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Influence of the vegan, vegetarian and omnivore diet on the oral health status in adults: a systematic review and meta-analysis

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Objective: This systematic review aimed to evaluate the influence of the nature of diet (vegan, vegetarian, and omnivore) on the oral health status in adults. Methods: This systematic review and meta-analysis was performed using the PRISMA guidelines. Electronic databases [PubMed, Embase, CENTRAL], online search engines (Google Scholar), research portals, and hand searches were performed systematically to identify studies. The last literature search was performed February 1st, 2021. Studies were included if they reported on the influence of the nature of diet on the oral health status (oral hygiene, periodontal health, dental status, and salivary function) in adults, by two investigators. Inter-investigator reliability was evaluated using Kappa (κ) statistics. PROSPERO registration number: CRD42020211567. Results: Twenty-two studies were included for data extraction and final analysis. The meta-analysis revealed that the bleeding on probing measure was higher in omnivores (Z = -4.057, p < 0.0001; 95% CI: -0.684, -0.238; I2 = 0.0%) and the overall periodontal health was significantly better in vegan/vegetarians than omnivores (Z = -2.632, p = 0.008; 95% CI: -0.274, -0.073; I2 = 29.7%). Vegan/vegetarians demonstrated more dental erosion (Z = 3.325, p = 0.001; 95% CI: 0.170, 0.659; I2 = 0.0%). In adults over 60 years old, the prevalence of caries was higher in omnivores (Z = 3.244, p = 0.001; 95% CI: 0.092, 0.371; I2 = 0.0%), while complete edentulism was more prevalent in vegetarians (Z = -4.147, p < 0.0001; 95% CI: -0.550, -0.197; I2 = 0.0%). Conclusions: This review reveals that adults on an omnivore diet may be associated with a higher risk for periodontal problems and dental caries, while vegetarians/vegans may be associated with a higher risk for dental erosion.

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... Cross-sectional/case-control data indicate that individuals who follow a WPBD experience lower bleeding on probing (BOP) measures compared to omnivores (Azzola, Fankhauser, and Srinivasan 2023;Linkosalo 1988;Linkosalo, Halonen, and Markkanen 1988;Staufenbiel et al. 2013). But the exclusion of animal-derived foods can lead to nutrient deficiencies (vitamin B12, omega-3 fatty acids) potentially elevating CVD, highlighting the importance of WPBDs that address these concerns (Benzie and Wachtel-Galor 2009;Hu, Hu, and Manson 2019;Mezzano et al. 2000). ...
... On the contrary, in plant-based cohorts, lower levels of CRP (Menzel et al. 2020) and lower incidences of CVD (Crowe et al. 2013;Kwok et al. 2014) are detected, as well as lower gingival BOP measurements (Azzola, Fankhauser, and Srinivasan 2023;Linkosalo 1988;Linkosalo, Halonen, and Markkanen 1988;Staufenbiel et al. 2013). ...
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... This is likely due to the high-fiber nature of plant-based diets. Additionally, vegan and vegetarian diets tend to be lower in pro-inflammatory saturated fats and higher in PUFAs [140]. This suggests that vegan and vegetarian diets could promote better oral health and thus result in a healthier oral-gut-brain axis. ...
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... Among the modalities, dental varnishes stand out due to their effectiveness, lack of substantial side effects, and high acceptability [10][11][12]. While caries prevalence and incidence have decreased worldwide in recent years [26], dental erosion has become increasingly prevalent due to shifts in lifestyle and eating habits. Within this context, several strategies have been investigated in order to prevent, minimize, or reverse enamel erosive lesions, among which topical fluoride application at high concentrations (e.g., dental varnishes) has been shown to be beneficial, despite a limited effect [4,5,16]. ...
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... Tooth loss is linked to suboptimal nutrient intake and increased risk of malnutrition [22] . Adults with an omnivorous diet have been observed to have an increased risk of periodontal problems and dental caries, while vegetarians/vegans may face an increased risk of dental erosion [23] . A study reveals that consumption of potato chips and cereal products increases dental caries, while dental erosion is associated with consumption of fruits, vegetables, meat, fish and alcoholic beverages. ...
... La perte tissulaire est potentialisée par l'interaction des composantes chimique et mécanique [16] : autrement dit, ED, abrasion, attrition et abfraction se conjuguent fréquemment. Ce phénomène n'est pas nouveau mais il est fort à parier que la démocratisation des régimes végétariens et végans soit dans un avenir proche responsables d'une augmentation marquée de ces lésions [17]. ...
