Added sugars and periodontal disease in young adults: An analysis of NHANES III data
Open accessAbstract
Background Added sugar consumption seems to trigger a hyperinflammatory state and may result in visceral adiposity, dyslipidemia, and insulin resistance. These conditions are risk factors for periodontal disease. However, the role of sugar intake in the cause of periodontal disease has not been adequately studied.Objective We evaluated the association between the frequency of added sugar consumption and periodontal disease in young adults by using NHANES III data.Design Data from 2437 young adults (aged 18-25 y) who participated in NHANES III (1988-1994) were analyzed. We estimated the frequency of added sugar consumption by using food-frequency questionnaire responses. We considered periodontal disease to be present in teeth with bleeding on probing and a probing depth ≥3 mm at one or more sites. We evaluated this outcome as a discrete variable in Poisson regression models and as a categorical variable in multinomial logistic regression models adjusted for sex, age, race-ethnicity, education, poverty-income ratio, tobacco exposure, previous diagnosis of diabetes, and body mass index.Results A high consumption of added sugars was associated with a greater prevalence of periodontal disease in middle [prevalence ratio (PR): 1.39; 95% CI: 1.02, 1.89] and upper (PR: 1.42; 95% CI: 1.08, 1.85) tertiles of consumption in the adjusted Poisson regression model. The upper tertile of added sugar intake was associated with periodontal disease in ≥2 teeth (PR: 1.73; 95% CI: 1.19, 2.52) but not with periodontal disease in only one tooth (PR: 0.85; 95% CI: 0.54, 1.34) in the adjusted multinomial logistic regression model.Conclusion A high frequency of consumption of added sugars is associated with periodontal disease, independent of traditional risk factors, suggesting that this consumption pattern may contribute to the systemic inflammation observed in periodontal disease and associated noncommunicable diseases.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis.
“Recent evidence suggests that consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding as well, while a diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis [72,73,74,75,76,77].”
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 [75]
Consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding.
“Recent evidence suggests that consumption of high-glycemic foods alone might increase gingival and periodontal inflammation and bleeding as well, while a diet abundant in complex carbohydrates, with no increase in total energy intake, may lower the risk of gingivitis and periodontitis [72,73,74,75,76,77].”
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 [75]
Cites
Obesity : Preventing and managing the global epidemic
Akram, D. S., Astrup, A. V., Atinmo, T., Boissin, J.-L., Bray, G. A., Carroll, K. N., Chitson, P., Chen, C., Dietz, W. H., Hill, J. O., et al. (2000) · Research at the University of Copenhagen (University of Copenhagen) · Cited by 12,945 · see citing works
Monnier, L., Mas, E., Ginet, C., Michel, F., Villon, L., Cristol, J.-P., & Colette, C. (2006) · JAMA · doi:10.1001/jama.295.14.1681 · Cited by 2,444 · see citing works
Stanhope, K. L., Schwarz, J. M., Keim, N. L., Griffen, S. C., Bremer, A. A., Graham, J. L., Hatcher, B., Cox, C. L., Dyachenko, A., Zhang, W., et al. (2009) · Journal of Clinical Investigation · doi:10.1172/jci37385 · Cited by 1,765 · see citing works
Johnson, R. K., Appel, L. J., Brands, M., Howard, B. V., Lefevre, M., Lustig, R. H., Sacks, F., Steffen, L. M., & Wylie-Rosett, J. (2009) · Circulation · doi:10.1161/circulationaha.109.192627 · Cited by 1,207 · see citing works
El-Osta, A., Brasacchio, D., Yao, D., Pocai, A., Jones, P. L., Roeder, R. G., Cooper, M. E., & Brownlee, M. (2008) · The Journal of Experimental Medicine · doi:10.1084/jem.20081188 · Cited by 1,115 · see citing works
