Association between diet and periodontitis: A cross-sectional study of 10,000 NHANES participants
Open accessAbstract
Background Periodontitis is a major cause of tooth loss globally. Risk factors include age, smoking, and diabetes. Intake of specific nutrients has been associated with periodontitis risk but there has been little research into the influence of overall diet, potentially more relevant when formulating dietary recommendations.Objectives We aimed to investigate potential associations between diet and periodontitis using novel statistical techniques for dietary pattern analysis.Methods Two 24-h dietary recalls and periodontal examination data from the cross-sectional US NHANES, 2009-2014 (n = 10,010), were used. Dietary patterns were extracted using treelet transformation, a data-driven hierarchical clustering and dimension reduction technique. Associations between each pattern [treelet component (TC)] and extent of periodontitis [proportion of sites with clinical attachment loss (CAL) ≥ 3 mm] were estimated using robust logistic quantile regression, adjusting for age, sex, ethnicity, education level, smoking, BMI, and diabetes.Results Eight TCs explained 21% of the variation in diet, 1 of which (TC1) was associated with CAL extent. High TC1 scores represented a diet rich in salad, fruit, vegetables, poultry and seafood, and plain water or tea to drink. There was a substantial negative gradient in CAL extent from the lowest to the highest decile of TC1 (median proportion of sites with CAL ≥ 3 mm: decile 1 = 19.1%, decile 10 = 8.1%; OR, decile 10 compared with decile 1: 0.67; 95% CI: 0.46, 0.99).Conclusions Most dietary patterns identified were not associated with periodontitis extent. One pattern, however, rich in salad, fruit, and vegetables and with plain water or tea to drink, was associated with lower CAL extent. Treelet transformation may be a useful approach for calculating dietary patterns in nutrition research.
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The lower extent of periodontal disease associated with that dietary pattern is attributable to reduced expression of periodontal bacteria in the oral microenvironment.
“This is attributable to reduced expression of periodontal bacteria in the oral microenvironment [56].”
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 [56]
A dietary pattern rich in fruits, vegetables, salad, water, and tea and with limited intake of fermentable carbohydrates, fatty acids, protein, and sugar-rich beverages had a lower extent of periodontal disease among 10,000 NHANES participants.
“That study found that a dietary pattern rich in fruits, vegetables, salad, water, and tea and with limited intake of fermentable carbohydrates, fatty acids, protein, and sugar-rich beverages had a lower extent of periodontal disease.”
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 [56]
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- Authors
- Wright, D. M., McKenna, G., Nugent, A., Winning, L., Linden, G. J., & Woodside, J. V.
- Affiliations
- Queen's University Belfast (GB)
- University College Dublin (IE)
- Dublin Dental University Hospital (IE)
- Corresponding author
- Wright, David M
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 112
- Issue
- 6
- Pages
- 1485-1491
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W3088033645
- Cited by
- 83
- References
- 32
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 29 · 2023: 8 · 2022: 11 · 2021: 9 · 2020: 1
- FWCI
- 7.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
- Funders
- Medical Research Council (MR/S003770/1)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Keywords
- periodontitis, diet, dietary habits, clinical attachment loss, salad consumption, fruit and vegetable intake, tooth loss, NHANES
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Diet, Female, Humans, Male, Middle Aged, Nutrition Surveys, Periodontitis, Risk Factors
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