Johansson Ann-Katrin, Norring Claes, Unell Lennart, Johansson Anders
1Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009 Bergen, Norway.
2Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
J Eat Disord. 2020 Feb 27;8:7. doi: 10.1186/s40337-020-0281-z. eCollection 2020.
Patients suffering from eating disorders (ED) have a substantially increased risk for developing poor oral health. In this regard, dietary habits in combination with obsessive behavior as well as the expression and intensity of the disease are of utmost importance. This study aimed to investigate diet and behavioral habits in patients with ED compared to healthy controls.
All patients who initiated treatment in an ED clinic during 1 year were invited to participate in the study. Sixty-five patients were admitted out of which 54 agreed to participate: 50 women and 4 men, mean age 21.5 years, range 10-50 years. From a public dental health clinic, 54 sex-and age-matched controls where selected. In all participants a comprehensive questionnaire was completed. ED patients were analyzed with respect to their self-perceived disease state: when they felt "relatively good" (ED-good) and "bad" (ED-bad) as well as if they reported vomiting or not.
The ED-good patients reported significantly higher intake of caffeine-containing and cola light soft drinks and both study groups reported a lower intake of regularly sweetened carbonated drinks compared to controls. ED-bad reported significantly lower intake of number of meal and sweet intake while both study groups brushed their teeth more frequently than controls. As regards awareness of detrimental dietary intake and the possible risk for oral health complications did not differ between patients and controls except that the ED groups were more aware that vomiting and brushing thereafter could damage their teeth. ED patients went less often to the dentist for regular checkups than controls. Vomiting ED patients differed in several of the parameters related to dietary and other behaviors compared to no vomiting subjects. According to regression analyses and compared to healthy controls, predictive variables for ED-good were: higher intake of caffeine containing drinks (OR 1.34, CI 1.10-1.64) and lower intake of regular soft drinks (OR 0.57, CI 0.35-0.94). For ED-bad, lower frequency intake of lunch meals (OR 0.59, CI 0.39-0.88) and sweet biscuits were predictive (OR 0.15, CI 0.05-0.48).
ED patients present a number of dietary and other types of behavior that are potentially harmful for oral health. It is important to retrieve reports on the ED behaviors in both relatively good and bad disease state in order for the medical team to prescribe adequate advice and treatment.
患有饮食失调症（ED）的患者出现口腔健康不良的风险大幅增加。在这方面，饮食习惯与强迫行为以及疾病的表现和严重程度至关重要。本研究旨在调查与健康对照组相比，ED患者的饮食和行为习惯。
邀请在1年内开始在ED诊所接受治疗的所有患者参与研究。65名患者入院，其中54名同意参与：50名女性和4名男性，平均年龄21.5岁，年龄范围10 - 50岁。从一家公共牙科保健诊所选取了54名性别和年龄匹配的对照。所有参与者都完成了一份综合问卷。对ED患者的自我感知疾病状态进行分析：他们感觉“相对良好”（ED良好）和“不佳”（ED不佳）的情况，以及他们是否报告有呕吐行为。
ED良好组患者报告摄入含咖啡因饮料和低糖可乐软饮料的量显著更高，与对照组相比，两个研究组报告的常规加糖碳酸饮料摄入量均较低。ED不佳组报告用餐次数和甜食摄入量显著较低，而两个研究组刷牙频率均高于对照组。关于对有害饮食摄入的认知以及口腔健康并发症的潜在风险，患者和对照组之间没有差异，只是ED组更清楚呕吐及随后刷牙可能会损害牙齿。ED患者定期看牙医进行检查的频率低于对照组。与未呕吐的受试者相比，呕吐的ED患者在与饮食和其他行为相关的几个参数上存在差异。根据回归分析并与健康对照组相比，ED良好的预测变量为：含咖啡因饮料摄入量较高（OR 1.34，CI 1.10 - 1.64）和常规软饮料摄入量较低（OR 0.57，CI 0.35 - 0.94）。对于ED不佳，午餐用餐频率较低（OR 0.59，CI 0.39 - 0.88）和甜饼干摄入量较低具有预测性（OR 0.15，CI 0.05 - 0.48）。
ED患者呈现出一些对口腔健康有潜在危害的饮食和其他行为类型。重要的是获取处于疾病相对良好和不佳状态下的ED行为报告，以便医疗团队提供适当的建议和治疗。