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Cet article se propose de rappeler le contexte épidémiologique de l’ED puis de présenter les résultats d’une enquête par questionnaire inspirée d’un outil pédagogique développé par le Collège national des enseignants en odontologie conservatrice (CNEOC) en partenariat avec Colgate. Cette enquête a été menée auprès d’étudiants en chirurgie dentaire s’agissant de leur connaissance sur le sujet de l’ED et de leur propre exposition à ses facteurs de risque. Mots clefs : érosion, enquête par questionnaire, étudiants en chirurgie dentaire
... The inclusion of participants adhering to an all-inclusive dietary regimen was deemed crucial to consider potential oral health changes that may arise from the exclusion of specific food groups. For example, omnivores seem to be more prone to dental caries and eventual loss of all teeth, and they also have worse periodontal health indices when compared to vegans and vegetarians, who, in turn, are more predisposed to dental erosion due to the highly acidic nature of their nutrition [39]. Atarbashi-Moghadam and colleagues came to similar conclusions as they found that raw vegans had better periodontal health indices when compared to controls, but just like Azzola and colleagues, they emphasized that vegan participants often exhibited better oral hygiene practices and overall healthier lifestyle choices [40]. ...
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... Consuming a vegan diet was also linked to a higher risk of dental caries and a more significant number of decayed, missing, and filled teeth, possibly because these diets are deficient in vitamin B12. [23][24][25] Fi-Index Tool This manuscript has been checked with the Fi-index tool and obtained a score of 0 for the first author only on 17/03/2023, according to SCOPUS. 26,27 The fi-index tool aims to ensure the quality of the reference list and limit any auto-citations. ...
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Aim To determine the severity and distribution of occlusal tooth wear among young North Indian adults and to evaluate the correlation of occlusal tooth wear with bite force. Materials and Methods A total of 164 subjects were enrolled in the present study. Inclusion criteria included subjects with age range of 25-40 years having a full complement of natural dentition (excluding third molars), with no history of orthodontic treatment, FPD and trauma. Maxillary and mandibular casts of each subject were taken. Tooth wear score of anterior and posterior teeth of both the arches was calculated using a five-point (0 to 4) ordinal scoring system. The calculated tooth wear scores were then compared with data concerning age, sex, number of daily meals, vegetarian/non-vegetarian diet, Group function/Canine guided occlusion and bite force. Nonparametric (Mann-Whitney) test was used to determine the relationship between various factors and occlusal tooth wear. Spearman’s correlation coefficient was used to determine the correlation between tooth wear and bite force. Results After applying statistical analysis to the data collected, total tooth wear score of the whole sample was 30.07 ± 6.39. Anterior teeth had significantly higher wear score than posteriors (P < 0.01). Males showed significantly higher (P < 0.001) tooth wear in both arches factors such as bite force and age showed significant correlation with tooth wear (P=0.000), however, the number of meals taken per day did not show any significant correlation. Higher tooth wear loss was seen in non vegetarian dietary pattern but it was statistically insignificant. It was also found that Group function occlusion showed significantly higher mean tooth wear loss 45.76 ± 9.19 as compared to Canine guided occlusion 26.37 ± 10.68 (P=0.000).
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Little is known about the effect of long-term diet patterns on the composition and functional potential of the human salivary microbiota. In the present study, we sought to contribute to the ongoing elucidation of dietary effects on the oral microbial community by examining the diversity, composition and functional potential of the salivary microbiota in 160 healthy vegans and omnivores using 16S rRNA gene amplicon sequencing. We further sought to identify bacterial taxa in saliva associated with host inflammatory markers. We show that compositional differences in the salivary microbiota of vegans and omnivores is present at all taxonomic levels below phylum level and includes upper respiratory tract commensals (e.g. Neisseria subflava, Haemophilus parainfluenzae, and Rothia mucilaginosa) and species associated with periodontal disease (e.g. Campylobacter rectus and Porphyromonas endodontalis). Dietary intake of medium chain fatty acids, piscine mono- and polyunsaturated fatty acids, and dietary fibre was associated with bacterial diversity, community structure, as well as relative abundance of several species-level operational taxonomic units. Analysis of imputed genomic potential revealed several metabolic pathways differentially abundant in vegans and omnivores indicating possible effects of macro- and micro-nutrient intake. We also show that certain oral bacteria are associated with the systemic inflammatory state of the host.
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Background: There is a growing trend for vegetarian and vegan diets in many Western countries. Epidemiological evidence suggesting that such diets may help in maintaining good health is rising. However, dietary and sociodemographic characteristics of vegetarians and vegans are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of self-reported, adult vegetarians and vegans, compared to meat-eaters, from the French NutriNet-Santé study. Methods: Participants were asked if they were following a specific diet. They were then classified into three self-reported diet groups: 90,664 meat-eaters, 2370 vegetarians, and 789 vegans. Dietary data were collected using three repeated 24-h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex and age for micronutrients, as well as by type of self-reported diet. Results: Compared with meat-eaters, vegetarians were more likely to have a higher educational level, whereas vegans had a lower education level. Compared with meat-eaters, vegetarians were more likely to be women, younger individuals, and to be self-employed or never employed rather than managerial staff. Vegetarians and vegans substituted animal protein-dense products with a higher consumption of plant protein-dense products (e.g., soy-based products or legumes). Vegetarians had the most balanced diets in terms of macronutrients, but also had a better adherence to French dietary guidelines. Vegetarians exhibited a lower estimated prevalence of inadequacies for micronutrients such as antioxidant vitamins (e.g., for vitamin E, 28.9% for vegetarian women <55 years of age vs. 41.6% in meat-eaters) while vegans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men and 83.4% in women <55 years of age), compared to meat-eaters. Conclusions: Our study highlighted that, overall, self-reported vegetarians and vegans may meet nutritional recommendations.
