Probiotics-containing beverages and dental caries: A systematic review and meta-analysis.

The aim was to evaluate the effect of probiotics-containing beverages on dental caries development by a systematic review and meta-analysis (PROSPERO CRD42021258010). PubMed, Embase, and Web of Science databases were assessed (up to October 2023) for randomized placebo-controlled trials that evaluated the consumption of probiotics-containing beverages having dental caries as endpoint. Risk of bias assessment (Cochrane Handbook) was performed for all studies. Risk ratio (RR), standardized mean difference (SMD) and 95% confidence interval (CI), were calculated for caries prevalence and caries increment, respectively. Meta-analysis was performed. Qualitative analysis of more than 2000 individuals aged from 1 to 84 years (9 studies) showed inconsistent effects of these probiotics-containing beverages. Synthesis of more than 1000 children and adolescents did not demonstrate a statistically significant difference in the proportion of individuals with cavitated lesions (RR 0.60 [95 % CI 0.34 to 1.08]; n = 2), but a significantly smaller increment of both cavitated and non-cavitated carious lesions (SMD -0.23 [95 % CI -0.39 to -0.08]; n = 4) was related to the consumption of probiotics-containing beverages. Certainty of evidence for caries prevalence and caries increment were moderate and low, respectively. Current evidence is not substantial to strengthen the impact of these beverages on caries development.

Addition of substances to reduce the erosive potential of acidic beverages to tooth enamel: A scoping review.

OBJECTIVE: This scoping review aimed (1) to map, analyse, interpret and synthesize data from in situ studies on which substances were added to acidic beverages to reduce the erosive potential on tooth enamel and (2) to establish the level of evidence of the effectiveness of adding substances to acidic beverages to reduce the erosive potential on tooth enamel. DESIGN: This is a scoping review, according to the methods from the Joanna Briggs Institute and PRISMA-ScR, with high-sensitivity searches in the databases PubMed (MEDLINE), Virtual Health Library, Embase (Elsevier), Scopus (Elsevier), Web of Science and ScienceDirect (Elsevier). In situ studies published in English until December 2022 were included. Studies that did not report a control group were excluded. To map and summarize the results, tables and figures were used. RESULTS: From 895 potentially eligible articles, nine were included. Blackcurrant juices (n = 5) with the addition of calcium (n = 3) or xanthan gum (n = 2) formulations were the most tested in terms of reducing the erosive potential of the beverages on tooth enamel. The profilometer was the equipment of choice (n = 8) for evaluating the loss of enamel structure after the experimental tests. CONCLUSIONS: Calcium and xanthan gum are among the most tested by in situ studies, offering promising results in reducing the erosive potential of fruit juices and carbonated and energy drinks.

Is the increment of diabetes mellitus in Brazil associated with the consumption of artificially sweetened beverages? A time trend analysis with 757,386 adults from 2006 to 2020.

OBJECTIVE: To describe trends in the prevalence of diabetes mellitus (DM) in Brazil and to analyze its association with the consumption of artificially sweetened beverages among individuals aged 18 years or older. STUDY DESIGN: This was a repeated cross-sectional study. METHODS: Annual data from VIGITEL surveys (2006-2020) were used, which included adults from all Brazilian state capitals. The outcome was the prevalence of DM (type 1 and type 2). The main exposure variable was consuming beverages like soft drinks and artificial juices, either in its 'diet, light, or zero' form. Covariates included sex, age, sociodemographic characteristics, smoking, alcohol consumption, physical activity, fruit consumption, and obesity. The temporal trend in the indicators and the etiological fraction (population attributable risk [PAR]) were calculated. Analyses were performed using Poisson regression. The association between DM and consumption of beverages was tested, excluding the year 2020 due to the pandemic; restricting the analysis to the final three years (2018-2020). RESULTS: Overall, 757,386 subjects were included. The prevalence of DM increased from 5.5% to 8.2%, with an annual growth of 0.17 percentage points (95% CI 0.11-0.24). Among those who consumed diet/light/zero beverages, the annual percentage change of DM was four times greater. The PAR corresponding to the consumption of diet/light/zero beverages on the occurrence of DM was 17%. CONCLUSIONS: An increasing prevalence of DM was observed, while diet/light/zero beverages consumption remains stable. A substantial reduction in the annual percentage change of DM could be observed if people stopped consuming diet/light soda/juice.

Sugar-Sweetened Beverages and Allergy Traits at Second Year of Life: BRISA Cohort Study.

