Chewing gum, occupational stress, work performance and wellbeing. An intervention study

Chewing Gum Is Associated with Better Diet Quality but Not Oral Health Measures in U.S. Adults

OBJECTIVE

Chewing gum (especially sugar-free gum) has been linked to improved oral health, however there is an absence of observational research using nationally-representative data in the United States. We sought to examine the factors associated with chewing gum and its relationship with the oral health status of U.S. adults.

METHODS

Cross-sectional data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2013-2018 cycles were used in these analyses. Primary outcomes were the odds of having gum disease, treatment for gum disease, ever being told of bone loss around teeth, root caries, caries, and restoration. Unadjusted and multivariate logistic regression models were used to investigate the relationship of chewing gum use with demographic/lifestyle factors and the oral health status of participants.

RESULTS

2.40% (n = 365) of adults were users of chewing gum and the average among users was 5.20 ± 0.40 g/d. Users of chewing gum were more likely to be female, younger in age, and non-Hispanic Black or Hispanic. Self-reported chewing gum use did not affect the oral health status of U.S. adults (OR: 1.10, 95% CI: 0.42-2.88 for gum disease; OR: 1.34, 95% CI: 0.64-2.81 for treatment for gum disease; OR: 0.56, 95% CI: 0.27-1.17 for bone loss around teeth; OR: 1.01, 95% CI: 0.32-3.12 for root caries; OR: 0.96, 95% CI: 0.54-1.69 for caries), except for restoration (OR: 3.54, 95% CI: 1.78-7.06), but was associated with improved diet quality (OR: 1.86, 95% CI: 1.11-3.12 for a healthy eating index (HEI) of 51-59; OR: 1.96, 95% CI: 1.08-3.56 for HEI of 60-93); and decreased intakes of snacks (OR: 1.64, 1.01-2.69), and added sugars.

CONCLUSION

Future observational studies that more accurately capture chewing gum usage are needed, as these analyses have several limitations.

Effects of Dual Tasks Including Gum Chewing on Prefrontal Cortex Activity

The purpose of this study was to examine the effects on prefrontal cortex (PFC) activity of listening to pleasant sounds (PS) while walking, gum chewing (GCh), or performing the dual task of walking and gum chewing at the same time (walking + GCh). A total of 11 healthy adult male volunteers participated in the study (mean age: 29.54 ± 3.37). The block design of the trial consisted of a 30-sec rest, a 60-sec task (target task or control task), and a 30-sec rest. There were three target task conditions: walking, GCh, and the dual task. All of these were performed while listening to PS. The control condition was rest (no exercise) while listening to PS. The outcomes measured and measurements used were PFC activity using two-channel near-infrared spectroscopy and participant self-evaluation of the pleasantness of the experience using the visual analogue scale (VAS). Compared to the control condition, there was significantly greater PFC activation during the GCh and the walking + GCh tasks. Compared to the control condition, GCh and walking + GCh showed significantly greater activation on the VAS measure. In conclusion, listening to PS while GCh or walking + GCh increases PFC activity in the lower central region and induces positive emotional change.

Cross-Sectional Association between Estimated Hardness of the Habitual Diet and Depressive Symptoms in Older Japanese Men

This cross-sectional study aimed to investigate the association between dietary hardness and depressive symptoms in older Japanese men. Participants were 1487 men aged 60-69 years enrolled in the baseline survey of the Hitachi Health Study II (2017-2020). Habitual dietary intake was estimated by a brief-type, self-administered diet history questionnaire. Dietary hardness was defined as the magnitude of masticatory muscle activity necessary to consume solid foods. The participants who scored ≥ 9 points on a short version of the Center for Epidemiologic Studies Depression Scale were considered to have depressive symptoms. The prevalence of depressive symptoms was 12.7%. The ORs (95% CIs) for depressive symptoms in the third tertile of dietary hardness were significantly lower after adjustment for sociodemographic and lifestyle-related variables and mood-modulating nutrients (ORs [95% CIs]: 0.93 [0.63, 1.36] and 0.58 [0.35, 0.97] for the second and third tertile, respectively [p-value for trend = 0.04]). Dietary hardness was inversely associated with the prevalence of depressive symptoms in older Japanese men. Future studies should confirm these findings and clarify the role of consuming a hard diet in preventing depressive disorders.

