBs) and periodontitis and whether the awareness of diabetes modifies this relationship. MATERIALS AND METHODS Cross-sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES III) data involving US adults aged 30-50. Periodontitis was classified according to the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC-AAP), and SSB consumption as dichotomous (<5 or ≥5, <7 or ≥7 and <14 or ≥14 times/week), ordinal and continuous variables. Confounders included family income poverty ratio, education, race/ethnicity, sex, age, food energy intake, smoking and alcohol. Odds ratios (ORs) were obtained by logistic regressions using inverse probability weighting. Effect modification analysis was performed considering self-reported diabetes. RESULTS Among 4473 cases analysed, 198 self-reported diabetes. SSBs were associated with periodontitis when individuals consumed ≥5 (OR 1.64; 95% confidence interval [CI] = 1.30-2.06), ≥7 (OR 1.92; 95% CI = 1.50-2.46) and ≥14 (OR 2.19; 95% CI = 1.50-3.18) times/week. The combined effect of consuming SSBs (≥5 and ≥14 times/week) and self-reported diabetes had less impact than the cumulative effect. CONCLUSIONS SSB consumption was associated with higher odds of periodontitis, and the estimates were reduced among those with awareness of diabetes.
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Affiliation(s)
- Silas Alves-Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Huihua Li
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Susilena Arouche Costa
- Graduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Fábio Renato Manzolli Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Alves-Costa S, Leite FRM, Ladeira LLC, Lima-Soares F, de Andrade Paes AM, de Souza BF, Nascimento GG, Ribeiro CCC. Behavioral and metabolic risk factors associated with periodontitis in Brazil, 1990-2019: a multidimensional analysis for the Global Burden of Disease Study 2019. Clin Oral Investig 2023; 27:7909-7917. [PMID: 38008803 PMCID: PMC10713794 DOI: 10.1007/s00784-023-05384-6] [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: 05/23/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES Periodontitis is a non-communicable disease (NCD) that may be linked to other NCDs through shared risk factors. Accordingly, we analyzed the relationship between periodontitis and behavioral and metabolic risks common to NCDs in Brazilian adults over three decades. METHODS Indicators of periodontitis, behavioral risks (smoking, alcohol use, sugar-sweetened beverages (SSB), and physical activity), and metabolic risks (overweight/obesity, dyslipidemia, hyperglycemia, and hypertension) in Brazilian adults (25-49 y-old) between 1990 to 2019 were obtained from the Global Burden of Disease Study 2019. Data were adjusted for Gini index. Fixed-effects and Prais-Winsten regressions were performed (p < 0.05). RESULTS The prevalence of periodontitis has increased among Brazilians since 2005. High-SSB diet, alcohol use, and metabolic risks increased between 1990-2019, whereas smoking decreased. In crude models, periodontitis prevalence increased with alcohol use (2545.1; 95%CI: 2307.9-2782.3), high-SSB diet (365.5; 95%CI: 322.5-408.4), low physical activity (1784.4; 95%CI: 763.7-2805.0), overweight/obesity (172.3; 95%CI: 156.3-188.4), dyslipidemia (734.5; 95%CI: 624.7-844.2), and hyperglycemia (1774.3; 95%CI: 1555.9-1992.7). After adjustment for the Gini index, periodontitis prevalence raised with a high-SBB diet (1416.0; 95%CI: 1120.2-1711.8), overweight/obesity (629.9; 95%CI: 573.1-686.8), dyslipidemia (2035.8; 95%CI: 1728.1-2343.5), and hyperglycemia (8918.1; 95%CI: 7979.8-9856.3). CONCLUSIONS Periodontitis has increased in Brazil since 2005, despite the smoking reduction. Sugar-sweetened beverage was the behavioral risk that mostly accompanied the periodontal trend. CLINICAL RELEVANCE Our results support upstream strategies targeting commercial, social, political, and structural determinants to tackle NCDs and reduce oral health inequities.
