Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis

The Oral-Gut Microbiome-Brain Axis in Cognition

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and neuronal loss, affecting millions worldwide. Emerging evidence highlights the oral microbiome-a complex ecosystem of bacteria, fungi, viruses, and protozoa as a significant factor in cognitive health. Dysbiosis of the oral microbiome contributes to systemic inflammation, disrupts the blood-brain barrier, and promotes neuroinflammation, processes increasingly implicated in the pathogenesis of AD. This review examines the mechanisms linking oral microbiome dysbiosis to cognitive decline through the oral-brain and oral-gut-brain axis. These interconnected pathways enable bidirectional communication between the oral cavity, gut, and brain via neural, immune, and endocrine signaling. Oral pathogens, such as Porphyromonas gingivalis, along with virulence factors, including lipopolysaccharides (LPS) and gingipains, contribute to neuroinflammation, while metabolic byproducts, such as short-chain fatty acids (SCFAs) and peptidoglycans, further exacerbate systemic immune activation. Additionally, this review explores the influence of external factors, including diet, pH balance, medication use, smoking, alcohol consumption, and oral hygiene, on oral microbial diversity and stability, highlighting their role in shaping cognitive outcomes. The dynamic interplay between the oral and gut microbiomes reinforces the importance of microbial homeostasis in preserving systemic and neurological health. The interventions, including probiotics, prebiotics, and dietary modifications, offer promising strategies to support cognitive function and reduce the risk of neurodegenerative diseases, such as AD, by maintaining a diverse microbiome. Future longitudinal research is needed to identify the long-term impact of oral microbiome dysbiosis on cognition.

The Relationship Between Processed Food Consumption and Periodontal Disease: Sex Disparities in the Majorcan Adolescent Population

BACKGROUND

The diet of young people in Spain has changed significantly, with a departure from a balanced dietary pattern and a greater intake of processed foods. Such food generates an acidic environment in the mouth, which promotes the multiplication of bacteria capable of causing inflammation and damage to the gums.

AIM

This study aimed to determine the association between the frequency of consuming processed foods and periodontal disease, as well as sex differences, in an adolescent population.

METHODS

A study was conducted on 233 students aged 15 to examine the frequency of food consumption and its correlation with periodontal disease. Differences were determined via a Student's t-test to compare the means. A chi-square test was used to compare categorical variables. The 95% confidence interval estimate was used in all cases (p < 0.05).

RESULTS

It was observed that girls have a higher mean number of healthy sextants than boys (3.26 ± 0.20 vs. 2.70 ± 0.21; p = 0.029). A statistically significant difference was noted between healthy and affected subjects in the frequency of consumption of packaged milkshakes (p = 0.003), industrial juices (p = 0.009), industrial pastries (p = 0.018), and fruits in syrup (p = 0.022). When segmented by sex, a statistically significant difference was noted in boys between healthy and affected subjects in the frequency of consumption of packaged milkshakes (p = 0.044), salty snacks (p = 0.032), and cold cuts (p = 0.033); in girls, the difference was detected in industrial juices (0.024).

CONCLUSIONS

The results of this study suggest that adolescent boys are more affected periodontally than girls. In both sexes, the level of consumption of processed foods affects the presence of periodontal disease.

Strengthening health systems to tackle oral diseases in Africa: Africa centers for disease control and prevention's role

Oral diseases remain a significant public health challenge in Africa. Despite their prevalence, oral health is often overlooked in national health agendas and universal health coverage frameworks. This manuscript explores the crucial role of the Africa Centers for Disease Control and Prevention (Africa CDC) in strengthening health systems to address the growing oral health problem in Africa. A rapid review of the literature was conducted in databases like PubMed and ScienceDirect identified 18 relevant studies focusing on workforce size, retention, distribution, patient access, and system outcomes. The analysis revealed severe workforce shortages, uneven distribution, and systemic neglect, particularly in rural areas. Promising interventions included dental education programs, task-shifting to mid-level workers, and mobile dental units. Key recommendations emphasize integrating oral health into national policies, addressing inequities, expanding training, and improving infrastructure and workforce retention through incentives. By leveraging its position and resources, the Africa CDC can take strategic actions to strengthen surveillance and data-driven policy development, provide technical assistance to Africa Union Member States for health system integration, support capacity building for oral health workforce development, promote preventive and community-based oral health interventions, facilitate cross-border collaboration and knowledge sharing, mobilize resources and funding for oral health programs, and support the local production of oral health products. These all aligns with the institution's new public health order for Africa's health security and one of the institutions' 2023-2027 goals.