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Tongue coating is the most common cause of oral halitosis and eating results in its reduction. Only limited data are available on the effect of different food items on tongue coating and halitosis. Therefore, the aim of this study was to investigate the effect of a single consumption of food with high fiber content versus low fiber content on halitosis parameters. Based on a randomized clinical cross-over study, 20 subjects were examined over a period of 2.5 hours after consumption of a high-fiber and a low-fiber meal. The determination of volatile sulfur compounds (VSC) was performed using a Halimeter, and the organoleptic assessment of halitosis was done on the basis of a distance index. The tongue coating was determined using a modified Winkel index, and the mouth sensation was evaluated subjectively by the subjects. In both the test and the control phase, a statistically significant reduction of all selected parameters was detected (p<0.05). Only for the organoleptic assessment of halitosis was a statistically significantly higher reduction found after consumption of a high-fiber meal compared to the control meal (p<0.05). In conclusion, the consumption of the meals in this study resulted in an at least 2.5-hour reduction of oral halitosis. The chewing-intensive (high-fiber) meal even resulted in a slightly higher reduction of oral halitosis in terms of organoleptic assessment (p<0.05).
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The prevalence of type 2 diabetes is rising worldwide, especially in older adults. Diet and lifestyle, particularly plant-based diets, are effective tools for type 2 diabetes prevention and management. Plant-based diets are eating patterns that emphasize legumes, whole grains, vegetables, fruits, nuts, and seeds and discourage most or all animal products. Cohort studies strongly support the role of plant-based diets, and food and nutrient components of plant-based diets, in reducing the risk of type 2 diabetes. Evidence from observational and interventional studies demonstrates the benefits of plant-based diets in treating type 2 diabetes and reducing key diabetes-related macrovascular and microvascular complications. Optimal macronutrient ratios for preventing and treating type 2 diabetes are controversial; the focus should instead be on eating patterns and actual foods. However, the evidence does suggest that the type and source of carbohydrate (unrefined versus refined), fats (monounsaturated and polyunsaturated versus saturated and trans), and protein (plant versus animal) play a major role in the prevention and management of type 2 diabetes. Multiple potential mechanisms underlie the benefits of a plant-based diet in ameliorating insulin resistance, including promotion of a healthy body weight, increases in fiber and phytonutrients, food-microbiome interactions, and decreases in saturated fat, advanced glycation endproducts, nitrosamines, and heme iron.
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The aim of this systematic review and meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups and risk of type 2 diabetes (T2D). We conducted a systematic search in PubMed, Embase, Medline (Ovid), Cochrane Central, and Google Scholar for prospective studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSB) on risk of T2D. Summary relative risks were estimated using a random effects model by contrasting categories, and for linear and non-linear dose–response relationships. Six out of the 12 food-groups showed a significant relation with risk of T2D, three of them a decrease of risk with increasing consumption (whole grains, fruits, and dairy), and three an increase of risk with increasing consumption (red meat, processed meat, and SSB) in the linear dose–response meta-analysis. There was evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains, and SSB and T2D risk. Optimal consumption of risk-decreasing foods resulted in a 42% reduction, and consumption of risk-increasing foods was associated with a threefold T2D risk, compared to non-consumption. The meta-evidence was graded “low” for legumes and nuts; “moderate” for refined grains, vegetables, fruit, eggs, dairy, and fish; and “high” for processed meat, red meat, whole grains, and SSB. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of T2D. Electronic supplementary material The online version of this article (doi:10.1007/s10654-017-0246-y) contains supplementary material, which is available to authorized users.
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Background: Beneficial effects of vegetarian and vegan diets on health outcomes have been supposed in previous studies. Objectives: Aim of this study was to clarify the association between vegetarian, vegan diets, risk factors for chronic diseases, risk of all-cause mortality, incidence and mortality from cardio-cerebrovascular diseases, total cancer and specific type of cancer (colorectal, breast, prostate and lung), through meta-analysis. Methods: A comprehensive search of Medline, EMBASE, Scopus, The Cochrane Library and Google Scholar was conducted. Results: Eighty-six cross-sectional and 10 cohort prospective studies were included. The overall analysis among cross-sectional studies reported significant reduced levels of body mass index, total cholesterol, LDL-cholesterol, and glucose levels in vegetarians and vegans versus omnivores. With regard to prospective cohort studies, the analysis showed a significant reduced risk of incidence and/or mortality from ischemic heart disease (RR 0.75; 95% CI, 0.68 to 0.82) and incidence of total cancer (RR 0.92; 95% CI 0.87 to 0.98) but not of total cardiovascular and cerebrovascular diseases, all-cause mortality and mortality from cancer. No significant association was evidenced when specific types of cancer were analyzed. The analysis conducted among vegans reported significant association with the risk of incidence from total cancer (RR 0.85; 95% CI, 0.75 to 0.95), despite obtained only in a limited number of studies. Conclusions: This comprehensive meta-analysis reports a significant protective effect of a vegetarian diet versus the incidence and/or mortality from ischemic heart disease (-25%) and incidence from total cancer (-8%). Vegan diet conferred a significant reduced risk (-15%) of incidence from total cancer.
