Is dietary pattern a mediator of the relationship between socioeconomic status and dental caries?
Abstract
Objective To investigate whether a healthy diet and added sugar mediate the relationship between socioeconomic status and oral health status in adults.Methods This is a secondary cross-sectional analysis of adult participants from the 2015-2016 National Health and Nutrition Examination Survey from the United States (n=3367). Structural equation modeling tested direct and indirect pathways from a latent variable for socioeconomic status to oral health via healthy eating (Health Eating Index) and added sugar in a multiple-mediator multiple-outcome model.Results Added sugar was directly associated with untreated dental caries [Standardized coefficient (SC)=0.10], and healthy eating was directly associated with both untreated dental caries (SC=-0.11) and tooth loss (SC=-0.05). Higher socioeconomic status was associated with lower untreated dental caries through direct (SC =-0.246) and small indirect paths via healthy diet (SC= -0.026), lower consumption of added sugar (SC=-0.007), and dental visits (SC=-0.162). Higher socioeconomic status was associated with fewer teeth lost through direct (SC =-0.306) and very small indirect paths via healthy diet (SC=-0.016), added sugar consumption (SC=-0.001), and untreated dental caries (SC=-0.094).Conclusions Both socioeconomic status and dietary pattern independently contributed to tooth loss and dental caries. The contribution of dietary factors as a mediator to socioeconomic inequities in oral health was small, and statistically significant.Clinical relevance A systems approach to socioeconomic inequities in oral health takes into account the complex relationships between socioeconomics, dietary patterns, oral health and health. Socioeconomic conditions and nutrition, as common risk factors to noncommunicable disorders, should be tackled in programs to improve oral health.
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Saturated fatty acids (trans fats and omega-6 fatty acids) are implicated in promoting inflammatory conditions.
“Much research has indicated that saturated fatty acids (trans fats and omega-6 fatty acids) are unhealthy, as they are implicated in promoting inflammatory conditions [85].”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [85]
Omega-3 fatty acids have been shown to be associated with reduced systemic inflammation.
“In contrast, studies on omega-3 fatty acids have been analyzed extensively over the past several years, as they have been shown to be associated with reduced and systemic inflammation [85].”
From A Cross-Talk between Diet and the Oral Microbiome: Balance of Nutrition on Inflammation and Immune System’s Response during Periodontitis (2022) · cites this paper as [85]
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- Authors
- Stein, C., Cunha-Cruz, J., & Hugo, F. N.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Corresponding author
- Stein, Caroline
- Venue
- Clinical Oral Investigations
- Published
- 2021-04-07
- Volume
- 25
- Issue
- 9
- Pages
- 5441-5447
- ISSN
- 1432-6981 (ISSN-L)
- 1436-3771
- OpenAlex
- W3149730050
- Cited by
- 23
- References
- 33
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 1
- FWCI
- 3.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Oral Investigations (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- socioeconomic status, dental caries, tooth loss, dietary habits, healthy eating, added sugars, oral health inequities, mediation, dental visits
- MeSH terms
- Adult, Cross-Sectional Studies, Dental Caries, Diet, Humans, Nutrition Surveys, Social Class, Socioeconomic Factors, United States
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