High masticatory ability attenuates psychosocial stress: A cross-sectional study

Mastication interventions have previously been shown to alleviate acute stress. However, the relationship between masticatory performance and stress response among individuals remains unclear. This study aimed to examine the relationship between masticatory ability and stress response in young women by measuring the autonomic nerve function and salivary α-amylase activity during psychosocial stress. Eighty women (aged 20.0 ± 1.9 years) were divided into either a low or high masticatory performance group, and the Trier Social Stress Test was conducted. Moreover, the autonomic function was measured at rest, immediately before stress, immediately after stress, and 10 min after stress. The salivary α-amylase activity was also measured at rest, 5 min after stress, and 15 min after stress. The visual analog scale (VAS) was used for subjective stress evaluation. There was a significant increase in the autonomic balance of both groups immediately before stress loading, but whilst the high masticatory ability group showed a return to resting-state levels after stress loading, the low masticatory ability group showed elevated levels after stress loading. Salivary α-amylase activity significantly increased 5 min after stress loading in the low, but not high, masticatory ability group. Furthermore, the VAS scores for tension and confusion after stress were significantly higher in the low masticatory ability group than in the high masticatory ability group. Our findings suggest that high masticatory performance may contribute to alleviating psychosocial stress. This is the first study to clarify the relationship between habitual masticatory performance and psychosocial stress suppression in young women.

An empirical study of the use of Chewing Gum by Youth as a replacement to Cigarette addiction

The current study aimed to add to this of knowledge by examining the effect of chewing gum on smoking withdrawal severity over a long period, as well as identifying the specific characteristics of chewing gum that may be responsible for the reported reductions in withdrawal. Chewing, flavour, and the combination of the two were all investigated separately. The study is based on quantitative research. The data has been classified on basis of smoker and non-smoker. Participants reported a significant difference in withdrawal severity across conditions using repeated measures Chi square, F(3, 69)=2.89, p.05. The flavoured gum condition had considerably lower withdrawal scores than the flavourless gum base and no product control conditions, according to follow-up analyses. These data suggest that chewing gum is effective in reducing the severity of nicotine withdrawal symptoms over a 24-hour period of nicotine abstinence, and that the impact is due to a combination of flavour and chewing. These findings, together with findings from previous laboratory studies, show that chewing gum could be a useful coping mechanism for those who are trying to quit smoking. 

Effect of Gum Chewing on PFC Activity During Discomfort Sound Stimulation

The prefrontal cortex (PFC) is sensitive to the stress exposure and involved in stress coping. And the effects of gum chewing on the stress have been studied using NIRS. However, when measuring NIRS on PFC during gum chewing, blood flows in shallow tissues (scalp, skin, muscle) might be affected. A NIRS used in the present study first, which has a short distance (1 cm) and the usual (3 cm) source-detector (S-D) regression, can allow eliminating shallow tissues effect of gum chewing. The aim of this study was to investigate the hypothesis that gum chewing activates the right prefrontal cortex (PFC) in stress coping against negative sounds (NS) from the International Affective Digitized Sounds-2 (IADS) as a mental stress task. NS showed activation in the right PFC. There was a significant difference between NS, and NS with Gum, where NS with Gum showed an increased PFC activity, increased alpha wave appearance rate, a higher value in heart rate level, and a higher VAS score indicating 'pleasant'. Gum chewing activated right PFC activity while exposed to negative sounds from IADS as a mental stress task.

Effect of chewing gum on stress, anxiety, depression, self-focused attention, and academic success: A randomized controlled study

Chewing gum is thought to increase focus via a reduction in stress and anxiety. Chewing gum contributes to success by improving short-term memory. This study was conducted to determine the effect of chewing gum on stress, anxiety, depression, self-focused attention, and exam success. A randomized controlled trial was conducted with a total of 100 students. In the long-term (19 days) and short-term (7 days) chewing gum groups, the pretest scores of depression, anxiety, and stress were significantly higher than the posttest scores. Although the posttest scores on the self-focused attention subscale were higher than the pretest scores in long-term chewing gum group, there was no significant difference between the pretest and posttest scores in this group. The academic success mean scores of the long-term experimental group students were higher than those of the other groups. Students are recommended to chew gum before exams in order to overcome exam stress and to enhance exam success. However, chewing gum is not recommended in the long term for students who have difficulty focussing their attention.