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The presence of hormones in milk and dairy foods was discussed decades ago but rather more concerns attended to that with respect to finding hormones as biomarkers in milk for diseases and pregnancy diagnosis. Moreover, considerable amount of studies demonstrated that existing of hormones in humans and animals milk are essential for infants growing and immunity. During the last couple of years, increasing body of evidence are indicating another property of hormones in dairy products as possible impact on human health including the role of some estrogens and insulin-like growth factor-1 in initiation and provoking of breast, prostate and endometrial tumours. Data was gathered from the published articles in database such as MEDLINE, science direct, Google scholar and web of science. We put no limitation on date of published date. Moreover, our own published and conducted methods and results also are presented. In this review we concentrated on several aspects of presence of hormones in dairy foods with especial emphasize on cow's milk as a major source of consuming milk for humans especially for children. The collected data from other researchers and our own data are indicating that the presence of steroid hormones in dairy products could be counted as an important risk factor for various cancers in humans. Our gathered data in this review paper may suggest more sophisticate analytical detection methods for oestrogens determination and also could be considered as a remarkable concern for consumers, producers and public health authorities.
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The salivary microbiota has been linked to both oral and non-oral diseases. Scant knowledge is available on the effect of environmental factors such as long-term dietary choices on the salivary microbiota and metabolome. This study analyzed the microbial diversity and metabolomic profiles of the saliva of 161 healthy individuals who followed an omnivore or ovo-lacto-vegetarian or vegan diet. A large core microbiota was identified, including 12 bacterial genera, found in >98% of the individuals. The subjects could be stratified into three "salivary types" that differed on the basis of the relative abundance of the core genera Prevotella, Streptococcus/Gemella and Fusobacterium/Neisseria. Statistical analysis indicated no effect of dietary habit on the salivary microbiota. Phylogenetic beta-diversity analysis consistently showed no differences between omnivore, ovo-lacto-vegetarian and vegan individuals. Metabolomic profiling of saliva using 1H-NMR and GC-MS/SPME identified diet-related biomarkers that enabled a significant discrimination between the 3 groups of individuals on the basis of their diet. Formate, urea, uridine and 5-methyl-3-hexanone could discriminate samples from omnivores, whereas 1-propanol, hexanoic acid and proline were characteristic of non-omnivore diets. Although the salivary metabolome can be discriminating for diet, the microbiota has a remarkable inter-individual stability and did not vary with dietary habits. Microbial homeostasis might be perturbed with sub-standard oral hygiene or other environmental factors, but there is no current indication that a choice of an omnivore, ovo-lacto-vegetarian or vegan diet can lead to a specific composition of the oral microbiota with consequences on the oral homeostasis.
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Vegetarian dietary patterns have been reported to be associated with a number of favourable health outcomes in epidemiological studies, including the Adventist Health Study 2 (AHS-2). Such dietary patterns may vary and need further characterisation regarding foods consumed. The aims of the present study were to characterise and compare the food consumption patterns of several vegetarian and non-vegetarian diets. Dietary intake was measured using an FFQ among more than 89 000 members of the AHS-2 cohort. Vegetarian dietary patterns were defined a priori, based on the absence of certain animal foods in the diet. Foods were categorised into fifty-eight minor food groups comprising seventeen major food groups. The adjusted mean consumption of each food group for the vegetarian dietary patterns was compared with that for the non-vegetarian dietary pattern. Mean consumption was found to differ significantly across the dietary patterns for all food groups. Increased consumption of many plant foods including fruits, vegetables, avocados, non-fried potatoes, whole grains, legumes, soya foods, nuts and seeds was observed among vegetarians. Conversely, reduced consumption of meats, dairy products, eggs, refined grains, added fats, sweets, snack foods and non-water beverages was observed among vegetarians. Thus, although vegetarian dietary patterns in the AHS-2 have been defined based on the absence of animal foods in the diet, they differ greatly with respect to the consumption of many other food groups. These differences in food consumption patterns may be important in helping to explain the association of vegetarian diets with several important health outcomes.