Sugar-Sweetened Beverage (SSBs) consumption has risen in early life and it is plausible that it might increase children's risk of allergies. In this paper, we analyzed the association of SSB consumption with allergies in children's second year of life. This study analyzed data from a São Luís BRISA prenatal cohort in the follow-up of children (n = 1144) in their second year of life. Allergy Traits were a latent variable deduced from medical diagnoses of allergic rhinitis, atopic dermatitis, and food allergies. SSBs were investigated as a percentage of daily calories based on 24 h recalls, including industrialized fruit juices, soft drinks, and ready-made chocolate milk. Other variables analyzed were socioeconomic status, age, body mass index z-score, episodes of diarrhea, and breastfeeding. Our finds were that higher consumption of daily calories from SSBs was associated with higher Allergy Trait values (SC = 0.174; p = 0.025); older age (SC = -0.181; p = 0.030) was associated with lower Allergy Trait values; and episodes of diarrhea were correlated with Allergy Traits (SC = 0.287; p = 0.015). SSB exposure was associated with Allergy Traits in children's second year of life; thus, abstaining from these beverages may also confer additional advantages in curtailing allergic diseases during early childhood.

Exploratory Analysis of Social Networks Linked to the Provision of Beverages in Costa Rican Schools.

Sugar-sweetened beverages (SSBs) are implicated in weight gain and adverse cardiometabolic heath. Social networks of stakeholders involved in providing potable water and sugar-sweetened beverages (SSBs) in high schools in Costa Rica were studied using social analysis network. In public and private schools, the interactions between the stakeholders in charge of providing beverages are fragmented and their role in preventing the availability of SSBs is weak. School canteen owners ultimately decide what beverages are available at school, which may cause students to choose beverages that increase the risk of overweight/obesity. It is therefore urgently necessary to improve the capacity for two-way interactions between the stakeholders to enhance their roles in the provision of beverages. Hence, it is essential to reinforce the stakeholders' leadership, and set up innovative ways to exert it in order to develop a shared vision of the types of drinks that should be available in the school environment.

Beverage Consumption Patterns and Nutrient Intake Are Associated with Cardiovascular Risk Factors among Urban Mexican Young Adults.

Regular consumption of sugar-sweetened beverages has been related to metabolic diseases. Our objective was to identify beverage consumption patterns, nutrient intake, and their possible association with the prevalence of cardiovascular risk factors among Mexican young adults. A cross-sectional survey was conducted. Beverage consumption patterns were obtained by principal components analysis. Logistic regression models were applied to assess the association between the beverage patterns and cardiovascular risk factors. Four beverage patterns were identified. Higher consumption of alcoholic beverages was associated with lower odds for high body fat percent (OR: 0.371; 95% CI: 0.173-0.798), high blood pressure (OR: 0.318; 95% CI: 0.116-0.871), and high glucose (OR: 0.232; 95% CI: 0.061-0.875). Higher consumption of yogurt was associated with lower odds for high glucose (OR: 0.110; 95% CI: 0.22-0.559). In contrast, highest consumption of juice had greater odds for high triglycerides (OR: 1.084; 95% CI: 1.011-4.656). Higher consumption of milk was associated with greater odds for high glucose (OR: 5.304; 95% CI: 1.292-21.773). Beverage consumption habits in Mexican young adults are associated with increased risk factors for cardiovascular disease. Therefore, intervening during young adulthood should be considered in order to improve current health and prevent cardiovascular mortality in later decades.

The burden of disease and economic impact of sugar-sweetened beverages' consumption in Argentina: A modeling study.

BACKGROUND: Approximately two-thirds of Argentine adults are overweight or obese, and 11% have diabetes. Over the last two decades, all population groups have increased their consumption of ultra-processed foods and sugar-sweetened beverages (SSB). We aimed to estimate the disease burden-deaths, events, and costs to the health system-attributed to SSB consumption in Argentina. METHODS: We used a comparative risk assessment framework to estimate the health and economic impacts that would be avoided in a scenario without sugar-sweetened beverage (SSB) consumption. We calculated the direct effects on diabetes, cardiovascular disease, and BMI, and then estimated the effects of BMI on disease incidence. Finally, we applied the population attributable factor to calculate the health and economic burden avoided in Argentina in 2020. RESULTS: Our model estimated that about 4,425 deaths, 110,000 healthy life years lost to premature death and disability, more than 520,000 cases of overweight and obesity in adults, and 774,000 in children and adolescents would be attributed to SSB Consumption in Argentina. This disease burden corresponds to 23% of type-2 diabetes cases and other significant proportions of cardiovascular disease and cancer. The overweight and obesity costs attributable to SSB totaled approximately $47 million in adults and $15 million in children and adolescents. CONCLUSION: A significant number of disease cases, deaths, and health care costs could be attributed to SSB consumption in Argentina. Implementing measures to reduce the sugar content in beverages is a pending debt for the country and could lead to measurable improvements in population health, especially among children and adolescents.

