Effects of fruit and vegetables intake in periodontal diseases: A systematic review

Abstract

Periodontal diseases affect up to 90% of the population worldwide. Deficiencies in vitamins, minerals and polyphenolic compounds, whose main sources are fruit and vegetables (F&V), may predispose to these diseases. The PICO (Patient, Intervention of interest, Comparison or Control Intervention, and Outcome) question was: What is the effect of F&V intake on the outcomes of periodontal diseases, observed in either experimental or observational studies of human populations suffering from periodontitis or gingivitis, compared to controls without intervention or healthy people. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol for search strategy, selection criteria and data extraction. The searched databases included MEDLINE (PubMed), Scopus and Google Scholar. A total of 181 potentially relevant articles were identified, which were then evaluated according to pre-specified criteria relating to relevance and quality. Finally, 15 articles were selected for review. Four articles described intervention studies, 3 reported on prospective and retrospective cohort studies, and 8 concerned cross-sectional studies. A total of 10,604 people aged 15-90 years took part in the studies. On the basis of the research it can be concluded that the consumption of at least 5 servings of F&V per day may prevent the progression of periodontal diseases, especially periodontitis, and even tooth loss. Moreover, incorporation of specific F&V into the diet or, alternatively, their lyophilized forms, and nutritional education activities seem to support the standard of care therapy of gingivitis and periodontitis. However, further observational and well-designed experimental studies, with homogeneous periodontal status outcomes, are needed to confirm these findings. Furthermore, professional dietetics care for periodontal patients should become an integral component of the healthcare program.

Poor diet predicts periodontal disease development in 11‐year follow‐up study

“…The main finding of this study was that a poor‐quality diet was associated with periodontal pocket formation during the 11‐year follow‐up period. This is in line with earlier studies where the progression of disease has been examined in relation to food groups or a combination of nutrients either alone or combined with periodontal treatment . For example, in a study performed among 70‐year‐old people, dark green and yellow vegetables were inversely associated and cereals, nuts and seeds, sugar, sweeteners and confectioneries were positively associated with periodontal disease events during a 6‐year follow‐up.…”

“…This is in line with earlier studies where the progression of disease has been examined in relation to food groups or a combination of nutrients either alone or combined with periodontal treatment. 29 For example, in a study performed among 70-year-old people, 30 dark green and yellow vegetables were inversely associated and cereals, nuts and seeds, sugar, sweeteners and confectioneries were positively associated with periodontal disease events during a 6-year follow-up. In another study, 31 the consumption of fruits and vegetables and the intake of β-carotene, vitamin C, α-tocopherol, eicosapentaenoic acid and docosahexaenoic acid were associated with enhanced periodontal healing after scaling and root planing in a group of 34-to 90-year-old nonsmokers with chronic periodontitis.…”

A Mediterranean Diet Intervention Reduces the Levels of Salivary Periodontopathogenic Bacteria in Overweight and Obese Subjects

“…Besides polyphenols, other phytochemicals, including vitamin C (ascorbic acid), vitamin E (␣-tocopherol), vitamin A, ␤-carotene, and coenzyme Q-10, and minerals provided by fruits, vegetables, nuts, and whole grains in the MD are effective for maintaining periodontal homeostasis (50)(51)(52)(53). Indeed, Skoczek-Rubiń ska and colleagues (54) found that the consumption of at least 5 servings of fruits and vegetables per day may prevent the progression of periodontal diseases. Accordingly, in our intervention, species-level OTUs annotated as periodontopathogenic bacteria were found to be anticorrelated with dietary fiber intake and to the Mediterranean diet adherence score.…”

Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review

“…Periodontitis patients need continuous professional care including behavioural support to reduce the harmful impact of both aetiological causes and risk factors. Current evidence from clinical studies reveal that smoking cessation (Leite et al, 2018), diabetes control (Botero, Rodriguez, & Agudelo-Suarez, 2016; Kapellas et al, 2017), increase in physical activity (Ferreira et al, 2019), dietary adjustments (Skoczek-Rubinska, Bajerska, & Menclewicz, 2018;Van der Velden, Kuzmanova, & Chapple, 2011) and weight loss (Weyant et al, 2004) improve periodontal health and the patients' quality of life. Therefore, periodontal care providers have a key role to play in supporting their patients' health behaviour and thus face the challenge to adopt interventions for the promotion of health behaviour change specifically through interventions for smoking cessation, diabetes control, increase in physical exercise (activity), change of diet, carbohydrate (dietary sugar) reduction or weight loss.…”