Influence of unhealthy diet and sedentary behavior on the oral health-related quality of life of 12-year-old Brazilian adolescents

This study analyzed the factors associated with the oral health-related quality of life (OHRQOL) of 12-year-old adolescents and their relationship with unhealthy eating and sedentary behavior. Data were collected from 615 adolescents from the five largest cities in Mato Grosso do Sul, Brazil. The theoretical framework of the social determinants of oral health guided all analyses and the measurement instrument was OIDP (impact of oral health on daily performance). Multilevel logistic and negative binomial regressions were performed to test the association of OHRQOL with unhealthy eating, sedentary behavior, sociodemographic characteristics and health behaviours. Considering the sample weights, 43% of the adolescents reported some impact on OHRQOL. In the adjusted models, higher consumption of unhealthy foods (moderate and high) was associated with a prevalence of impact on OHRQOL [OR = 3.59 (95%CI 1.99; 6.46)] and higher OHRQOL severity [RR = 2.05 (95%CI 1.43; 2.94)] compared to their counterparts. Sedentary behaviour was associated with the prevalence of impact on OHRQOL [OR = 1.52 (95%CI 1.22; 1.89)] and greater severity [RR = 1.21 (95%CI 1.07; 1.37)] compared to their counterparts. Unhealthy food consumption and sedentary behavior were associated with OHRQOL. Intersectoral health public policies for healthy eating and for reducing sedentary behavior on the internet and electronic games can help in the quality of life of adolescents.

Relationship between children's eating behavior (1-6 years) and body mass index: a cross-sectional study in French maternal-infant protection centers within the Parisian region

BACKGROUND

Early detection of obesity-promoting dietary behavior patterns improves the identification of at-risk families and the implementation of interventions. This is accomplished through the use of the Child Eating Behavior Questionnaire (CEBQ). No study has been conducted using the CEBQ in children followed in Essonne's Maternal-Infant Protection (PMI) centers. We investigated, in a cross-sectional design, the differences in children's eating behavior with PMI follow-up according to their weight status.

METHODS

A questionnaire addressed to parents was collected in PMI centers. Multiple hierarchical regression analysis was used to investigate the predictability of the child's CEBQ on body mass index (BMI).

RESULTS

From January to April 2022, 850 children were selected, from which 500 (aged 1-6 years) were included, and of whom 10.6% were obese. There was a significant positive association between 'Food Responsiveness', 'Enjoyment of Food' and BMI. In contrast, there was a significant negative association between 'Satiety Responsiveness', 'Slowness in Eating' and BMI. Besides, 'Food approach' and 'food avoidance' behaviors were positively and negatively related to BMI z-scores, respectively.

CONCLUSION

Due to significant differences in children's eating behavior according to their weight, it is needed to raise awareness among parents about their impact on them.

Nutritional Quality of Breakfast Cereals on the French, Belgian and Luxembourg Markets: Which Cereals for Children?

Objective: Analyse the breakfast cereal market to help to help healthcare professionals to guide parents in choosing healthy products for their children. Study design: Observational study of the breakfast cereals available in the biggest supermarkets, discount stores and organic chains in France, Belgium and Luxembourg. Methods: An analysis of nutritional qualities using three indicators: Nutri-Score (initial and modified version), WHO Europe nutrient profile model, and Nova. Results: 645 products were listed; 559 excluding duplicates. A total of 28.8% are marketed to children and make up the group of "children's" cereals, 62.1% of cereals are Muesli, Oats and other cereal flakes (MOCF), and 54.9% are "organic". The study shows that "children's" cereals have a poorer nutritional profile: a higher proportion of Nutri-Score D, higher sugar content, lower fibre content, less conformity with the WHO Europe nutrient profile model and a higher proportion ofultra-processed. On the other hand, MOCF and "organic" products generally have a better nutritional profile: less sugar, more fibre, more Nutri-Score A, less Nutri-Score D and fewer ultra-processed products. Conclusions: Parents should therefore opt for cereals that do not bear any reference to children on the packaging.

Decoding children dental health risks: a machine learning approach to identifying key influencing factors

Introduction and objectives

This study investigates key factors influencing dental caries risk in children aged 7 and under using machine learning techniques. By addressing dental caries' prevalence, it aims to enhance early identification and preventative strategies for high-risk individuals.

Methods

Data from clinical examinations of 356 children were analyzed using Logistic Regression, Decision Trees, and Random Forests models. These models assessed the influence of dietary habits, fluoride exposure, and socio-economic status on caries risk, emphasizing accuracy, precision, recall, F1 score, and AUC metrics.

Results

Poor oral hygiene, high sugary diet, and low fluoride exposure were identified as significant caries risk factors. The Random Forest model demonstrated superior performance, illustrating the potential of machine learning in complex health data analysis. Our SHAP analysis identified poor oral hygiene, high sugary diet, and low fluoride exposure as significant caries risk factors.

Conclusion

Machine learning effectively identifies and quantifies dental caries risk factors in children. This approach supports targeted interventions and preventive measures, improving pediatric dental health outcomes.