Efficiency of chewable toothbrush in reduction of dental plaque in students

Background

Besides classical and electrical toothbrushes market offers tooth brushes that can be chewed, like chewing gums. The aim of this study was to show the effectiveness of chewable toothbrush versus a conventional brush in the students’ population.

Methods

The prospective study included 346 students. For this research, we used a e-questionnaire for “smart” phones, that students completed outside the dental office. Respondents are divided into two groups: control group used conventional toothbrushes, respondents from the tested group used chewable toothbrush. For assessment of accumulation of the plaque we used TQHI index. For testing statistical hypotheses, the following were used: t-test for two independent samples and analysis of the variance of repeated measurements.

Results

Before brushing teeth, the average TQHI value for chewable brushes is 2.8 ± 0.3, while conventional is 2.7 ± 0.3, which is not a statistically significant difference (p = 0.448). After brushing teeth, the average TQHI value for chewable brushes is 2.0 ± 0.1, while conventional 2.0 ± 0.3, which is also not statistically significant (p = 0.729). Observing the index of the plaque values on the tooth surfaces in the upper jaw, in both groups, there was a statistically significant change in the amount of plaque in time (p < 0.001). There is a statistically significant interaction between groups and changes in the amount of plaque in the observed period (p = 0.013).

Conclusions

The fact that there is no significant difference in the effectiveness of the tested brushes indicates the benefits of using chewable toothbrushes in order to reduce plaque, primarily in the inability to use conventional brushes.

Masticatory performance alters stress relief effect of gum chewing

PURPOSE

We evaluated the effects of gum chewing on the response to psychological stress induced by a calculation task and investigated the relationship between this response and masticatory performance.

METHODS

Nineteen healthy adult volunteers without dental problems undertook the Uchida-Kraepelin (UK) test (30 min of reiterating additions of one-digit numbers). Before and immediately after the test, saliva samples were collected from the sublingual area of the participants. Three min after the UK test, the participants were made to chew flavorless gum for 3 min, and the final saliva samples were collected 10 min after the UK test. The experiment was performed without gum chewing on a different day. Masticatory performance was evaluated using color-changing chewing gum.

RESULTS

Salivary CgA levels at immediately and 10 min after the UK test were compared with and without gum chewing condition. Two-way repeated measures analysis of variance revealed significant interaction between gum chewing condition and changes in CgA levels during post 10 min UK test period. A significant correlation was found between changes in CgA levels and masticatory performance in all participants.

CONCLUSION

Our results indicate that gum chewing may relieve stress responses; however, high masticatory performance is required to achieve this effect.

Mastication as a Stress-Coping Behavior

Exposure to chronic stress induces various physical and mental effects that may ultimately lead to disease. Stress-related disease has become a global health problem. Mastication (chewing) is an effective behavior for coping with stress, likely due to the alterations chewing causes in the activity of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Mastication under stressful conditions attenuates stress-induced increases in plasma corticosterone and catecholamines, as well as the expression of stress-related substances, such as neurotrophic factors and nitric oxide. Further, chewing reduces stress-induced changes in central nervous system morphology, especially in the hippocampus and hypothalamus. In rodents, chewing or biting on wooden sticks during exposure to various stressors reduces stress-induced gastric ulcer formation and attenuates spatial cognitive dysfunction, anxiety-like behavior, and bone loss. In humans, some studies demonstrate that chewing gum during exposure to stress decreases plasma and salivary cortisol levels and reduces mental stress, although other studies report no such effect. Here, we discuss the neuronal mechanisms that underline the interactions between masticatory function and stress-coping behaviors in animals and humans.