Consumption of sweetened beverages is associated with the incidence of type 2 diabetes in Brazilian adults (CUME project).

BACKGROUND AND AIM: To evaluate the association between the energy consumption of sweetened beverages (SBs) adjusted for daily energy intake and the incidence of type 2 diabetes. METHODS AND RESULTS: This was a prospective study with 2480 type 2 diabetes mellitus (T2DM)-free Cohort of Universities of Minas Gerais (CUME) participants at baseline and 2-4 years of follow-up. A longitudinal analysis was performed with generalized equation estimation to verify the effect of SB consumption, adjusted for sociodemographic and lifestyle variables, on the incidence of T2DM. The incidence of T2DM was 2.78%. The median calorie intake of daily SB consumption adjusted for energy was 47.7 kcal/day. Participants with the highest consumption of SBs (≥47.7 kcal/day) were 63% (odds ratio [OR] = 1.63; p value-0.049) more likely to acquire T2DM over time compared to the lowest consumption (<47.7 kcal/day). CONCLUSIONS: Higher energy consumption from SBs favored a higher incidence of T2DM among CUME participants. The results reinforce the need for marketing restrictions on these foods and taxation to reduce the consumption of these beverages to prevent T2DM and other chronic noncommunicable diseases.

High Consumption of Sugar-Sweetened Beverages Is Associated with Low Bone Mineral Density in Young People: The Brazilian Birth Cohort Consortium.

Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18-23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm2), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1-16.7 times/day) was associated with a lower lumbar spine BMD (ß = -0.009; 95% CI: -0.017; -0.001; standardized ß = -0.03). This association persisted after adjustment for confounders (ß = -0.008; 95% CI: -0.016; -0.001; standardized ß = -0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.

Health Risk Assessment in Mexican Children Exposed to Fluoride from Sweetened Beverages.

The primary source of fluoride exposure is groundwater, but evidence suggests that beverages and food are additional fluoride sources. Intake of these products at an early age affects the optimal functioning of soft organs. An increase in sweetened beverage consumption by the pediatric population has been reported, suggesting an increase in fluoride exposure. The objectives of this study were to determine the fluoride concentrations in beverages and analyze the risk to human health from fluoride exposure to sweetened beverages consumed by children. Eighty-two sugar-sweetened beverages produced in different Mexican states were analyzed. The fluoride determination was carried out with an ion-selective electrode. The highest fluoride concentration was 1.92 mg/L; 73.2% of beverages showed fluoride values above permitted limits. Low-cost beverages had the highest fluoride values, suggesting that the water used for their production does not comply with fluorine regulations. According to the risk assessment in children from 3 to 6 years, the daily consumption of juices and sodas with concentrations that exceeded the normative of 0.7 mg/L could represent a risk to dental fluorosis development. It is crucial to control fluoride and regulate its concentrations in beverages for children to ensure food safety, especially in areas of endemic hydrofluorosis.

The Frequency of Daily Consumption of Sugar-Sweetened Beverages Is Associated with Reduced Muscle Mass Index in Adolescents.

The consumption of sugar-sweetened beverages (SSBs) has increased in recent years and has become a cause of concern because these beverages pose a risk to human health. Thus, we evaluated the association between SSBs consumption and muscle mass index (MMI) in adolescents. This cross-sectional study evaluated 2393 adolescents (18/19-years-old). Consumption of SSBs was analyzed based on the frequency of daily consumption and energy contribution categorized into tertiles. MMI was examined using the ratio of muscle mass (kilograms) to height (meters squared). The highest tertile of the frequency of daily SSB intake was associated with a reduced MMI in men (ß = -0.31; 95%CI: -0.60, -0.01) and women (ß = -0.24; 95%CI: -0.45, -0.02). However, these associations were not observed after adjusting for sugar contained in SSBs in men (ß = -0.26; 95%CI: -0.69, 0.17) and for carbohydrate, lipid, and protein intake in women (ß = -0.19; 95%CI: -0.42, 0.04). The highest energy contribution tertile of SSBs was associated with a reduced MMI in male adolescents (ß = -0.34; 95%CI: -0.64, -0.04). This association was not observed after adjusting for intake of sugar in SSBs (ß = -0.38; 95%CI: -0.75, 0.01). The frequency of daily consumption of SSBs was considered a risk factor for decreased MMI in both sexes, and the energy contribution of these drinks was a risk factor for MMI reduced only in male adolescents.

