The Associations Between Dietary Intake and Incidence of Periodontal Disease

Abstract

Periodontitis is one of the most common chronic inflammatory diseases worldwide. The relationship between diet and periodontitis is not well understood. This dissertation addresses the relationship between long-term dietary intake and incidence of periodontal disease in the Health Professionals Follow-up Study, over 24 years. Chapter I investigated the association using two principal component analysis derived major dietary patterns, termed the “prudent” and the “Western” patterns. The prudent pattern was high in vegetables, fruit, legumes, whole grains, fish, and poultry, while the Western pattern was high in processed meat, red meat, butter, high-fat dairy products, eggs, and refined grains. The results showed that there was no overall association between Western or prudent dietary patterns and periodontitis, but the Western diet was significantly associated with higher periodontitis risk only among obese individuals. Chapter II examined the cumulative long-term inflammatory impact of diet on modifying the risk of periodontal disease. We used a reduced rank regression derived empirical dietary inflammatory pattern. There was no association between the inflammatory dietary pattern and incidence of periodontitis in the study population, overall and in subgroup analyses. However, there was some evidence that the inflammatory dietary pattern was associated with increased risk of periodontitis among obese nonsmokers. Chapter III focused on the associations between habitual intake of flavonoids and incidence of periodontal disease. Due to their anti-inflammatory and antibacterial activities, we hypothesized that flavonoid intake would reduce the risk of periodontitis. Our results however showed no association between flavonoids and incidence of periodontal disease. The findings of the dissertation support the notion that diet may be a modifiable risk factor of periodontal disease, at least among obese. Additional studies are needed to verify the findings among other populations, and focus on potential dietary contributors.