How Much Does Plant Food (Fruits and Vegetables) Intake Affect the Prevention of Periodontal Disease in the Korean Elderly?

Does adopting a healthy diet improve periodontal parameters in patients susceptible to periodontal disease? A systematic review

OBJECTIVES

The aim of this systematic review is to evaluate evidence relating to whether adopting a diet, associated with improved outcomes for chronic systemic diseases with an inflammatory component, can improve periodontal parameters in patients with periodontal diseases.

DATA SOURCES

Electronic databases and one platform were systematically searched; Medline, Embase, Web of Science and the Cochrane Library including references of relevant studies.

DATA SELECTION AND EXTRACTION

1220 studies were identified of which 9 studies were eligible; 4 RCT's, 1 controlled trial and 4 observational cohort studies DATA SYNTHESIS: 8 out of 9 studies found improved periodontal parameters associated with a diet that was low in refined carbohydrates, low in saturated fats, high in fibre and high in nutrition but the studies were low to medium quality of evidence and the diets, method of recording the diets and periodontal parameters varied between the studies as did the study duration and age of participants.

CONCLUSION

Current evidence supports the hypothesis that adopting a healthy diet has the potential to positively impact periodontal parameters in patients with periodontal diseases, particularly in the older population but the effects may be negated by confounding factors such as smoking. 9 studies were included in the review which were rated moderate or low quality of evidence.

Assessing periodontitis risk from specific dietary patterns: a systematic review and meta-analysis

AIMS

Our goal is to perform a meta-analysis to investigate the risk of periodontitis associated with specific dietary patterns.

METHODS

We employed the PRISMA methodology in a meta-analysis to examine the correlation between dietary patterns and the risk of periodontitis. We systematically searched three online databases from inception to November 2024 to identify relevant studies. Summary estimates with 95%CI were calculated to assess the relationship between specific dietary patterns and the risk of periodontitis. Cumulative estimates were synthesized using random-effects or fixed-effects models. Heterogeneity among studies was evaluated using Cochran's Q and I2 statistics.

RESULTS

In total, we included 19 articles that analyzed 5 dietary patterns The study showed that a diet high in inflammation-promoting foods significantly raised the likelihood of periodontitis (OR = 1.39, 95% CI, 1.09-1.77), in contrast, dietary patterns like the mediterranean diet (OR = 0.96, 95% CI, 0.94-0.98), plant-based diet (OR = 0.92, 95% CI, 0.86-0.98), or dairy-rich diet (OR = 0.76, 95% CI, 0.66-0.87) lowered the risk of periodontitis. The analysis revealed no statistically significant association between a western diet (OR = 1.07; 95% CI, 0.86-1.33) and the risk of periodontitis.

CONCLUSIONS

As dietary diversity and complexity continue to expand, there has been a concomitant increase in the prevalence of periodontal disease. This study has identified specific dietary patterns associated with the risk of periodontitis, particularly highlighting the heightened risk linked to pro-inflammatory diets. These findings emphasize the importance of implementing targeted dietary practices to reduce the incidence of this condition.

Exploring Putative Causal Associations between Diet and Periodontal Disease Susceptibility

INTRODUCTION

Dietary factors may play an important role in periodontal health. However, current evidence from observational studies remains inconclusive.

OBJECTIVE

This study aimed to investigate the causal relationships between dietary exposures and periodontal disease risks using Mendelian randomization analysis.

METHODS

Large-scale genome-wide association study summary statistics for 20 dietary factors were obtained from the MRC-IEU consortium. Multivariable and univariable 2-sample Mendelian randomization analyses were performed to assess the causal effects of each dietary exposure on 6 periodontal outcomes, including gingivitis and periodontitis.