Impact of a reduction in sugar-sweetened beverage consumption on the burden of type 2 diabetes in Brazil: A modeling study.

AIM: To model the impact of a 20 % tax on sugar-sweetened beverages (SSBs) on the disease burden of T2DM among Brazilian adults. METHODS: This is an ex-ante risk comparative study. The model applied a 20 % tax on SSB and projected the incidence, prevalence, and mortality of T2DM over a 20-year period (2019 to 2039). Using recent national data on consumption, previously published cross- and own-price elasticities of SSBs and diabetes relative risk we estimated changes on T2DM burden. RESULTS: With a 20 % tax on SSBs, after 10 years, we estimated a reduction of 37,303 new cases of T2DM for men and 56,757 for women; 184,129 prevalent cases for men and 219,236 for women; and 5,386 and 6,075 deaths for men and women, respectively. After 20 years, 8.6 % and 12.4 % new cases of T2DM will have been prevented, 4.0 % and 5.5 % prevalent cases, and 13.7 % and 12.7 % deaths among men and women, respectively. CONCLUSIONS: SSB taxes have the potential to reduce the burden of and deaths attributable to T2DM. Our results show that a fiscal policy may significantly impact strategic plans to tackle noncommunicable diseases.

Sugar-Sweetened Beverages and Cancer Risk: A Narrative Review.

Cancer continues to be a major public health challenge worldwide, not only for being one of the leading causes of death but also because the number of incident cases is projected to grow in the next decades. Meanwhile, sugar-sweetened beverages (SSB) consumption has risen since the past century and constitutes a considerable fraction of added sugars in daily diet. Several studies have analyzed the relationship between SSB intake and health and found substantial evidence for effects on obesity, type 2 diabetes and metabolic syndrome. However, there is little knowledge about the relationship of SSB with cancer risk. It may be speculated that there is an indirect relationship between SSB and cancer through obesity and metabolic syndrome, but obesity-independent associations through hormonal imbalances or chronic inflammation could also exist. In this review, we describe the epidemiological evidence of the association of SSB and the risk of cancer in adults. Although the epidemiological evidence linking SSB consumption and cancer risk is still limited, prospective studies suggest that high SSB intake may increase the risk of obesity-related cancers, breast and prostate cancer.

Is store density associated with sugar-sweetened beverages consumption and overweight or obesity in Mexican adolescents?

BACKGROUND: The consumption of sugar-sweetened beverages (SSBs) is a risk factor for obesity. In Mexico, SSBs are widely available and consumed daily by adolescents. OBJECTIVES: The purpose of this study was to estimate the indirect association between store density (including grocery, convenience, non-alcoholic beverage stores and supermarkets) and overweight or obesity (OW/O) among Mexican adolescents, using SSB consumption as a mediator. METHODS: We used cross-sectional data on adolescent SSB consumption, weight status (body mass index for age [BMI for age]), physical activity, screen time and sociodemographic factors from the 2016 Mexican Midway National Health and Nutrition Survey (ENSANUT MC 2016). The National Statistical Directory of Economic Units provided information on stores selling SSBs. We estimated structural equations models to test associations between store density and OW/O, using SSB consumption as a mediator. RESULTS: We found a direct positive association between store density and SSB intake in adolescents (ß =1.229), including density of supermarkets (ß = 132.07), grocery stores (ß = 1.170) and non-alcoholic beverage stores (ß = 1.537). No significant association was observed for convenience stores. Direct association between store density and OW/O was strongest for supermarket density (ß = 0.426). In addition, SSB intake was significantly associated with OW/O (p = 0.033). No significant indirect association between density of any store and OW/O was found. CONCLUSIONS: Store density was directly associated with SSB consumption but not indirectly associated with OW/O mediated by SSB. Further research on food environment is required in order to design evidence-based strategies aimed at reducing SSB intake and OW/O in adolescents.

