Association between an Anti-Inflammatory Dietary Score and Periodontitis—Evidence from the Population-Based Hamburg City Health Study

Abstract

While the effects of dietary patterns on cardiovascular risk and diabetes have been well studied, the evidence is scarce as to which diet has the greatest anti-inflammatory potential and how dietary patterns are associated with periodontitis. In the Hamburg City Health Study (HCHS), we developed an anti-inflammatory dietary score using a data-driven approach based on the relationship of relevant selected food groups with inflammatory biomarkers (hsCRP and IL-6). The aim of this cross-sectional study was to evaluate the association between the anti-inflammatory dietary score and the incidence of periodontitis in Hamburg, Germany. A total of n = 5642 participants fit the required inclusion criteria and were selected for analysis. Periodontal disease was assessed using probing depth, gingival recession, and bleeding on probing. Dietary intake was measured using a food frequency questionnaire (FFQ). A self-developed anti-inflammatory dietary score served as the key explanatory variable. Higher scores reflected lower inflammatory processes (measured through the biomarkers hsCRP and IL-6). Several covariates were included in the regression analysis. Regressions revealed that a higher anti-inflammatory dietary score was significantly associated with lower odds to be affected by periodontal disease in an unadjusted model (OR 0.86, 95% CI 0.82–0.89, p < 0.001) and in an adjusted model (age, sex, smoking, diabetes, hypertension, and physical activity) (OR 0.93, 95% CI 0.89–0.98, p = 0.003). Our study demonstrated a significant inverse association between an anti-inflammatory dietary score and periodontitis. Individuals with higher intake of proinflammatory nutrition should be specifically addressed to avoid periodontitis.

Empirically derived dietary patterns in relation to periodontitis and number of teeth among Norwegian adults

“…We have previously shown that periodontitis was associated with cardiovascular risk and higher C-reactive protein concentrations ( 41 ) . Owing to the relation between diet and chronic inflammation, several studies reported associations between Dietary Inflammatory Index and periodontitis ( 6 , 7 , 11 ) and more lost teeth ( 17 ) .…”

“…Recently, several studies have attempted to assess the relationship between overall diet and periodontitis ( 5 – 11 ) . Most studies have used hypothesis-driven dietary patterns based on a priori indices, such as indices derived using intake of foods and nutrients correlated with inflammatory biomarkers, e.g.…”

“…Most studies have used hypothesis-driven dietary patterns based on a priori indices, such as indices derived using intake of foods and nutrients correlated with inflammatory biomarkers, e.g. the Dietary Inflammatory Index (mainly nutrient-based) ( 6 , 7 ) and anti-inflammatory dietary score (based on nine food groups) ( 11 ) , as well as indices that measure adherence to established evidence-based dietary patterns for chronic disease prevention, e.g. the Dietary Approaches to Stop Hypertension and the Mediterranean Diet Score ( 9 , 12 ) , plant-based diet indices ( 13 ) and food groups according to the degree of processing ( 14 ) .…”

“…the Dietary Approaches to Stop Hypertension and the Mediterranean Diet Score ( 9 , 12 ) , plant-based diet indices ( 13 ) and food groups according to the degree of processing ( 14 ) . Most studies of a priori indices reported lower adherence to the anti-inflammatory/healthier diet in individuals with periodontitis ( 6 , 7 , 9 , 11 , 13 , 14 ) . However, hypothesis-driven approaches neither reflect overall dietary patterns nor consider the correlated structure of the dietary components and nutrients ( 15 ) .…”

The underlying relationship between exercise and the prevalence of periodontitis: a systematic review and meta-analysis

“…Substantial evidence suggests that interventions targeting lifestyle behaviors are effective, underscoring the importance of behavioral support in managing periodontitis [ 12 ]. Significant factors such as diet and smoking have been thoroughly investigated regarding their role in the risk of periodontal tissue decay [ 13 , 14 ]. Nevertheless, there is limited research on the potential role of exercise in preventing periodontitis.…”