Department of Periodontics, University of Washington, Seattle, WA, USA.
Department of Endodontics, University of Washington, Seattle, WA, USA.
Clin Nutr. 2018 Aug;37(4):1306-1312. doi: 10.1016/j.clnu.2017.06.001. Epub 2017 Jun 9.
BACKGROUND & AIMS: The deleterious effect of cariogenic dietary patterns on tooth loss is well characterized, but the contribution of diet-borne systemic inflammation to loss of teeth remains uncharted. Recent efforts have unveiled a protective role of single nutrients to periodontal health. However, the assessment of overall diet as a modifiable risk factor for oral health remains elusive. Thus, the aim of this study was to assess the association between diet-borne systemic inflammation and tooth loss in a representative sample of the US adult non-institutionalized population.
A cross-sectional analysis of a sample of participants of the 2009-2010 and 2011-2012 continuous NHANES receiving an oral exam and providing dietary recall data was performed. Dietary inflammatory potential was assessed by the Dietary Inflammatory Index (DII), a composite measure computed based on the association between nutrients and systemic pro-inflammatory cytokine levels. The outcome measure was prevalent tooth loss. Numbers of missing teeth were regressed across quartiles of the DII using multivariable linear regression models.
6887 eligible NHANES participants were included in the analysis; participants in the highest quartile of the DII index (pro-inflammatory diet) had an average [95% CI] of 0.84 [0.24, 1.45] additional more teeth lost as compared to those in the lowest quartile of DII (anti-inflammatory diet) (p = 0.015), after adjusting for known confounders. This significant association remained in subgroup analyses, including the lowest tertiles of energy-adjusted carbohydrate intake, and in persons aged ≥50 years.
Adherence to an anti-inflammatory diet is associated with fewer missing teeth. These results suggest protective dietary patterns as a modifiable protective factor for tooth loss in the US adult population and support the incorporation of tooth loss prevention in the agenda of dietary public health interventions to prevent chronic inflammatory diseases.
致龋饮食模式对牙齿缺失的有害影响已得到充分证实，但饮食源性全身炎症对牙齿缺失的作用仍不清楚。最近的研究揭示了单一营养素对牙周健康的保护作用。然而，评估整体饮食作为口腔健康的可改变危险因素仍然难以捉摸。因此，本研究旨在评估美国非住院成年人群体代表性样本中饮食源性全身炎症与牙齿缺失之间的关系。
对 2009-2010 年和 2011-2012 年连续 NHANES 中接受口腔检查并提供饮食回忆数据的参与者样本进行了横断面分析。饮食炎症潜力通过饮食炎症指数（DII）进行评估，这是一种根据营养素与全身促炎细胞因子水平之间的关联计算得出的综合衡量标准。结局指标为普遍的牙齿缺失。使用多变量线性回归模型，根据 DII 四分位数对缺失牙齿数量进行回归。
共纳入 6887 名符合条件的 NHANES 参与者进行分析；与 DII 指数最低四分位数（抗炎饮食）的参与者相比，DII 指数最高四分位数（促炎饮食）的参与者平均 [95%CI]多缺失 0.84 [0.24, 1.45] 颗牙齿（p = 0.015），调整了已知混杂因素后仍具有统计学意义。在包括能量调整后的碳水化合物摄入量最低三分位数的亚组分析中以及年龄≥50 岁的人群中，这种显著关联仍然存在。
遵循抗炎饮食与缺失牙齿较少有关。这些结果表明，保护性饮食模式是美国成年人群体预防牙齿缺失的可改变保护因素，并支持将预防牙齿缺失纳入饮食公共卫生干预措施的议程，以预防慢性炎症性疾病。
