Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.
Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico,
Caries Res. 2021;55(2):88-98. doi: 10.1159/000511699. Epub 2021 Feb 3.
To examine the association of dietary fluoride intake, total carbohydrate consumption and other key dietary variables with dental caries experience among adolescents, a cross-sectional analysis was conducted in a sample of 402 participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort. The presence and severity of dental caries were assessed using the International Caries Detection and Assessment System (ICDAS) to calculate the number of decayed, missing, and filled teeth or surfaces (D1MFT/D4MFT). The dietary intake of fluoride, energy, carbohydrates, and food groups was estimated using a validated food frequency questionnaire (FFQ). Multivariate zero-inflated negative binomial regression models and negative binomial regression models were run to estimate the association of fluoride intake (mg/day) and total carbohydrate intake (g/day) with the D1MFT/D4MFT index. We found that 80% of the adolescents experienced dental caries (D1MFT >0), with 30% presenting cavitated lesions (D4MFT >0). The mean scores for D1MFT and D4MFT were 6.2 (SD 5.3) and 0.67 (SD 1.3), respectively. The median intake of fluoride estimated by the FFQ was 0.015 mg/kg/day. This intake was statistically higher in participants with a D4MFT = 0 compared to those with a D4MFT >0 (0.90 vs. 0.82 mg/day; 0.016 vs. 0.014 mg/kg/day; p < 0.05). For D1MFT, D1MFS, D4MFT, and D4MFS scores, a higher fluoride consumption (mg/day) from foods and beverages was associated with a statistically significant reduction in the number of lesions. The reported frequency of consumption of sugary foods in a whole day was statistically higher in those with D1MFT >0 than in those with D1MFT = 0 (p < 0.05). The total carbohydrate intake (g/day) was positively associated with dental caries experience. We conclude that a higher fluoride intake through foods and beverages is associated with a lower dental caries experience among adolescents; this effect was seen even when the dietary intake of fluoride was 0.015 mg/kg/day, which is lower than the average intake recommendation. In contrast, a higher total carbohydrate intake and the frequency of intake of sugary foods were associated with a higher dental caries experience, with no apparent threshold for the effects.
为了研究饮食氟摄入、总碳水化合物摄入量和其他关键饮食变量与青少年龋齿经历之间的关联，对来自墨西哥早期环境毒物暴露队列的 402 名参与者的样本进行了横断面分析。使用国际龋齿检测和评估系统（ICDAS）评估龋齿的存在和严重程度，以计算龋齿、缺失和填充的牙齿或表面数量（D1MFT/D4MFT）。氟、能量、碳水化合物和食物组的饮食摄入量通过验证的食物频率问卷（FFQ）进行估计。使用零膨胀负二项回归模型和负二项回归模型来估计氟摄入量（mg/天）和总碳水化合物摄入量（g/天）与 D1MFT/D4MFT 指数的关联。我们发现，80%的青少年经历了龋齿（D1MFT>0），其中 30%有龋洞病变（D4MFT>0）。D1MFT 和 D4MFT 的平均得分分别为 6.2（SD 5.3）和 0.67（SD 1.3）。FFQ 估计的氟摄入中位数为 0.015mg/kg/天。与 D4MFT>0 的参与者相比，D4MFT=0 的参与者的氟摄入量（0.90 与 0.82mg/天；0.016 与 0.014mg/kg/天；p<0.05）统计学上更高。对于 D1MFT、D1MFS、D4MFT 和 D4MFS 评分，来自食物和饮料的较高氟消耗（mg/天）与病变数量的统计学显著减少相关。报告的全天含糖食品的消费频率在 D1MFT>0 的参与者中明显高于 D1MFT=0 的参与者（p<0.05）。总碳水化合物摄入量（g/天）与龋齿经历呈正相关。我们的结论是，通过食物和饮料摄入较高的氟与青少年龋齿经历较低有关；即使氟的饮食摄入量为 0.015mg/kg/天，这低于平均摄入量建议，也能观察到这种效果。相比之下，较高的总碳水化合物摄入量和含糖食品的摄入频率与较高的龋齿经历相关，且无明显的效应阈值。
