The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011-2012.

AIM: Periodontal disease is one of the most prevalent oral pathologies and a major chronic disease worldwide. Lifestyle habits such as poor nutrition and smoking have been established to contribute to the development of periodontal disease, but limited research has investigated whether physical activity and sedentary lifestyle play a role. The purpose of this study is to evaluate the association between physical activity, sedentary behaviour, and periodontal disease. MATERIALS AND METHODS: We used a nationally representative data set from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. We examined the association between physical activity and sedentary behaviour and periodontal disease using multivariable logistic regression models and reported odds ratios (ORs). RESULTS: Individuals with higher total physical activity, higher leisure time physical activity, and lower amount of total sedentary behaviour had lower periodontal disease prevalence. Adjusted multivariable regression models showed that higher sedentary behaviour (more than 7.5 h/day) was associated with higher odds of periodontal disease (OR = 1.17; 95% confidence interval = 1.00-1.36; p = .045). CONCLUSIONS: The findings showed that higher sedentary behaviour is associated with higher odds of periodontal disease. Future prospective longitudinal studies and strategies are needed to investigate implications further and define the magnitude of the association between physical activity and periodontal disease.

Predicted vitamin D status and incidence of tooth loss and periodontitis.

OBJECTIVE: Vitamin D insufficiency is highly prevalent, with particular subgroups at greater risk (e.g. the elderly and those with darker skin). Vitamin D insufficiency may partly explain US racial/ethnic disparities in the prevalence of periodontitis and tooth loss. We evaluated the association between a predictor score of plasma 25-hydroxyvitamin D (25(OH)D) and incidence of periodontitis and tooth loss. DESIGN: Detailed biennial questionnaires were collected on medical history, lifestyle practices and incident periodontitis and tooth loss. The predictor score was derived from variables known to influence circulating concentrations of plasma 25(OH)D and validated against plasma concentrations among a sub-sample. Multivariable Cox proportional-hazards models with time-varying covariates estimated the association between the predicted 25(OH)D score and time until first tooth loss. SUBJECTS: A total of 42,730 participants of the Health Professionals Follow-Up Study aged 40-75 years at baseline were followed from 1986 to 2006. SETTING: USA, representing all fifty states and the District of Columbia. RESULTS: We observed 13,581 incident tooth loss events from 539,335 person-years. There was a dose-dependent significant inverse association across quintiles of the predicted 25(OH)D score and incidence of tooth loss. In multivariable analyses, the highest quintile of the updated predicted 25(OH)D score compared with the lowest was associated with a 20% lower incidence of tooth loss (hazard ratio = 0.80, 95 % CI 0.76, 0.85; P value for trend <0.001); UV-B was also independently associated. Results for the predicted 25(OH)D score and periodontitis were similar. CONCLUSIONS: These results are suggestive of an association between predictors of vitamin D and lower incidence of tooth loss and periodontitis.

Intakes of (n-3) fatty acids and fatty fish are not associated with cognitive performance and 6-year cognitive change in men participating in the Veterans Affairs Normative Aging Study.

High intake of fish and (n-3) PUFA may protect against age-related cognitive decline. However, results are inconsistent and limited data exist regarding changes in multiple cognitive functions over a longer period of time. In this study, we assessed the association between fatty fish intake as well as (n-3) PUFA intake with cognitive performance and cognitive change over 6 y in 1025 elderly men. Participants were from the Veterans Affairs Normative Aging Study. Cognitive function was assessed with a battery of cognitive tests focusing on factors representing memory/language, speed, and visuospatial/attention. Dietary intakes were assessed with a validated FFQ. We used general linear models to assess cross-sectional associations and mixed models to assess the associations over time. Models were adjusted for age, education, BMI, smoking, diabetes, and intake of alcohol, saturated fat, vitamin C, and vitamin E. The mean age of participating men was 68 y at baseline. Median fish consumption ranged from 0.2 to 4.2 servings/wk across quartiles. Cross-sectional analyses showed no association between fatty fish or (n-3) PUFA intake and cognitive performance. Longitudinal analyses, over 6 y of follow-up, also did not show any significant associations between fatty fish or (n-3) PUFA intake and cognitive change. In this population of elderly men, intake of neither fatty fish nor (n-3) PUFA was associated with cognitive performance.

Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease.

BACKGROUND: Several epidemiological studies have suggested periodontitis as a risk factor for coronary heart disease (CHD), but results have been inconsistent. METHODS AND RESULTS: We evaluated the association between clinical and radiographic measures of periodontitis, edentulism, and incident CHD (angina, myocardial infarction, or fatal CHD) among 1203 men in the VA Normative Aging and Dental Longitudinal Studies who were followed up with triennial comprehensive medical and dental examinations up to 35 years (median 24 years). Cox proportional hazards models with time-varying effects of exposure and potential confounders were fit. We found a significant dose-dependent association between periodontitis and CHD incidence among men < 60 years of age (hazard ratio 2.12, 95% confidence interval 1.26 to 3.60 comparing highest versus lowest category of radiographic bone loss, P for trend=0.02), independent of age, body mass index, smoking, alcohol intake, diabetes mellitus, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, hypertension, systolic and diastolic blood pressure, education, marital status, income, and occupation. No association was found among men > 60 years of age. Similar results were found when the sum of probing pocket depths was used as a measure of periodontitis. Among men > or = 60 years of age, edentulous men tended to have a higher risk of CHD than dentate men in the lowest bone loss (hazard ratio 1.61, 95% confidence interval 0.95 to 2.73) and lowest pocket depth (hazard ratio 1.72, 95% confidence interval 1.03 to 2.85) categories, independent of confounders. CONCLUSIONS: Chronic periodontitis is associated with incidence of CHD among younger men, independent of established cardiovascular risk factors.

Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study.

OBJECTIVES: Report results of a randomized-clinical trial of the efficacy of periodontal care in the improvement of glycemic control in 165 veterans with poorly controlled diabetes over 4 months. METHODS: Outcomes were change in Haemoglobin A1c (HbA1c) in the Early Treatment versus untreated (Usual Care) groups and percent of participants with decreases in HbA1c. Analyses included simple/multiple variable linear/logistic regressions, adjusted for baseline HbA1c, age, and duration of diabetes. RESULTS: Unadjusted analyses showed no differences between groups. After adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c change in the Early Treatment group was -0.65% versus -0.51% in the Usual Care group (p=0.47). Adjusted odds for improvement by 0.5% in the Early Treatment group was 1.67 (95% confidence interval: 0.84, 3.34, p=0.14). Usual Care subjects were twice as likely to increase insulin from baseline to 4 months (20% versus 11%, p=0.12) and less likely to decrease insulin (1% versus 6%, p=0.21) than Early Treatment subjects. Among insulin users at baseline, more increased insulin in the Usual Care group (40% versus 21%, p=0.06). CONCLUSIONS: No significant benefit was found for periodontal therapy after 4 months in this study; trends in some results were in favour of periodontal treatment.