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Aim: The aim of this paper was to investigate the effects of fluorotherapy on the oral health of subjects who had been following a vegan diet (lacking in meat and animal derivatives) for a long period of time (at least 1 year and 6 months). Methods: A preliminary study (t0) evaluated 50 subjects, all from northern Italy and aged 24-60 years (28 male and 22 female) who had been following a vegan diet for a minimum of 18 months to a maximum of 20 years, and compared them with a control group of 50 individuals following a Mediterranean diet. All vegan subjects showed oral changes such as white spots, lesions invisible to the naked eye and decreased salivary pH values (~5-6). In a second study (t1), the 50 vegan subjects were randomly divided into two subgroups of 25. Subgroup SG1 underwent fluorotherapy with sodium fluoride (Elmex fluoride gel® 1.25%) administered once daily for 1 year. Subgroup SG2 served as controls and did not receive fluorotherapy. The following parameters were recorded before the start of fluorotherapy and again after 1 year: salivary pH; Decayed, Missing, Filled teeth Index; presence and location of white spots and lesions not visible to the naked eye; Plaque Index, and Gingival Index. Results: In SG1, larger lesions became smaller in diameter and small lesions disappeared, a statistically significant improvement compared with SG2, despite the persistence of restricted eating habits and the oral hygiene conditions being similar to those at t0. Salivary pH showed no significant change in either subgroup. Conclusion: Daily application of a topical 1.25% fluoride gel is effective in reducing the incidence of white spot lesions caused by a vegan diet.
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Background and objective The bacterial profile of saliva is composed of bacteria from different oral surfaces. The objective of this study was to determine whether different diet intake, lifestyle, or socioeconomic status is associated with characteristic bacterial saliva profiles. Design Stimulated saliva samples from 292 participants with low levels of dental caries and periodontitis, enrolled in the Danish Health Examination Survey (DANHES), were analyzed for the presence of approximately 300 bacterial species by means of the Human Oral Microbe Identification Microarray (HOMIM). Using presence and levels (mean HOMIM-value) of bacterial probes as endpoints, the influence of diet intake, lifestyle, and socioeconomic status on the bacterial saliva profile was analyzed by Mann–Whitney tests with Benjamini–Hochberg's correction for multiple comparisons and principal component analysis. Results Targets for 131 different probes were identified in 292 samples, with Streptococcus and Veillonella being the most predominant genera identified. Two bacterial taxa (Streptococcus sobrinus and Eubacterium [11][G-3] brachy) were more associated with smokers than non-smokers (adjusted p-value<0.01). Stratification of the group based on extreme ends of the parameters age, gender, alcohol consumption, body mass index (BMI), and diet intake had no statistical influence on the composition of the bacterial profile of saliva. Conversely, differences in socioeconomic status were reflected by the bacterial profiles of saliva. Conclusions The bacterial profile of saliva seems independent of diet intake, but influenced by smoking and maybe socioeconomic status.
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Periodontal disease (perio‐dz) affects 40% of adult US women; prevalence increases sharply with age. Risk factors include smoking, SES, diabetes, overweight/obesity, hormones. Diet also may influence perio‐dz. A National Health and Nutrition Examination Survey III analysis showed that a good compared to poor quality diet assessed by Healthy Eating Index 2005 (HEI), resulted in lower odds of perio‐dz in adults (OR 0.40; 95% CI 0.19,0.85). Here we examine the association of diet quality (HEI) and perio‐dz in 74,222 postmenopausal women ages 50–79 years at baseline during WHI‐enrollment from 1994–98. Logistic regression analysis of cross‐sectional data was used to assess the association of self‐reported diet (HEI computed from food frequency questionnaire) with perio‐dz (ever told by dentist). Higher diet quality (higher HEI score) was associated with lower odds of perio‐dz. Data were limited to cross‐sectional analysis and causal direction may not be inferred. Diet Quality Score: Healthy Eating Index OR 1 (95% CI) P trend <51 Poor (reference) 1.00 0.001 51–80 Needs Improvement 0.88 (0.81, 0.95) >;80 Good 0.84 (0.77, 0.92) Adjusted for demographics (age, race/ethnicity, income, education), health behaviors (smoking, physical activity, BMI, waist circumference, sunlight exposure, hormone therapy use, dental visits), chronic diseases. Source of research support: National Heart Lung and Blood Institute
Article
Introduction: Plant-based diets are associated with a lower: (i) body mass index, (ii) rates of death from ischemic heart disease, (iii) serum cholesterol, (iv) incidence of high blood pressure, (v) type II diabetes mellitus and cancer, with an overall longer life expectancy. However, little data concerning the oral health in individuals on a plant-based diet are available. Aim: The aim of the present study was to investigate the general and clinical oral health status in a cohort of adults who had been following a plant-based diet for a minimum of 24 months. Material and methods: For this purpose, individuals were administered two questionnaires (a.Questionnaire investigating risk areas for oral diseases; b. Italian version of the Oral Health Impact Profile -14 (IOHIP-14)) by a dental hygienist and clinical examination of the oral cavity was carried out. Results: Seventy-seven adult individuals were enrolled. On average, they followed a plant-based diet for the last four years, had four meals a day and brushed their teeth twice a day. Fruit was the most frequently consumed food at breakfast by 48 of the participants. Thirty-four responders did not drink beer or wine, 65 did not drink spirits, 57 avoided carbonated beverages and 62 (80.5%) did not consume any highly-sugared beverages. Different dental therapies in the previous three years were reported in 36 of the responders. Overall, answers "never and almost never" to the IOHIP-14 questionnaire were observed in 87% to 100% of the individuals. Multiple logistic regression analysis revealed that fresh fruit consumption at lunch had a protective effect against caries (p<0.05). Conclusions: In conclusion, this study showed that individuals on a plant-based diet have good overall oral health conditions. These features are in agreement with the behavior of these subjects towards an overall healthy life style.