Clinical significance

By leveraging machine learning to pinpoint crucial caries risk factors, this research lays the groundwork for data-driven preventive strategies, potentially reducing caries prevalence and promoting better dental health in children.

The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study

Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case-control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann-Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health.

Ultra-processed food consumption and dental caries in adolescents from the 2004 Pelotas Birth Cohort study

OBJECTIVE

To investigate the relationship between ultra-processed food (UPF) consumption and dental caries in adolescents.

METHODS

Data from 996 adolescents aged 12-13 years who participated in an oral health sub-study of the 2004 Pelotas Birth Cohort in southern Brazil were analysed. The main exposure was daily UPF consumption at age 10-11 years, measured by a food frequency questionnaire containing 24 UPF items defined based on the NOVA system. UPF consumption was calculated in frequency, grams and calories, in general and for six types of food (biscuits, savoury snacks and sugar-sweetened cereals; ultra-processed meats and fats; sweets; fast food and instant noodles; soft drinks and artificially flavoured drinks; and sweetened milk and powdered chocolate). The outcome was dental caries, measured according to the decayed, missing and filled indexes (DMFS and dmfs) at age 12-13 years. Poisson regression models were used to analyse the association between UPF consumption and dental caries, adjusting for socioeconomic and demographic variables, dental visits and oral hygiene.

RESULTS

Overall, the daily UPF consumption in frequency, grams and calories was associated with caries. The findings were consistent for UPF consumption for all six food groups. The higher the UPF consumption, the higher the probability of having caries in adolescence. The associations between ultra-processed meats and fats, and fast food and instant noodles intake with dental caries alert to the cariogenic potential of such UPF foods.

CONCLUSION

Ultra-processed food consumption was associated with greater caries burdens in young adolescents. The findings reinforce the need for interventions and public policies to reduce UPF consumption in adolescence.

Polyphenols in Oral Health: Homeostasis Maintenance, Disease Prevention, and Therapeutic Applications

Polyphenols, a class of bioactive compounds with phenolic structures, are abundant in human diets. They have gained attention in biomedical fields due to their beneficial properties, including antioxidant, antibacterial, and anti-inflammatory activities. Therefore, polyphenols can prevent multiple chronic or infectious diseases and may help in the prevention of oral diseases. Oral health is crucial to our well-being, and maintaining a healthy oral microbiome is essential for preventing various dental and systemic diseases. However, the mechanisms by which polyphenols modulate the oral microbiota and contribute to oral health are still not fully understood, and the application of polyphenol products lies in different stages. This review provides a comprehensive overview of the advancements in understanding polyphenols' effects on oral health: dental caries, periodontal diseases, halitosis, and oral cancer. The mechanisms underlying the preventive and therapeutic effects of polyphenols derived from dietary sources are discussed, and new findings from animal models and clinical trials are included, highlighting the latest achievements. Given the great application potential of these natural compounds, novel approaches to dietary interventions and oral disease treatments may emerge. Moreover, investigating polyphenols combined with different materials presents promising opportunities for developing innovative therapeutic strategies in the treatment of oral diseases.

Combined intake of sugar-sweetened beverages and sugar-containing ultra-processed foods is associated with an increase in body mass index during early childhood

BACKGROUND

Sugar-containing ultra-processed (SUP) foods and beverages consumption has increased globally in recent years and contributes to the rising global trends of obesity and diet-related chronic non-communicable diseases. However, there are limited longitudinal studies of SUP foods and beverages intake and weight gain in children.

OBJECTIVES

To examine associations between intake of sugar-sweetened beverages (SSB) and SUP foods and changes in body mass index during early childhood.

METHODS

Multistage sampling was used to select a nationally representative sample of Uruguayan children living in urban areas from the 2012-2013 Continuous Household Survey. The sample for this analysis included all children aged 0-3 years 11 months with dietary data in 2013-2014 (wave 1; n = 2611) and in 2015-2016 (wave 2; n = 2383). Multilevel regression modelling tested the association between children's consumption of SSB and SUP foods and change in BMI z-score (BMIz).

RESULTS

In multivariable-adjusted models, intake of SSB and SUP foods (in combination but not individually) in both waves was positively associated with change in BMIz over 2 years β coefficient: 0.13 (95% confidence interval [CI]: 0.02, 0.23). BMIz decreased among non-consumers (β: -0.12, 95% CI: -0.24, -0.00, p = 0.048). Associations were significant for SUP foods but not SSB foods individually. Children consuming ≥2 SSB and SUP foods (vs. <2) at baseline had increased BMIz (p for trend = 0.02).

CONCLUSION

Early and current intake of SSB and SUP foods and beverages was associated with increases in BMIz in children over 2 years.