Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.
Independent Researcher, Veemkade 466, 1019 HE Amsterdam, The Netherlands.
Nutrients. 2023 Jun 17;15(12):2787. doi: 10.3390/nu15122787.
For nearly a century, researchers have associated periodontal disease (PD) with risks of other adverse health outcomes such as cardiovascular disease, diabetes mellitus, and respiratory diseases, as well as adverse pregnancy outcomes. Those findings have led to the hypothesis that PD causes those adverse health outcomes either by increasing systemic inflammation or by the action of periodontopathic bacteria. However, experiments largely failed to support that hypothesis. Instead, the association is casual, not causal, and is due to shared underlying modifiable risk factors, including smoking, diet, obesity, low levels of physical activity, and low vitamin D status. Diabetes mellitus is also considered a risk factor for PD, whereas red and processed meat are the most important dietary risk factors for diabetes. Because PD generally develops before other adverse health outcomes, a diagnosis of PD can alert patients that they could reduce the risk of adverse health outcomes with lifestyle changes. In addition, type 2 diabetes mellitus can often be reversed rapidly by adopting an anti-inflammatory, nonhyperinsulinemic diet that emphasizes healthful, whole plant-based foods. This review describes the evidence that proinflammatory and prohyperinsulinemia diets and low vitamin D status are important risk factors for PD and other adverse health outcomes. We also make recommendations regarding dietary patterns, food groups, and serum 25-hydroxyvitamin D concentrations. Oral health professionals should routinely inform patients with PD that they could reduce their risk of severe PD as well as the risks of many other adverse health outcomes by making appropriate lifestyle changes.
近一个世纪以来，研究人员将牙周病（PD）与心血管疾病、糖尿病、呼吸系统疾病以及不良妊娠结局等其他不良健康后果的风险联系起来。这些发现导致了一种假设，即 PD 通过增加全身炎症或牙周病细菌的作用引起这些不良健康后果。然而，实验在很大程度上未能支持该假设。相反，这种关联是偶然的，而不是因果关系，并且是由于可改变的共同潜在风险因素，包括吸烟、饮食、肥胖、低水平的身体活动和低维生素 D 状态。糖尿病也被认为是 PD 的一个风险因素，而红色和加工肉类是糖尿病最重要的饮食风险因素。由于 PD 通常在其他不良健康后果之前发展，因此 PD 的诊断可以提醒患者，他们可以通过生活方式的改变来降低不良健康后果的风险。此外，通过采用强调健康、全植物性食物的抗炎、非高胰岛素血症饮食，2 型糖尿病通常可以迅速逆转。本综述描述了促炎和高胰岛素血症饮食以及低维生素 D 状态是 PD 和其他不良健康后果的重要风险因素的证据。我们还就饮食模式、食物组和血清 25-羟维生素 D 浓度提出了建议。口腔健康专业人员应定期告知 PD 患者，通过适当的生活方式改变，他们可以降低严重 PD 以及许多其他不良健康后果的风险。