Desenvolvimento de bebidas lácteas probióticas adicionadas de polpa de morango e suplementadas com L-triptofano elaboradas a partir de leite bubalino e bovino / Development of probiotic dairy beverages with strawberry pulp and supplemented with L-tryptophan from buffalo and bovine milk

O objetivo deste estudo foi desenvolver uma formulação de bebida láctea bubalina probiótica adicionada de polpa de morango, comparando os efeitos do uso do leite de búfala e de vaca na elaboração dos produtos e verificando a possibilidade de suplementação com triptofano nos produtos lácteos probióticos. Como primeira etapa do trabalho, bebidas lácteas probióticas foram elaboradas a partir de leite bubalino e bovino, fermentadas com Streptococcus thermophilus TA040, Lactobacillus bulgaricus LB340 e Lactobacillus acidophilus La5, e formuladas com 0, 25 e 50% de soro em sua formulação. As bebidas foram avaliadas quanto à cinética de fermentação das culturas láticas utilizadas, ao teor de proteína, gordura e sólidos totais não gordurosos, pós-acidificação, viabilidade das culturas fermentadoras e sua capacidade de sobrevivência ao estresse gastrointestinal in vitro. As bebidas lácteas bubalinas apresentaram resultados superiores as bebidas bovinas. O uso do leite de búfala na elaboração das bebidas lácteas promoveu benefícios quanto as culturas láticas presentes nos produtos, exercendo efeito protetivo e influindo na preservação da viabilidade das bactérias ao longo do armazenamento refrigerado e durante a simulação do estresse gastrointestinal in vitro. As bebidas lácteas elaboradas com 25% apresentaram os resultados mais próximos aos obtidos pelos produtos controle, sem adição de soro, sendo selecionadas para a segunda parte do estudo. Nesta etapa, as formulações de bebida láctea com 25% de soro, foram acrescidas de um preparado com polpa de morango e bebidas sem adição da fruta, utilizadas como controle. As bebidas lácteas bubalinas frutadas, apresentaram menor teor de gordura e melhores características reológicas, com maior viscosidade e consistência do que os produtos controle, sem afetar a pós-acidificação, o perfil de ácido graxo, assim como, a viabilidade e a resistência às condições de estresse gastrointestinal in vitro das culturas fermentadoras. A avaliação da possibilidade de suplementar lácteos probióticos com triptofano foi realizada em conjunto com a Universidade de Milão. Para isso, iogurtes probióticos receberam adição de triptofano antes ou após a fermentação, sendo avaliados com relação ao perfil de pós-acidificação, quantidade de triptofano nos produtos, número de células viáveis por plaqueamento e citometria de fluxo ao longo do armazenamento a 25° e 4°C. Complementarmente, a influência da presença do triptofano no crescimento e produção de compostos antimicrobianos pelas culturas láticas, também foi avaliada. A adição de triptofano após a fermentação dos iogurtes, que foram armazenados sob refrigeração (4°C), além de não afetar a pós-acidificação dos produtos, apresentou benefícios quanto a viabilidade L. acidophilus, redução do dano e aumento do número de células vivas, promovendo teor maior do aminoácido nos iogurtes. A presença do triptofano nos meios de cultivo, também influenciou de forma positiva o crescimento de S. thermophilus e L. acidophilus, melhorando o desenvolvimento das bactérias durante a fermentação e influindo em uma maior atividade antilistérica por parte do S. thermophilus. Diante da influência positiva da aplicação do leite de búfala na elaboração das bebidas lácteas, assim como, a adição do triptofano em iogurtes probióticos, a suplementação do aminoácido em bebidas lácteas bubalinas frutadas permitiria a obtenção de um produto funcional, onde seus benefícios estariam relacionados tanto ao consumo do probiótico presente no produto quanto a complementação de triptofano na dieta do consumidor