Chewing gum: cognitive performance, mood, well-being, and associated physiology

Recent evidence has indicated that chewing gum can enhance attention, as well as promoting well-being and work performance. Four studies (two experiments and two intervention studies) examined the robustness of and mechanisms for these effects. Study 1 investigated the acute effect of gum on mood in the absence of task performance. Study 2 examined the effect of rate and force of chewing on mood and attention performance. Study 3 assessed the effects of chewing gum during one working day on well-being and performance, as well as postwork mood and cognitive performance. In Study 4, performance and well-being were reported throughout the workday and at the end of the day, and heart rate and cortisol were measured. Under experimental conditions, gum was associated with higher alertness regardless of whether performance tasks were completed and altered sustained attention. Rate of chewing and subjective force of chewing did not alter mood but had some limited effects on attention. Chewing gum during the workday was associated with higher productivity and fewer cognitive problems, raised cortisol levels in the morning, and did not affect heart rate. The results emphasise that chewing gum can attenuate reductions in alertness, suggesting that chewing gum enhances worker performance.

Chewing gum intake in Europe: a survey of intakes in France, Germany, Italy, Spain and the UK

A limited number of studies have examined chewing gum intakes in Europe. In the current study, chewing gum intakes were estimated in children, adolescents and adults via customised online questionnaires developed to collect data on patterns of chewing gum consumption (including usage, duration and gum variety) in September and October 2011. A total sample of chewing gum consumers composed of 1001 children and 5186 adolescents and adults from five European countries was included in the survey, with 79% and 66% of children and adolescents/adults reporting chewing gum in the previous 3 and 6 months, respectively. The intake of chewing gum on a per g basis was estimated by establishing the mean weights of each form of gum, and using factors for the frequency of chewing gum intake obtained through the online survey. Intakes of chewing gum at the mean, 90th and 95th percentile in children were 1.87, 3.79 and 6.59 g day(-1) (equivalent to 0.75, 1.67 and 2.40 pieces/day), respectively. In adolescents and adults, intakes at the mean, 90th and 95th percentile were 1.87, 5.40 and 8.00 g day(-1) (equivalent to 0.98, 3.00 and 4.00 pieces/day), respectively. Intakes were similar across the five countries. Chewing gum use was significantly higher in older compared with younger children and was significantly higher in adolescents compared with older adults. The data reported herein provide a reliable resource for chewing gum intakes in Europe and will be important for estimating exposure to food additives and flavourings intended for use in chewing gum.

Demand characteristics, pre-test attitudes and time-on-task trends in the effects of chewing gum on attention and reported mood in healthy volunteers

Previous research has indicated that chewing gum enhances reported alertness, but has variable effects on attention. Demand characteristics may explain these effects. The current study investigated the effects of gum and demand characteristics on attention and reported mood over time. Participants completed measures of mood and attention, with and without chewing gum. To manipulate demand characteristics, they were told that the hypothesised effect of gum was either positive or negative, or no hypothesis was mentioned. Attitudes towards gum were assessed pre- and post-manipulation. Gum increased reported alertness; this effect was only significant for positive and neutral demand characteristics. Vigilance accuracy was reduced for chewing gum, but only in the fourth minute of the task, and gum reduced focussed attention accuracy, but only for the first 64 trials. Demand characteristics did not moderate time-on-task effects. Gum improved selective attention. A positive effect on response organisation was observed; this was significant when demand characteristics and pre-test attitudes to gum were both negative. The results suggest that demand characteristics moderate effects on self-reported alertness and response organisation, but cannot explain time-on-task effects or variable main effects on other aspects of attention.

Effects of chewing gum on the stress and work of university students

Recent research has indicated that chewing gum can relieve perceptions of stress in an occupational sample (Smith, 2009). In the present study, 72 students completed 2 weeks of either chewing gum or refraining from chewing gum. They completed scales measuring perceived stress, anxiety, depression, and single item measures of work levels and tiredness. These were completed both pre- and post-treatment. Perceived stress decreased as a function of the amount of gum chewed. The chewing gum condition was also associated with a decrease in not getting enough academic work done. There were no significant effects of chewing gum on mental health outcomes. These results confirm some of findings from previous studies of chewing gum and stress in other samples.