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Affiliation(s)
- Silas Alves-Costa
- Postgraduate Program of Dentistry, Federal University of Maranhão, São Luís, MA, Brazil
| | - Fábio Renato Manzolli Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Oral Health ACP, Singapore, Singapore
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | | | - Fernanda Lima-Soares
- Postgraduate Program of Health Sciences, Federal University of Maranhão, São Luís, MA, Brazil
| | | | - Bruno Feres de Souza
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
| | - Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Oral Health ACP, Singapore, Singapore.
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
- National Dental Research Institute Singapore, National Dental Centre Singapore, 5 Second Hospital Avenue, 168938, Singapore, Singapore.
| | - Cecilia Claudia Costa Ribeiro
- Postgraduate Program of Dentistry, Federal University of Maranhão, São Luís, MA, Brazil
- Postgraduate Program of Public Health, Federal University of Maranhão, São Luís, MA, Brazil
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Motoc GV, Juncar RI, Moca AE, Motoc O, Moca RT, Țig IA, Vaida LL, Juncar M. The Relationship between Dietary Habits and Periodontal Pathogens in a Sample of Romanian Children and Adolescents: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1779. [PMID: 38002870 PMCID: PMC10670252 DOI: 10.3390/children10111779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
The role of diet in shaping oral microbiota and its potential contribution to the development of periodontal pathogens cannot be understated. This study aimed to explore the correlation between dietary habits and the prevalence of 11 periodontal pathogens among children and adolescents in Oradea, Romania. The identification of these pathogens was performed using the micro-IDent test kit, capable of detecting 11 specific periodontal pathogens. Bacterial sampling was conducted from the crevicular fluid in the morning, prior to brushing, followed by the completion of a brief questionnaire by parents. The questionnaire captured various aspects of the children's eating habits, including meal frequency, consumption of sweets, and hydration levels. The collected samples were dispatched to the laboratory for analysis, which provided insights into the abundance of microorganisms. The study encompassed 60 participants aged between 2 and 18 years, with the majority reported by their parents to have regulated meal timings, frequent sugar intake, and adequate hydration. The findings revealed significant associations between certain dietary factors and the presence of specific periodontal pathogens. Notably, the absence of breastfeeding was linked with the detection of Tannerella forsythia and Campylobacter rectus. Furthermore, frequent consumption of sweets corresponded with the presence of Capnocytophaga spp., which was particularly observed in individuals consuming sweets 2-3 times a day. Insufficient age-appropriate hydration showed an association with the prevalence of T. forsythia, Peptostreptococcus micros, and Capnocytophaga spp. In this sample, it became evident that eating habits and diet influenced the presence of several periodontal pathogens. The lack of breastfeeding was predominantly associated with positive results for T. forsythia and C. rectus, while inadequate hydration correlated more frequently with the presence of T. forsythia and P. micros. Moreover, frequent consumption of sweets was linked to the presence of Capnocytophaga spp.
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Affiliation(s)
- Georgiana Veronica Motoc
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania; (G.V.M.); (R.T.M.)
| | - Raluca Iulia Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Abel Emanuel Moca
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Ovidiu Motoc
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Rahela Tabita Moca
- Doctoral School of Biomedical Sciences, University of Oradea, 1 Universității Street, 410087 Oradea, Romania; (G.V.M.); (R.T.M.)
| | - Ioan Andrei Țig
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Luminița Ligia Vaida
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
| | - Mihai Juncar
- Department of Dentistry, Faculty of Medicine and Pharmacy, University of Oradea, 10 Piața 1 Decembrie Street, 410073 Oradea, Romania; (A.E.M.); (O.M.); (I.A.Ț.); (L.L.V.); (M.J.)