RESULTS

Genetically predicted higher dried fruit intake was significantly associated with reduced risks of acute gingivitis (odds ratio [OR]: 0.02; 95% confidence interval [CI]: 0.00-0.42; P = 0.01) and bleeding gums (OR: 0.96; 95% CI: 0.93-0.99; P = 0.01). Higher fresh fruit and water intake showed protective effects against chronic gingivitis (OR: 0.18; 95% CI: 0.04-0.91; P = 0.04 and OR: 0.15; 95% CI: 0.04-0.53; P = 0.00) and bleeding gums (OR: 0.95; 95% CI: 0.92-0.981; P = 0.00 and OR: 0.98; 95% CI: 0.96-0.99; P = 0.02). Alcohol intake frequency and processed meat intake were risk factors for bleeding gums (OR: 1.01; 95% CI: 1.00-1.02; P = 0.01 and OR: 1.05; 95% CI: 1.01-1.08; P = 0.00) and painful gums (OR: 1.01; 95% CI: 1.00-1.01; P = 0.00 and OR: 1.02; 95% CI: 1.01-1.03; P = 0.00). Most of the causal relationships between genetic predisposition to the specified dietary factors and periodontal diseases remained statistically significant (P < 0.05) after adjusting for genetic risks associated with dentures, smoking, and type 2 diabetes in multivariable Mendelian randomization models.

CONCLUSIONS

The findings suggest potential protective effects of higher fruit and water intake against gingivitis and other periodontal problems, while alcohol and processed meat intake may increase the risks of periodontal disease. Our study provides preliminary causal evidence on the effects of diet on periodontal health and could inform prevention strategies targeting dietary habits to improve oral health.

KNOWLEDGE TRANSFER STATEMENT

This study suggests that fruit and water intake may protect against periodontal disease, while alcohol and processed meats increase risk, informing dietary guidelines to improve oral health.

Impact of dietary inflammatory index on gingival health

BACKGROUND

Periodontal disease is a biofilm-dependent chronic inflammatory condition triggered by a host response. Several factors impact systemic inflammation and could lead to changes in disease pathogenesis. Recently, studies have assessed the influence of nutritional patterns on the development of periodontitis. In the present cross-sectional study, we evaluated the dietary inflammatory profile on periodontal conditions, focusing on clinical, subgingival microbial, and cytokine assessment of individuals with periodontal health or gingivitis.

METHODS

One hundred patients with periodontal health or gingivitis were included. Plaque index (PI), Bleeding on probing (BoP), the probing depth (PD), and the clinical attachment level (CAL) for each patient were assessed. Nutritional data and the Dietary Inflammatory Index (DII) were recorded by two 24-h food recalls on non-consecutive days. Biofilm and gingival crevicular fluid (GCF) to assess the microbiome profile and inflammatory biomarkers were collected. Multiple regressions focused on the DII, age, and sex as predictors of periodontal conditions were done.

RESULTS

Age and moderate DII scores increased the risk of gingivitis by 1.64 and 3.94 times, respectively. Males with an elevated DII score had 27.15 times higher odds of being diagnosed with gingivitis and BoP (β = 6.54; p = 0.03). Elderly patients with a moderate or high DII score were less prone to gingivitis and increased BoP (p < 0.04) compared with younger subjects. Considering the DII, there were no differences in microbial alpha and beta diversity; however, distinct species abundance and a higher concentration of monocyte-chemoattractant protein-1 and interleukin 33 were seen in patients with a higher DII.

CONCLUSION

A pro-inflammatory diet significantly contributes to periodontal inflammation, modulating inflammatory biomarkers and affecting the subgingival microbial community in healthy individuals.

How Does the Frequency of Eating-Alone among Older People in Korea Affect Their Health and Dietary Behavior?

This study examined the relationship between general population characteristics and diet-related factors pertaining to eating alone for older adults (65 years and older) in Korea. This study used the Korea National Health and Nutrition Examination Survey (KNHANES), 2016-2020, and the target population was 7037 Koreans aged 65 years or older who participated in the nutritional survey and health interview. Eating alone variables were classified as follows. Eating together all day means "eating together", eating only one meal a day means "1/day", eating two meals a day alone means "2/day", and "3/day" means eating three meals a day alone. The main results are as follows. The rate of moderate or severe food insecurity was 3.41% in the "eating together" group to 7.86% in the "3/day" group, which was 4.45% higher in the "3/day" group. Fruit + vegetable intake among food intake lowered by about 35 g from 301.2 g in the "eating together" group to 266.2 g in the "3 day" group. In addition, as a result of analyzing the prevalence of depression using the PHQ-9 score, the "3/day" group had a 1.775 to 2.464 times higher risk of depression than the "eating together" group. Finally, EQ-5D variables and quality of life scores were significantly lowered from the "eating together" group to the "3/day" group. Overall, higher frequency of eating alone was associated with food safety, essential food intake, and quality of life. Based on these results, it is thought that a dietary life support program such as the eating together program is necessary to improve the quality of life of the older people who eat alone.