Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis

Abstract

The lack of access to a balanced diet, rich in vitamins and minerals, can predispose people to inflammatory diseases such as obesity, diabetes mellitus, and periodontitis. We aimed to evaluate the relationship between micronutrient intake, sociodemographic behavioral characteristics, and periodontal health in adults assisted by a public health care system. Participants (n = 450) answered a food frequency questionnaire and were submitted to anthropometric and oral clinical examinations. Principal component analysis was used to summarize the number of components emerging from 17-micronutrient intake. Subsequently, cluster analysis was employed. The prevalence of at least one periodontal pocket ≥ 4 mm was 67.4%. Three clusters were identified according to periodontal status. Cluster 1 “poor periodontal status” was characterized by older individuals (n = 202; 85% females) with poor periodontal status, lower education level, mainly smokers with non-transmissible chronic diseases (NTCD), with lower energy, omega-3, fiber, Zn, K, Cu, and vitamin C intake. Cluster 3 “healthy periodontal status” included younger individuals (n = 54) with the healthiest periodontal status, a higher education level, without NTCD, and with higher energy, omega-3, fiber, Zn, calcium, retinol, and riboflavin intake. Cluster 2 was labeled as “intermediate periodontal status”. Micronutrient ingestion was associated with periodontal status and may be considered in health promotion actions for low-income populations.

Association between Chronotype and Nutritional, Clinical and Sociobehavioral Characteristics of Adults Assisted by a Public Health Care System in Brazil

“…The dietary record was evaluated for the intake of the following nutrients as described previously [ 40 ]: omega-3, omega-6, fiber, calcium (Ca), magnesium (Mg), manganese (Mn), phosphorus (P), iron (Fe), sodium (Na), potassium (K), copper (Cu), zinc (Zn), vitamin A (retinol), thiamine, riboflavin, pyridoxine, niacin and vitamin C. In addition to these, the intake of macronutrients such as carbohydrates, proteins and lipids was quantified and associated with the respective energy content. For the estimation of dietary consumption of nutrients, we used a conversion table (TACO table) [ 41 ].…”

“…The sociodemographic and clinical characteristics evaluated were age, sex, educational level, income, physical activity frequency, smoking, consumption of alcoholic beverages and the presence of CNCDs (diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia, hypothyroidism, liver steatosis, cardiopathy, cancer history, depression). Some of these variables were dichotomized, namely educational level ≥8 years of study, smoking yes or no and family income up to two minimum wages or higher (approximately USD 500) [ 40 ] ( Figure 1 ).…”

“…In order to summarize the number of nutritional variables, principal component analysis was used to estimate the number of components emerging from the intake of the following micronutrients: omega-6, omega-3, fiber, calcium, magnesium, manganese, phosphorus, iron, sodium, potassium, copper, zinc, retinol, thiamine, riboflavin, pyridoxine, niacin and vitamin C [ 40 ]. First, the correlation matrix of the standardized variables was examined, and the number of components to retain was based on eigenvalues, total of explained variance and scree plot examination.…”

“…As the variables showed moderate correlations, the oblimin rotation was performed. The overall Kaiser–Meyer–Olkin (KMO) measure and Bartlett’s test of sphericity were examined as assumptions of the test [ 40 ].…”

Prevalence, extent, and severity of periodontitis among Australian older adults: Comparison of two generations

“…These include genetic 10 and epigenetic influences, 11 medication use 12 and/or environmental factors, 13 which together promote periodontal disease initiation and progression. Low socioeconomic status, poor oral hygiene, and oral health related behaviors, psychological stress, and/or depression, increased age, ethnicity, diet/obesity, and systemic health comorbidities are risk factors that contribute to the prevalence of periodontal diseases 14,15 . Large epidemiological studies have shown a relationship between periodontal disease and some systemic conditions.…”