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Lieske B, Moszka N, Borof K, Petersen EL, Jagemann B, Ebinghaus M, Beikler T, Heydecke G, Aarabi G, Zyriax BC. Association between an Anti-Inflammatory Dietary Score and Periodontitis-Evidence from the Population-Based Hamburg City Health Study. Nutrients 2023; 15:3235. [PMID: 37513653 PMCID: PMC10386141 DOI: 10.3390/nu15143235] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), we developed an anti-inflammatory dietary score using a data-driven approach based on the relationship of relevant selected food groups with inflammatory biomarkers (hsCRP and IL-6). The aim of this cross-sectional study was to evaluate the association between the anti-inflammatory dietary score and the incidence of periodontitis in Hamburg, Germany. A total of n = 5642 participants fit the required inclusion criteria and were selected for analysis. Periodontal disease was assessed using probing depth, gingival recession, and bleeding on probing. Dietary intake was measured using a food frequency questionnaire (FFQ). A self-developed anti-inflammatory dietary score served as the key explanatory variable. Higher scores reflected lower inflammatory processes (measured through the biomarkers hsCRP and IL-6). Several covariates were included in the regression analysis. Regressions revealed that a higher anti-inflammatory dietary score was significantly associated with lower odds to be affected by periodontal disease in an unadjusted model (OR 0.86, 95% CI 0.82-0.89, p < 0.001) and in an adjusted model (age, sex, smoking, diabetes, hypertension, and physical activity) (OR 0.93, 95% CI 0.89-0.98, p = 0.003). Our study demonstrated a significant inverse association between an anti-inflammatory dietary score and periodontitis. Individuals with higher intake of proinflammatory nutrition should be specifically addressed to avoid periodontitis.
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Affiliation(s)
- Berit Lieske
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Nina Moszka
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Elina Larissa Petersen
- Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Bettina Jagemann
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Merle Ebinghaus
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science-Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Jeong J, Kim HS, Lee D, Kim K, Kim YH. Association between Four Dietary Patterns and the Risk of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14204362. [PMID: 36297045 PMCID: PMC9611912 DOI: 10.3390/nu14204362] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Several dietary patterns are reported as risk factors for several chronic diseases including oral diseases. However, thus far, there has been no comprehensive quantitative analysis of nutrition and periodontal diseases. Methods: This systematic review was conducted according to the PRISMA guidelines. Cohort, case–control, and cross-sectional studies were eligible for inclusion in this study. The Newcastle–Ottawa scale was used to qualitatively assess the risk of bias in the included studies. The number of samples was used for odds ratio calculation, followed by the unadjusted value and 95% confidence interval. Results: Nine papers were included for the systematic review and meta-analysis. The results of screening for database search records showed that four diet patterns (western diet, dairy product intake, sugar intake, and vitamin C intake) have enough data for meta-analysis. The risk of periodontal disease in the western-diet group and the lowest dairy product intake group was 1.05 (0.51–2.13) and 1.28 (0.89–1.84), respectively. The risk of periodontal disease in the highest sugar intake group and the lowest vitamin C intake group was 1.52 (0.79–2.91) and 1.15 (1.08–1.23), respectively. Conclusions: With aging of the population globally, the prevalence of periodontal disease increases, and the associated cost also increases. Though this study, we found foods related to the risk of periodontal disease, and we are confident that it will contribute to lowering the incidence of the disease.
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Affiliation(s)
- Jaehun Jeong
- School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Hyung-Sik Kim
- Department of Oral Biochemistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Dongjun Lee
- Department of Convergence Medicine, School of Medicine, Pusan National University, Yangsan 50612, Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan 49267, Korea
- Correspondence: (K.K.); (Y.-H.K.); Tel.: +82-51-510-6368 (K.K.); +82-51-510-8091 (Y.-H.K.); Fax: +82-51-510-6694 (K.K.); +82-51-510-8049 (Y.-H.K.)
| | - Yun-Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan 50612, Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan 50612, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
- Correspondence: (K.K.); (Y.-H.K.); Tel.: +82-51-510-6368 (K.K.); +82-51-510-8091 (Y.-H.K.); Fax: +82-51-510-6694 (K.K.); +82-51-510-8049 (Y.-H.K.)
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