Tada Akio, Miura Hiroko
Department of Health Science, Hyogo University, 2301 Shinzaike Hiraoka-cho, Kakogawa, Hyogo, 675-0195, Japan.
Department of International Health and Collaboration, National Institute of Public Health, 2-3-6, Minami, Wako, Saitama, 351-0197, Japan.
BMC Oral Health. 2018 May 4;18(1):76. doi: 10.1186/s12903-018-0525-3.
A substantial number of adults suffer from obesity, that is caused by the risk factor, masticatory dysfunction. The association between mastication and obesity, however, is inconclusive. This systematic review aims to provide literature regarding the association between mastication and factors affecting masticatory function, and obesity in adults.
Four electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were used to search for publications that met the following criteria: published between 2007 and 2016, written in English, and assessed the associations between mastication and obesity among the population aged ≥18 years. The included publications were analyzed based on the study design, main conclusions, and strength of evidence identified by the two authors who screened all the abstracts and full-text articles and, abstracted data, and performed quality assessments by using a critical appraisal tool, the Critical Appraisal Skills Programme Cohort Studies Checklists.
A total of 18 articles (16 cross-sectional, 1 cohort studies, and 1 randomized controlled trial [RCT]) met our inclusion criteria and were evaluated. Poorer mastication was associated with obesity in 12 out of 16 cross-sectional studies. One cohort study showed that the obesity group displayed higher tooth loss than the normal weight group. One RCT demonstrated that gum-chewing intervention for 8 weeks significantly decreased waist circumference.
Most studies revealed a positive association between mastication and obesity among adults. Nonetheless, most of them are cross-sectional studies, which are insufficient to demonstrate a causal relation. Further advancement requires RCT, especially an intervention of improvement of mastication and obesity needed to confirm this association.
大量成年人患有肥胖症，其由咀嚼功能障碍这一风险因素引起。然而，咀嚼与肥胖之间的关联尚无定论。本系统综述旨在提供有关咀嚼与影响咀嚼功能的因素以及成年人肥胖之间关联的文献。
使用四个电子数据库（PubMed、EMBASE、Cochrane图书馆和科学网）搜索符合以下标准的出版物：2007年至2016年期间发表、英文撰写且评估了18岁及以上人群中咀嚼与肥胖之间的关联。纳入的出版物由两位作者根据研究设计、主要结论和证据强度进行分析，这两位作者筛选了所有摘要和全文文章，提取了数据，并使用批判性评估工具“批判性评估技能计划队列研究清单”进行了质量评估。
共有18篇文章（16篇横断面研究、1篇队列研究和1篇随机对照试验[RCT]）符合我们的纳入标准并进行了评估。在16篇横断面研究中的12篇中，较差的咀嚼功能与肥胖有关。一项队列研究表明，肥胖组的牙齿脱落率高于正常体重组。一项随机对照试验表明，为期8周的咀嚼口香糖干预显著降低了腰围。
大多数研究揭示了成年人咀嚼与肥胖之间存在正相关。尽管如此，其中大多数是横断面研究，不足以证明因果关系。进一步的进展需要随机对照试验，尤其是需要改善咀嚼和肥胖的干预措施来证实这种关联。
