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Aim: Investigating the association between sugar‐sweetened beverages (SSBs) and periodontitis and whether the awareness of diabetes modifies this relationship. Materials and Methods: Cross‐sectional analysis was conducted using the National Health and Nutrition Examination Survey (NHANES III) data involving US adults aged 30–50. Periodontitis was classified according to the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC‐AAP), and SSB consumption as dichotomous (<5 or ≥5, <7 or ≥7 and <14 or ≥14 times/week), ordinal and continuous variables. Confounders included family income poverty ratio, education, race/ethnicity, sex, age, food energy intake, smoking and alcohol. Odds ratios (ORs) were obtained by logistic regressions using inverse probability weighting. Effect modification analysis was performed considering self‐reported diabetes. Results: Among 4473 cases analysed, 198 self‐reported diabetes. SSBs were associated with periodontitis when individuals consumed ≥5 (OR 1.64; 95% confidence interval [CI] = 1.30–2.06), ≥7 (OR 1.92; 95% CI = 1.50–2.46) and ≥14 (OR 2.19; 95% CI = 1.50–3.18) times/week. The combined effect of consuming SSBs (≥5 and ≥14 times/week) and self‐reported diabetes had less impact than the cumulative effect. Conclusions: SSB consumption was associated with higher odds of periodontitis, and the estimates were reduced among those with awareness of diabetes. [ABSTRACT FROM AUTHOR]

Objective: To investigate pathways from micronutrient intake and serum levels to Chronic Oral Diseases Burden. Methods: We analyzed cross‐sectional data from NHANES III (n = 7936) and NHANES 2011–2014 (n = 4929). The exposure was the intake and serum levels of vitamin D, calcium, and phosphorus. Considering the high correlation of those micronutrients in the diet, they were analyzed as a latent variable dubbed Micronutrient intake. The outcome was the Chronic Oral Diseases Burden, a latent variable formed by probing pocket depth, clinical attachment loss, furcation involvement, caries, and missing teeth. Pathways triggered by gender, age, socioeconomic status, obesity, smoking, and alcohol were also estimated using structural equation modeling. Results: In both NHANES cycles, micronutrient intake (p‐value < 0.05) and vitamin D serum (p‐value < 0.05) were associated with a lower Chronic Oral Diseases Burden. Micronutrient intake reduced the Chronic Oral Diseases Burden via vitamin D serum (p‐value < 0.05). Obesity increased the Chronic Oral Diseases Burden by reducing vitamin D serum (p‐value < 0.05). Conclusion: Higher micronutrient intake and higher vitamin D serum levels seem to reduce Chronic Oral Diseases Burden. Healthy diet policies may jointly tackle caries, periodontitis, obesity, and other non‐communicable diseases. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between added sugar intake above the daily limit for the risk of noncommunicable diseases (NCDs) and the Chronic Oral Disease Burden in adolescents. Methods: This was a population‐based study using cross‐sectional data nested to RPS Cohorts Consortium, São Luís, Brazil, from the 18–19‐year‐old follow‐up (n = 2515). High consumption of added sugars was estimated according to the limits of the World Health Organization guidelines (WHO) (≥5% of total energy/day) and the American Heart Association statement (AHA) (≥25 g/day). The Chronic Oral Disease Burden was a latent variable (number of decayed teeth, periodontal probing depth ≥4 mm, clinical attachment level ≥3 mm, and bleeding on probing). Models were adjusted for Socioeconomic Status, sex, obesity, and plaque index and analyzed through structural equation modeling. Results: Adolescents had high sugar consumption according to the WHO (78.6%) and AHA (81.4%) recommendations. High sugar intake, according to WHO (SC = 0.096; p = 0.007) and AHA (SC = 0.056; p = 0.027), was associated with a heavier Chronic Oral Disease Burden. Even half of the recommended dose was sufficient to affect some oral disease indicators. Conclusion: Sugar intake over international statements to prevent NCDs is associated with higher Chronic Oral Disease Burden among adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The present study analysed the association between anaemia and dental caries in adolescents on the basis of predisposing factors and presence of severely decayed teeth. Materials and Methods: This observational study included a complex probabilistic sample of adolescents (17-18 years old) enrolled at public schools in São Luís, Brazil (n = 363). Two hypothesis models were tested: (1) anaemia and dental caries are associated given that they share predisposing factors, such as socioeconomic and high sugar consumption, and (2) the presence of severely decayed teeth may increase the susceptibility of patients to anaemia. In the first model, the association between anaemia and the history of dental caries (the outcome number of affected teeth) was analysed by Poisson regression. In the second model, the association between the presence of severely decayed teeth with pulp exposure/necrosis and the outcome anaemia was analysed by logistic regression. Bivariate and multivariate analyses after adjusting for socioeconomic factors and sugar consumption were performed, considering 5% of statistical significance level and using STATA 115.0. Results: Anaemia was associated with a higher number of affected teeth with a history of dental caries in bivariate (means ratio [MR]: 1.30; 95% confidence intervals [CI95%]: 1.10-1.52; p = 0.001) and multivariate (MR: 1.18; CI95%: 1.01-1.39; p = 0.046) analyses. Severely decayed teeth with pulp exposure/necrosis were associated with anaemia in bivariate (odds ratios [OR]: 5.75; CI95%: 1.97-16.8; p = 0.001)] and multivariate (OR 5.51; CI95%: 1.71-17.74; p = 0.004) analyses. Conclusion: This study suggests that anaemia and dental caries are associated in a population-based sample of adolescents and that predisposing factors and severely decayed teeth seem to be involved in this association.. [ABSTRACT FROM AUTHOR]