The aim of this study was to develop a formulation of probiotic buffalo dairy beverage added with strawberry pulp, comparing the effects of using buffalo and cow's milk in the preparation of products and verifying the possibility of tryptophan supplementation in probiotic dairy products. As a first stage of the work, probiotic dairy beverages were made from buffalo and bovine milk, fermented with Streptococcus thermophiles TA040, Lactobacillus bulgaricus LB340 and Lactobacillus acidophilus La5, and formulated with 0, 25 and 50% whey in their formulation. The beverages were evaluated for the fermentation kinetics of the used lactic cultures, the levels of protein, fat and total no fat solids, post-acidification, fermenting cultures viability and their ability to survive gastrointestinal stress in vitro. Buffalo milk use in dairy beverages production promoted benefits regarding the lactic cultures present in the products, exerting a protective effect and influencing the viability preservation of bacteria during the cold storage and simulation of gastrointestinal stress in vitro. Dairy beverages made with 25% whey addition showed results similar to those obtained by the control products, without whey addition, being selected for the second part of the study. In this part, the dairy beverages formulations with 25% whey, were added with a preparation were added with a strawberry pulp preparation and dairy beverages without added fruit, used as a control. Fruity bubaline dairy beverages had lower fat content and better rheological characteristics, with higher viscosity and consistency than control products, without affecting post-acidification, fatty acid profile, as well as viability and resistance to in vitro gastrointestinal condition of fermented cultures. The possibility of supplementing probiotic dairy products with tryptophan was evaluated in partnership with the University of Milan. For this, probiotic yogurts received the addition of tryptophan before or after fermentation, being evaluated in relation to the post-acidification profile, tryptophan amount in the products, viable cell number per plating and flow cytometry during storage at 25°C and 4°C. In addition, the influence of the tryptophan presence on the growth and production of antimicrobial compounds by lactic cultures was also evaluated. The addition of tryptophan after the yogurt fermentation, which were stored under refrigeration (4°C), in addition to not affecting the post-acidification of the products, showed benefits to the viability of L. acidophilus, reduced the damage and increased the number of cells promoting higher amino acid content in yogurts. Tryptophan presence in the culture media also positively influenced the growth of S. thermophiles and L. acidophilus, improving the development of bacteria during fermentation and influencing better antilisteric activity in the part of S. thermophiles. In view of the buffalo milk positive influence observed after the application in dairy beverage preparation, as well as the addition of tryptophan in probiotic yoghurts, amino acid supplementation in fruity buffalo dairy beverages would allow to obtain a functional product, where its benefits would be related both to the consumption of the probiotic present in the product as to the supplementation of tryptophan in the consumer's diet

Erosión del esmalte dental en dientes expuestos a bebidas de origen industrial. Estudio piloto in vitro / Erosion of dental enamel in teeth exposed to industrial drinks. In vitro pilot study

RESUMEN: Objetivo: determinar el efecto erosivo sobre el esmalte dental de dientes humanos extraídos, después de la exposición a bebidas industriales distribuidas comercialmente en Cartagena, Colombia. Materiales y métodos: estudio experimental in vitro en 26 dientes humanos extraídos con esmalte dental sano, distribuidos aleatoriamente en doce grupos experimentales que fueron expuestos a bebidas industriales comercializadas en la ciudad de Cartagena. Las bebidas fueron expuestas durante 7 días, dos veces al día. Para determinar el efecto erosivo, se valoró pH de la bebida, pérdida de peso de los dientes expuestos y aspecto clínico del esmalte dental posterior a la exposición. Resultados: todas las bebidas evaluadas presentaron pH<4.5, siendo la Coca Cola® y jugo Hit® naranja las que exhibieron el pH más bajo. Todas las bebidas causaron desmineralización del esmalte, sin embargo, las que causaron mayor pérdida de peso fueron Speed Max®, Vive 100® y Coca-Cola®. Conclusiones: Speed Max® y Coca-Cola® fueron las bebidas que generaron mayor efecto erosivo sobre la estructura dental, por lo cual es necesario informar a la población los riesgos para la salud oral que se derivan del consumo desmedido de estas bebidas.

ABSTRACT: Objective: to determine the erosive effect on dental enamel of extracted human teeth, after exposure to industrial drinks distributed commercially in Cartagena, Colombia. Materials and methods: experimental in vitro study in 26 human teeth extracted with healthy dental enamel, randomly distributed in twelve experimental groups that were exposed to industrial beverages commercialized in the city of Cartagena. The teeth were exposed to the drinks for 7 days, twice a day. To determine the erosive effect, pH of the drink, weight loss of the exposed teeth and clinical appearance of the dental enamel after exposure were evaluated. Results: all the evaluated drinks presented pH <4.5, being Coca Cola® and Hit® Orange Juice the ones that exhibited the lowest pH. All the drinks caused enamel demineralization, however, the ones that caused the most weight loss were Speed ​​Max®, Vive 100® and Coca Cola®. Conclusions: Speed Max® and Coca Cola® were the drinks that generated the greatest erosive effect on the dental structure. Therefore, it is necessary to inform the population about the risks to oral health derived from the excessive consumption of these drinks.

