Nutrition guidelines for dental care vs the evidence: is there a disconnect?

Dental caries is the most common chronic childhood disease in New Zealand. Concurrently, obesity and related chronic metabolic diseases are the most challenging public health problems of modern times. There is considerable evidence that a common dietary behaviour-high frequency consumption of sugar- and starch-containing foods-is the principal aetiological factor for both dental caries, and presentation of children and young people with increased adiposity or obesity. Conversely, consumption of full-fat dairy products by children and young people is associated with reduced risks of dental caries and obesity. Government-endorsed dietary guidelines for young people correctly provide recommendations to decrease intake of high-sugar foods. However, recommendations are provided to increase the frequency of consumption of sugar- and starch-containing foods as children age, and to choose low-fat dairy produce. We contend that this advice directly contradicts evidence of the dietary causes of both dental caries and obesity. This advice also does not reflect evidence regarding observed associations between the consumption of full-fat dairy produce and reduced dental caries and obesity. We present evidence to support our contention that important elements of New Zealand's dietary guidelines have been established without due consideration of the entirety of the evidence, including that which is updated, recent or evolutionarily. Given the epidemics of dental caries and metabolic disease are ongoing public health challenges in New Zealand and share common dietary causes, guidelines for healthy eating should limit refined sugar- and starch-containing foods and encourage intake of full-fat dairy items.