Johnson, R. J., Segal, M. S., Sautin, Y., Nakagawa, T., Feig, D. I., Kang, D.-H., Gersch, M. S., Benner, S., & Sánchez-Lozada, L. G. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.4.899 · Cited by 1,075 · see citing works
Dyslipidemia in type 2 diabetes mellitus
Mooradian, A. D. (2009) · Nature Reviews Endocrinology · doi:10.1038/ncpendmet1066 · Cited by 1,053 · see citing works
Lockhart, P. B., Bolger, A. F., Papapanou, P. N., Osinbowale, O., Trevisan, M., Levison, M. E., Taubert, K. A., Newburger, J. W., Gornik, H. L., Gewitz, M. H., et al. (2012) · Circulation · doi:10.1161/cir.0b013e31825719f3 · Cited by 1,038 · see citing works
Effect of Periodontal Treatment on Glycemic Control of Diabetic Patients
Teeuw, W. J., Gerdes, V. E. A., & Loos, B. G. (2010) · Diabetes Care · doi:10.2337/dc09-1378 · Cited by 526 · see citing works
Scannapieco, F. A., Bush, R. B., & Paju, S. (2003) · Annals of Periodontology · doi:10.1902/annals.2003.8.1.38 · Cited by 526 · see citing works
Association Between Chronic Periodontal Disease and Obesity: A Systematic Review and Meta‐Analysis
Chaffee, B. W., & Weston, S. J. (2010) · Journal of Periodontology · doi:10.1902/jop.2010.100321 · Cited by 509 · see citing works
Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence
Borgnakke, W. S., Ylöstalo, P., Taylor, G. W., & Genco, R. J. (2013) · Journal of Periodontology · doi:10.1902/jop.2013.1340013 · Cited by 499 · see citing works
O’Keefe, J. H., Gheewala, N. M., & O’Keefe, J. O. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.10.016 · Cited by 497 · see citing works
National Estimates of Dietary Fructose Intake Increased from 1977 to 2004 in the United States
Marriott, B. P., Cole, N., & Lee, E. (2009) · The Journal of Nutrition · doi:10.3945/jn.108.098277 · Cited by 473 · see citing works
Risk factors for periodontitis
Timmerman, M. F., & van der Weijden, G. A. (2006) · International Journal of Dental Hygiene · doi:10.1111/j.1601-5037.2006.00168.x · Cited by 470 · see citing works
Food sources of added sweeteners in the diets of Americans.
GUTHRIE, J. F., & MORTON, J. F. (2000) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(00)00018-3 · Cited by 451 · see citing works
Systemic Inflammation, Adipose Tissue Tumor Necrosis Factor, and Leptin Expression
Bulló, M., García‐Lorda, P., Megías-Rangil, I., & Salas‐Salvadó, J. (2003) · Obesity Research · doi:10.1038/oby.2003.74 · Cited by 449 · see citing works
Periodontal systemic associations: review of the evidence
Linden, G. J., Lyons, A., & Scannapieco, F. A. (2013) · Journal of Periodontology · doi:10.1902/jop.2013.1340010 · Cited by 428 · see citing works
Caraballo, R. S. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.8.807 · Cited by 396 · see citing works
Oxidative Stress, Systemic Inflammation, and Severe Periodontitis
D’Aiuto, F., Nibali, L., Parkar, M. H., Patel, K., Suvan, J. E., & Donos, N. (2010) · Journal of Dental Research · doi:10.1177/0022034510375830 · Cited by 357 · see citing works
The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis.
Chávarry, N. G. M., Vettore, M. V., Sansone, C., et al. (2009) · PubMed · Cited by 351 · see citing works
Periodontal Disease and Incident Type 2 Diabetes
Demmer, R. T., Jacobs, D. R., & Desvarieux, M. (2008) · Diabetes Care · doi:10.2337/dc08-0026 · Cited by 336 · see citing works
Periodontal systemic associations: review of the evidence
Linden, G. J., Lyons, A., & Scannapieco, F. A. (2013) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12064 · Cited by 309 · see citing works
D’Aiuto, F., Sabbah, W., Netuveli, G., Donos, N., Hingorani, A. D., Deanfield, J. E., & Tsakos, G. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-2522 · Cited by 280 · see citing works
Rippe, J. M., & Angelopoulos, T. J. (2013) · Advances in Nutrition · doi:10.3945/an.112.002824 · Cited by 194 · see citing works
Methodological issues in epidemiological studies of periodontitis - how can it be improved?