Article
Purpose of review: Plant-based diets have been used with growing popularity for the treatment of a wide range of lifestyle-related diseases, including diabetes, hypertension, and obesity. With the reinvigoration of the conservative and dietary management of chronic kidney disease (CKD) and the use of low protein diets for secondary prevention of CKD to delay or prevent dialysis therapy, there is an increasing interest in the potential role of plant-based diets for these patients. Recent findings: Recently, a body of evidence related to the role of plant-based diet in preventing CKD has reemerged. Several observational studies have shown that red and processed meat have been associated with increased risk of CKD as well as faster progressing in those with preexisting CKD. In several substitution analyses, replacement of one serving of red and/or processed meat has been linked with sizable reductions in CKD risk as primary prevention. Although limited, experimental trials for the treatment of metabolic acidosis in CKD with fruits and vegetables show outcomes comparable to oral bicarbonate. The use of plant-based diets in CKD may have other benefits in the areas of hypertension, weight, hyperphosphatemia, reductions in hyperfiltration, and, possibly, mortality. The risk of potassium overload from plant-based diets appears overstated, mostly opinion-based, and not supported the evidence. Plant-based diets are generally well tolerated and provide adequate protein intake, including essential amino acids as long as the is correctly implemented. Summary: Plant-based diets should be recommended for both primary and secondary prevention of CKD. Concerns of hyperkalemia and protein inadequacy related to plant-based diets may be outdated and unsupported by the current body of literature. Healthcare providers in general medicine and nephrology can consider plant-based diets as an important tool for prevention and management of CKD.
Article
Aim Aim of this study was to investigate the influence of an anti‐inflammatory diet on different parameters in patients with gingivitis. Materials and Methods Thirty patients were randomly allocated to an experimental and a control group stratified by their plaque values. The experimental group had to change to a diet low in processed carbohydrates and animal proteins, and rich in omega‐3 fatty acids, vitamin C, vitamin D, antioxidants, plant nitrates and fibres for 4 weeks. The control group did not change their diet. Both groups suspended interdental cleaning. Periodontal parameters were assessed by a blinded dentist. Serological and subgingival plaque samples were taken at baseline and end. Results While there were no differences regarding the plaque values, the experimental group showed a significant reduction in gingival bleeding (GI Baseline: 1.04 ± 0.21, GI End: 0.61 ± 0.29, p < 0.05), a significant increase in Vitamin D values and a significant weight loss. There were no inter‐group differences regarding the inflammatory serological parameters, the serological omega fatty acids, nor the subgingival microbiome composition. Conclusion The evaluated diet could significantly reduce gingivitis in a clinically relevant range, while serological inflammatory parameters and the subgingival microbiome seem to be unaffected in this study duration. (German Clinical Trials Register; DRKS00009888).
Article
1 Background Authors were assigned the task to develop case definitions for periodontitis in the context of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. The aim of this manuscript is to review evidence and rationale for a revision of the current classification, to provide a framework for case definition that fully implicates state‐of‐the‐art knowledge and can be adapted as new evidence emerges, and to suggest a case definition system that can be implemented in clinical practice, research and epidemiologic surveillance. 2 Methods Evidence gathered in four commissioned reviews was analyzed and interpreted with special emphasis to changes with regards to the understanding available prior to the 1999 classification. Authors analyzed case definition systems employed for a variety of chronic diseases and identified key criteria for a classification/case definition of periodontitis. 3 Results The manuscript discusses the merits of a periodontitis case definition system based on Staging and Grading and proposes a case definition framework. Stage I to IV of periodontitis is defined based on severity (primarily periodontal breakdown with reference to root length and periodontitis‐associated tooth loss), complexity of management (pocket depth, infrabony defects, furcation involvement, tooth hypermobility, masticatory dysfunction) and additionally described as extent (localized or generalized). Grade of periodontitis is estimated with direct or indirect evidence of progression rate in three categories: slow, moderate and rapid progression (Grade A‐C). Risk factor analysis is used as grade modifier. 4 Conclusions The paper describes a simple matrix based on stage and grade to appropriately define periodontitis in an individual patient. The proposed case definition extends beyond description based on severity to include characterization of biological features of the disease and represents a first step towards adoption of precision medicine concepts to the management of periodontitis. It also provides the necessary framework for introduction of biomarkers in diagnosis and prognosis.