Modelos in situ para Evaluar Potencial Erosivo de Bebidas / in situ Models to Evaluate Erosive Potential of Beverages

Existen varias metodologias in vitro, in situ e in vivo para evaluar el potencial erosivo de diferentes bebidas como jugos de frutas naturales, jugos procesados, bebidas alcohólicas, bebidas funcionales o productos y técnicas para el control de esta patología. Los modelos in situ permiten que los tejidos evaluados se desarrollen en un entorno natural, en presencia de saliva y película adquirida; además los especímenes pueden ser retirados para analizar sus propiedades mecánicas, físicas y biológicas de manera cuantitativa y cualitativa. El objetivo de esta revisión de literatura fue presentar los diferentes modelos in situ para evaluar el potencial erosivo de las bebidas sobre tejidos dentarios. Se desarrollarán los criterios para la selección de participantes, sustrato, dispositivos intraorales, agentes erosivos, ciclos erosivos y ensayos o test empleados.

There are several methodologies in vitro, in situ and in vivo to evaluate the erosive potential of different drinks such as natural fruit juices, processed juices, alcoholic drinks, functional drinks or products and techniques for the control of this pathology. The in situ models allow tissues evaluated to develop in a natural environment, in the presence of saliva and acquired pellicle; in addition, the specimens can be removed to analyze their mechanical, physical and biological properties in a quantitative and qualitative way. The objective of this literature review was to present the different in situ models to evaluate the erosive potential of beverages on dental tissues. The criteria for the selection of participants, substrate, intraoral devices, erosive agents, erosive cycles and tests or tests used will be developed.

Sugar sweetened beverages attributable disease burden and the potential impact of policy interventions: a systematic review of epidemiological and decision models.

BACKGROUND: Around 184,000 deaths per year could be attributable to sugar-sweetened beverages (SSBs) consumption worldwide. Epidemiological and decision models are important tools to estimate disease burden. The purpose of this study was to identify models to assess the burden of diseases attributable to SSBs consumption or the potential impact of health interventions. METHODS: We carried out a systematic review and literature search up to August 2018. Pairs of reviewers independently selected, extracted, and assessed the quality of the included studies through an exhaustive description of each model's features. Discrepancies were solved by consensus. The inclusion criteria were epidemiological or decision models evaluating SSBs health interventions or policies, and descriptive SSBs studies of decision models. Studies published before 2003, cost of illness studies and economic evaluations based on individual patient data were excluded. RESULTS: We identified a total of 2766 references. Out of the 40 included studies, 45% were models specifically developed to address SSBs, 82.5% were conducted in high-income countries and 57.5% considered a health system perspective. The most common model's outcomes were obesity/overweight (82.5%), diabetes (72.5%), cardiovascular disease (60%), mortality (52.5%), direct medical costs (57.35%), and healthy years -DALYs/QALYs- (40%) attributable to SSBs. 67.5% of the studies modelled the effect of SSBs on the outcomes either entirely through BMI or through BMI plus diabetes independently. Models were usually populated with inputs from national surveys -such us obesity prevalence, SSBs consumption-; and vital statistics (67.5%). Only 55% reported results by gender and 40% included children; 30% presented results by income level, and 25% by selected vulnerable groups. Most of the models evaluated at least one policy intervention to reduce SSBs consumption (92.5%), taxes being the most frequent strategy (75%). CONCLUSIONS: There is a wide range of modelling approaches of different complexity and information requirements to evaluate the burden of disease attributable to SSBs. Most of them take into account the impact on obesity, diabetes and cardiovascular disease, mortality, and economic impact. Incorporating these tools to different countries could result in useful information for decision makers and the general population to promote a deeper implementation of policies to reduce SSBs consumption. PROSPERO PROTOCOL NUMBER: CRD42020121025 .

Taxes to Unhealthy Food and Beverages and Oral Health in Mexico: An Observational Study.