Leroy, R., Eaton, K. A., & Savage, A. (2010) · BMC Oral Health · doi:10.1186/1472-6831-10-8 · Cited by 169 · see citing works
Fructose Induces the Inflammatory Molecule ICAM-1 in Endothelial Cells
Glushakova, O. Y., Kosugi, T., Roncal, C., Mu, W., Heinig, M., Cirillo, P., Sánchez‐Lozada, L. G., Johnson, R. J., & Nakagawa, T. (2008) · Journal of the American Society of Nephrology · doi:10.1681/asn.2007121304 · Cited by 163 · see citing works
Dietary carbohydrates and dental-systemic diseases
Hujoel, P. (2009) · Journal of Dental Research · doi:10.1177/0022034509337700 · Cited by 156 · see citing works
Beck, J. D., & Offenbacher, S. (2002) · Annals of Periodontology · doi:10.1902/annals.2002.7.1.79 · Cited by 139 · see citing works
Tl, C. (1974) · PubMed · Cited by 112 · see citing works
Yoshihara, A., Watanabe, R., Hanada, N., & Miyazaki, H. (2009) · Gerodontology · doi:10.1111/j.1741-2358.2008.00244.x · Cited by 98 · see citing works
Influence of Frequent Sugar Intakes on Experimental Gingivitis
Sidi, A. D., & Ashley, F. P. (1984) · Journal of Periodontology · doi:10.1902/jop.1984.55.7.419 · Cited by 86 · see citing works
Xu, F., & Lü, B. (2011) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2011.07.091 · Cited by 81 · see citing works
Defining a periodontitis case: analysis of a never‐treated adult population
Bælum, V., & López, R. (2011) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2011.01812.x · Cited by 45 · see citing works
Yang, E. J., Kerver, J. M., Park, Y. K., Kayitsinga, J., Allison, D. B., & Song, W. O. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.6.1426 · Cited by 40 · see citing works
Ringsdorf, W. M., & Cheraskin, E. (1964) · The Journal of the American Dental Association · doi:10.14219/jada.archive.1964.0032 · Cited by 7 · see citing works
Periodontal pathosis in man. 13. Effect of sucrose drinks upon sulcus depth.
Cheraskin, E., Wm, R., & Setyaadmadja, A. T. (1965) · PubMed · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Santonocito, S., Giudice, A., Polizzi, A., Troiano, G., Merlo, E. M., Sclafani, R., Grosso, G., & Isola, G. (2022) · Nutrients · doi:10.3390/nu14122426 · Cited by 144 · see citing works
Association between diet and periodontitis: A cross-sectional study of 10,000 NHANES participants
Wright, D. M., McKenna, G., Nugent, A., Winning, L., Linden, G. J., & Woodside, J. V. (2020) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqaa266 · Cited by 83 · see citing works
Dietary Factors Affecting the Prevalence and Impact of Periodontal Disease
Santonocito, S., Polizzi, A., Palazzo, G., Indelicato, F., & Isola, G. (2021) · Clinical Cosmetic and Investigational Dentistry · doi:10.2147/ccide.s288137 · Cited by 55 · see citing works
Chapter 13: Diet and periodontal diseases
Woelber, J. P., & Tennert, C. (2020) · Monographs in Oral Science · doi:10.1159/000455380 · Cited by 54 · see citing works
- Authors
- Lula, E. C., Ribeiro, C. C., Hugo, F. N., Alves, C. M., & Silva, A. A.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- ORCID
- Hugo, Fernando N
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 100
- Issue
- 4
- Pages
- 1182-1187
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1997117136
- Semantic Scholar
- 2640f15cfdf7a9cd20f83a3a3e2123a80770db1e
- Cited by
- 112
- References
- 37
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 16 · 2023: 17 · 2022: 16 · 2021: 15 · 2020: 9 · 2019: 6 · 2018: 7 · 2017: 2 · 2016: 6 · 2015: 3
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Keywords
- added sugars, periodontal disease, young adults, systemic inflammation, non-communicable diseases, dental caries, NHANES III
- MeSH terms
- Adolescent, Adult, Dietary Carbohydrates, Female, Humans, Male, Nutrition Surveys, Periodontal Diseases, Risk Factors, Socioeconomic Factors, United States, Body Mass Index, Prevalence, Logistic Models, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