Aim: To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans. Materials and Methods: This cross‐sectional study explored the grouping among a set of caries and periodontitis indicators (the proportion of sites with bleeding on probing, moderate probing pocket depth [PPD, 4–5 mm], severe PPD [≥6 mm], moderate clinical attachment level [CAL, 3–4 mm], severe CAL [≥5 mm], number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement, and the number of missing teeth) in 14,421 Americans from the NHANES III study. Exploratory factorial analysis was used to determine the constructs between those indicators (factorial loading ≥0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011–2014. Results: Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13–39 years old), while for the subjects over 50 years, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators. Conclusions: Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between increased serum markers of iron (ferritin and transferrin saturation) and the severity and extent of periodontitis in post‐menopausal (PM) women. Materials and Methods: Data from 982 PM women participating in NHANES III were analysed. Exposures were high ferritin (≥300 μg/ml) and transferrin saturation (≥45%). The primary outcome was moderate/severe periodontitis defined according to Centers for Disease Control and Prevention and the American Academy of Periodontology. The extent of periodontitis was also assessed as outcome: proportion of sites affected by clinical attachment loss ≥4 mm and probing depth ≥4 mm. Crude and adjusted prevalence ratio (PR) and mean ratio (MR) were estimated using Poisson regression. Results: The prevalence of moderate/severe periodontitis was 27.56%. High ferritin was associated with moderate/severe periodontitis in the crude (PR 1.55, p =.018) and in the final adjusted model (PR 1.53, p =.008). High ferritin and transferrin saturation levels were associated with a higher proportion of sites with clinical attachment loss ≥4 mm (p <.05). Conclusions: The increasing serum iron markers seem to contribute to periodontitis severity and extent in PM women. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association of the consumption of foods of the ultra-processed group (UPF) with inflammatory markers in the adolescent population in Northeastern Brazil.Design: A cross-sectional population-based study. Food consumption was evaluated using two 24-h dietary recalls using the NOVA classification for food processing levels. The following inflammatory markers were evaluated: adiponectin, IL-6, IL-8, C-reactive protein (CRP) and TNF-α. Multivariate linear regression was used to investigate the association between the percentage of UPF energy contribution and inflammatory markers.Setting: São Luís, Maranhão, Brazil.Participants: The sample consisted of 391 male and female adolescents, aged from 17 to 18 years.Results: The average daily energy consumption by adolescents was 8032·9 kJ/d, of which 26·1 % originated from UPF. The upper tertile (T3) of UPF consumption presented higher intake of simple carbohydrates, lipids, saturated fat, and Na and lower protein intake. Individuals in T3 presented higher serum leptin and CRP levels (P < 0·05). Adolescents with UPF energy consumption ≥30·0 % (tertile 3 of UPF) had a 79 % (exp (0·58) = 1·79) increase in IL-8 levels when compared with adolescents in tertile 1 of UPF (P = 0·013).Conclusions: The association between the consumption of UPF, poor quality diet and pro-inflammatory markers have important harmful effects that can be observed as early as in adolescence. [ABSTRACT FROM AUTHOR]

Objective: Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life.Design: BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life.Setting: A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling.Participants: Data of pregnant women (n 1136) and their offspring.Results: Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time.Conclusions: Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life. [ABSTRACT FROM AUTHOR]