Article
Purpose: Evidence exists which suggests that a vegetarian diet is a predisposing factor to erosive tooth wear. The aim of this study was to assess the influence of dietary pattern (vegetarian, lacto-ovo vegetarian and omnivore) on erosive tooth wear. Materials and methods: Two hundred seven subjects (29 vegetarians, 96 lacto-ovo vegetarians and 82 omnivores) underwent an oral assessment and were asked to answer questionnaires about diet and oral care. Results: Individuals who followed vegetarian and lacto-ovo vegetarian diets had statistically significantly more erosive tooth wear than did omnivores (p = 0.004). Conversely, omnivores presented more tooth loss than did lacto-ovo vegetarians (p = 0.027). Being a vegetarian or a lacto-ovo vegetarian entailed an increased risk (4 times and 2.5 times, respectively) of presenting erosive tooth wear than being omnivorous. Conclusion: Vegetarian and lacto-ovo vegetarian dietary patterns seem to favour the loss of dental structure by erosion. Vegetarian patients should thus be informed about preventive measures and treated accordingly.
Article
Erosion is a common phenomenon in the general population of developed countries. However, due to variations in indices, sample sizes and general study designs, it is difficult to compare the various studies and to estimate actual global prevalence. Therefore, the aim of this present paper is to give a narrative overview on the data available on the global prevalence of erosion. Information on prevalence is not available from each country; in particular, data from Asia, Africa, South America, North America and large parts of South-Eastern Europe are unavailable. There is a large variation in global prevalence ranging between 0 and 100%. Calculating a rough mean from the data available, a mean prevalence in deciduous teeth between 30% and 50% and in permanent teeth between 20% and 45% can be estimated. There seems to be a gender difference and an increase in prevalence with age. Prevalence studies on erosion risk groups show comparable variation. Only in patients with gastro-oesophageal reflux disease (GORD) and eating disorders associated with vomiting can a clear impact on erosion prevalence be found. In people who consume acidic foods and drinks, a higher risk can be found for some specific comestibles. However, there is a lack of controlled epidemiological studies, making it difficult to generalise. There is a clear need for well-designed studies on this issue.
Article
Objective Vegetarian diets contain various anti-inflammatory components. We aimed to investigate the effects of vegetarianism on inflammatory biomarkers when compared with omnivores. Design Systematic review and meta-analysis. Setting Literature search was conducted in Science Direct, Proquest, MEDLINE and Google Scholar up to June 2016. Summary estimates and corresponding 95 % CI were derived via the DerSimonian and Laird method using random effects, subgroup analyses were run to find the source of heterogeneity and a fixed-effect model examined between-subgroup heterogeneity. Subjects Studies were included if they evaluated effects of any type of vegetarianism compared with omnivores on circulating levels of inflammatory biomarkers. No restriction was made in terms of language or the date of study publications. Results Eighteen articles were included. Pooled effect size showed no difference in high-sensitivity C-reactive protein (hs-CRP) levels in vegetarians v. omnivores (Hedges’ g=−0·15; 95 % CI −0·35, 0·05), with high heterogeneity (I 2=75·6 %, Pv. omnivores (Hedges’ g=−0·29; 95 % CI −0·59, 0·01), with moderate heterogeneity (I 2=68·9 %, PI 2=0·0 %, P=0·60). Conclusions The meta-analysis provides evidence that vegetarianism is associated with lower serum concentrations of hs-CRP when individuals follow a vegetarian diet for at least 2 years. Further research is necessary to draw appropriate conclusions regarding potential associations between vegetarianism and IL-6 levels. A vegetarian diet might be a useful approach to manage inflammaging in the long term.
Article
Diet and culture plays a huge part in the heath of our patients, so how best to meet their specific needs in the chair
Article
Caries and erosion are common diseases of the dental hard tissues. The influence of vegetarianism on the development of caries and erosion has scarcely been investigated in the past. The aim of the present study was to evaluate the influence of fruit consumption and topical fluoride application on the prevalence of caries and erosion in vegetarians. In 100 vegetarians and 100 nonvegetarians, a dental examination was performed. The indices for decayed, missing, filled teeth (DMFT) and surfaces (DMFS) were determined. DMFT and DMFS were subdivided into decayed teeth (DT), filled teeth (FT), decayed surfaces (DS) and filled surfaces (FS). In addition, the hygiene index and the number of teeth with dental erosion (DE), root caries (RC) and overhanging restoration margins (ORM) were recorded. A questionnaire assessed patients' eating habits, frequency of oral hygiene, dentist visits and topical fluoride application. For statistical analysis, unpaired t-test, Mann-Whitney test and Pearson's chi-square test were applied. Vegetarians had significantly more DT (P<0.001), DS (P<0.001), more teeth with DE (P=0.026), RC (P=0.002) and ORM (P<0.001) than nonvegetarians. Daily consumption of fruits was significantly more prevalent (P<0.001), and topical fluoride application was less prevalent (P<0.001) in vegetarians compared with nonvegetarians. In particular, fluoride-containing toothpaste (P<0.001) and table salt (P=0.039) were less frequently used in vegetarians. The presented data suggest that vegetarians have an increased risk for caries and erosion. Topical fluoride application was shown to be effective in preventing caries, but not in preventing erosion.European Journal of Clinical Nutrition advance online publication, 18 March 2015; doi:10.1038/ejcn.2015.20.