In January 2014, taxes on sugar-sweetened beverages and nonessential energy-dense food were implemented in Mexico to discourage the consumption of these products. Published evaluations have shown reductions in purchases of taxed food and beverages associated with the implementation of this fiscal policy. Although there are some studies on the impact on health based on simulation studies, no evaluations with empirical data on changes in oral health have been published. We used administrative records and data from an epidemiological surveillance system to estimate changes in (1) outpatient visits related to dental caries; (2) having experienced dental caries: Decayed, Missing and Filled Teeth (DMFT) >0 for permanent dentition or dmft >0 for primary dentition (dmft); (3) number of teeth with caries experience (DMFT and dmft), (4) cases with DMFT >0 or dmft >0, and (5) the series of mean DMFT or dmft, associated with the taxes. We estimated probit and negative binomial models for outcomes at individual level, and interrupted time series analysis for population-level outcomes. The implementation of the taxes was associated with negative changes in the trends of outpatient visits, as well as for cases with DMFT >0, dmft >0 and mean DMFT. Taxes were also associated with a lower probability of having experienced dental caries and with a lower number of teeth with caries experience in the samples studied. Our results suggest positive impacts of the implementation of taxes on unhealthy food and beverages in the oral health of Mexicans, which are the first health benefits observed, and add to the health benefits predicted by modeling studies.

Conocimientos de erosión en adolescentes españoles / Conhecimento sobre a erosão dentaria em adolescentes espanhóisArtigo originale-220178Vol 11 N° 1 Enero - Junio 2021 / Erosion knowledge in Spanish adolescents

Objetivos: Determinar en una muestra de adolescentes españoles sus conocimientos sobre la erosión dental y los alimentos, bebidas y hábitos alimenticios que la producen. Material y métodos: Se llevó a cabo un estudio transversal. La muestra estuvo constituida por 348 adolescentes entre 12 y 17 años. Se valoró su conocimiento sobre la erosión dental y sus factores etiológicos mediante un cuestionario. Resultados: El 17,82% refirió conocer la erosión dental, el 26,44% solo había oído hablar de ella y el 62,35% pensaba erróneamente que los términos erosión y caries eran equivalentes. Al relacionar el conocimiento sobre los alimentos que producen erosión dental y la edad de los participantes se observó que el grupo de 16-17 años conocía en un porcentaje significativamente mayor la capacidad erosiva de la naranja (p<0,05), el limón (p<0,05), la fresa (p<0,01) y el kiwi (p<0,01). Esto se observó también con las bebidas gaseosas (p<0,01) y las isotónicas (p<0,01). Conclusiones: El nivel de conocimientos sobre la erosión dental es en general bajo, aumentando con la edad. La capacidad erosiva de los cítricos y de las bebidas gaseosas es más conocida entre los adolescentes que la de otros alimentos o bebidas.

Objetivos: Determinar em uma amostra de adolescentes espanhóis seu conhecimento sobre a erosão dentaria e os alimentos, as bebidas e os hábitos alimentares que a produzem. Material e métodos: Foi realizado um estudo transversal. A amostra foi composta por 348 adolescentes entre 12 e 17 anos. O conhecimento sobre erosão dentaria e seus fatores etiológicos foi avaliada por meio de um questionário. Resultados: 17,82% relataram conhecer erosão dentaria; 26,44% tinham ouvido falar dela e 62,35% pensavam erroneamente que os termos erosão e càrie eram equivalentes. Ao relacionar o conhecimento sobre os alimentos que produzem erosão dentaria y a idade dos participantes observou-se que o grupo de 16-17 anos conhecia em uma porcentagem significativamente maior a capacidade erosiva da laranja (p<0,05), do limão (p<0,05), do morango (p<0,01) e do kiwi (p<0,01). Isto também foi observado com refrigerantes (p<0,01) e bebidas isotônicas (p<0,01). Concluções: O conhecimento sobre erosão dentaria foi geralmente baixo, aumentando com a idade. Os adolescentes conhecem melhor a capacidade erosiva de frutas cítricas e refrigerantes do que outros alimentos ou bebidas.

Objectives: To determine in a sample of Spanish adolescents their knowledge of dental erosion and the food, drinks and eating habits that produce it. Material and methods: A cross-sectional study was carried out. The sample consisted of 348 adolescents between 12 and 17 years old. Their knowledge of dental erosion and its etiological factors was assessed through a questionnaire. Results: 17.82% reported knowing dental erosion, 26.44% had only heard of it and 62.35% mistakenly thought that the terms erosion and caries were equivalent. When relating knowledge about the foods that cause dental erosion and the age of the participants, it was observed that the group of 16-17 years knew in a significantly higher percentage the erosive capacity of the orange (p <0.05), the lemon ( p <0.05), strawberry (p <0.01) and kiwi (p <0.01). This was also observed with soft drinks (p <0.01) and isotonic drinks (p <0.01). Conclusions: The level of knowledge about dental erosion was generally low, increasing with age. The erosive capacity of citrus fruits and soft drinks is better known among adolescents than that of other foods or drinks.