Article
The analysis of published epidemiological data on colon and breast cancer reveals a remarkable concordance for most regions of the world. A low incidence for both cancers has been recorded in Mongolia and Bolivia. Discrepant data, however, have been reported for India, Japan and Korea. In India the incidence of breast cancer is significantly higher than for colon cancer, in Japan and Korea colon cancer exceeds by far the rate of breast cancer. Here studies are summarized pointing to a species-specific risk for colon cancer after consumption of beef originating from dairy cattle. Uptake of dairy products of Bos taurus-derived milk cattle, particularly consumed at early age, is suggested to represent one of the main risk factors for the development of breast cancer. A recent demonstration of reduced breast cancer rates in individuals with lactose intolerance (1) seems to be in line with this interpretation. Species-specific risk factors for these cancers are compatible with the transmission of different infectious factors transferred via meat or dairy products. Countries with discordant rates of colon and breast cancer reveal a similar discordance between meat and milk product consumption of dairy cattle. The recent isolation of a larger number of novel presumably viral DNAs from serum, meat, and dairy products of healthy dairy cows, at least part of them infectious for human cells, deserves further investigation. Systemic infections early in life, resulting in latency and prevention of subsequent infections with the same agent by neutralizing antibodies, would require reconsideration of ongoing prospective studies conducted in the adult population. This article is protected by copyright. All rights reserved. © 2015 UICC.
Article
Early human food cultures were plant-based. Major religions such as Hinduism and Buddhism have recommended a vegetarian way of life since their conception. The recorded history of vegetarian nutrition started in the sixth century bc by followers of the Orphic mysteries. The Greek philosopher Pythagoras is considered the father of ethical vegetarianism. The Pythagorean way of life was followed by a number of important personalities and influenced vegetarian nutrition until the 19th century. In Europe, vegetarian nutrition more or less disappeared during the Middle Ages. In the Renaissance era and in the Age of Enlightenment, various personalities practiced vegetarianism. The first vegetarian society was started in England in 1847. The International Vegetarian Society was founded in 1908 and the first vegan society began in 1944. Prominent vegetarians during this time included Sylvester Graham, John Harvey Kellogg, and Maximilian Bircher-Benner. A paradigm shift occurred at the turn of the 21st century. The former prejudices that vegetarianism leads to malnutrition were replaced by scientific evidence showing that vegetarian nutrition reduces the risk of most contemporary diseases. Today, vegetarian nutrition has a growing international following and is increasingly accepted. The main reasons for this trend are health concerns and ethical, ecologic, and social issues. The future of vegetarian nutrition is promising because sustainable nutrition is crucial for the well-being of humankind. An increasing number of people do not want animals to suffer nor do they want climate change; they want to avoid preventable diseases and to secure a livable future for generations to come.
Article
In 2007 the World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) report judged that the evidence for an association between red and processed meat consumption and colorectal cancer was convincing. In addition, the effect of other animal products on cancer risk has been studied, and the WCRF/AICR report concluded that milk probably decreases the risk of colorectal cancer but diets high in calcium probably increase the risk of prostate cancer, whereas there was limited evidence for an association between milk and bladder cancer and insufficient evidence for other cancers. There are several potential mechanisms relating meat to cancer, including heterocyclic amines, polycyclic aromatic hydrocarbons, N-nitroso compounds, and heme iron. Although the evidence in favor of a link between red and processed meat and colorectal cancer is convincing, the relations with other cancers are unclear. In this review, we summarize cohort studies conducted by the National Cancer Institute on meat and dairy intake in relation to cancer since the 2007 WCRF/AICR report. We also report the findings of meta-analyses published since 2007.
Article
Aim: The aim of this study is to investigate the effect various dietary nutrients in aggressive periodontitis patients. Materials and methods: A total of 85 patients were selected and divided into two groups, 45 patients are with aggressive periodontitis and 40 patients are healthy. Periodontal parameters such as oral hygiene index, Russels periodontal index and radiograph were taken. The food consumption survey was conducted in all the households of subjects both in control and experimental group. The individual of food intake of the subjects was assessed by the oral questionnaire (24 hours recall) method. The quantity of raw foods used for various preparations and volumes of cooked quantities of such preparations in terms of standardized cups were noted. Body measurements were taken on all the subjects, standing height using a height measuring rod and weight in standard weighing machine. Results: Aggressive periodontitis is seen in young individual and mostly in females; majority of the patients of both groups belongs to low socioeconomic group. Body mass index which is a refection of nutritional status of an individual indicated that chronically energy defcient subjects in experimental group appeared to be higher. The average food and nutrient intake in control group was slightly better than that of experimental group. Conclusion: The diet survey indicated marginal and negligible defciencies in aggressive periodontitis patients compared to controls, and this coupled with chronically energy defciency as indicated by body mass index, calls for a detailed study of this aspect of aggressive periodontitis. The present study indicates that nutritional infuences point to a needle of suspicion toward the etiology of aggressive periodontitis.