High-Fiber Foods Reduce Periodontal Disease Progression in Men Aged 65 and Older: The Veterans Affairs Normative Aging Study/Dental Longitudinal Study

Authors

  • Natalie Schwartz MA,

    1. Department of Physiology and Neurobiology, University of Connecticut, Storrs, Connecticut
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  • Elizabeth Krall Kaye PhD,

    Corresponding author
    1. Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine
    • Veterans Affairs Boston Healthcare System, Boston, Massachusetts
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  • Martha E. Nunn PhD,

    1. Department of Periodontology, Creighton University, Omaha, Nebraska
    2. Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts
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  • Avron Spiro III PhD,

    1. Veterans Affairs Boston Healthcare System, Boston, Massachusetts
    2. Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine
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  • Raul I. Garcia DMD

    1. Veterans Affairs Boston Healthcare System, Boston, Massachusetts
    2. Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine
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Address correspondence to Elizabeth Krall Kaye, 560 Harrison Ave., Boston, MA 02218. E-mail: kralle@bu.edu

Abstract

Objectives

To determine whether foods that are good to excellent sources of fiber reduce periodontal disease progression in men.

Design

Prospective, observational study.

Setting

Greater Boston, Massachusetts, metropolitan area.

Participants

Six hundred twenty-five community-dwelling men participating in the Department of Veterans Affairs Dental Longitudinal Study.

Measurements

Dental and physical examinations were conducted every 3 to 5 years. Diet was assessed using food frequency questionnaires (FFQs). Mean follow-up was 15 years (range: 2–24 years). Periodontal disease progression on each tooth was defined as alveolar bone loss (ABL) advancement of 40% or more, probing pocket depth (PPD) of 2 mm or more, or tooth loss. Good and excellent fiber sources provided 2.5 g or more of fiber per serving. Multivariate proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of periodontal disease progression and tooth loss in relation to fiber sources, stratified according to age younger than 65 versus 65 and older, and controlled for smoking, body mass index, calculus, baseline periodontal disease level, caries, education, exercise, carotene, thiamin and caffeine intake, and tooth brushing.

Results

In men aged 65 and older, each serving of good to excellent sources of total fiber was associated with lower risk of ABL progression (HR = 0.76, 95% CI = 0.60–0.95) and tooth loss (HR = 0.72, 95% CI = 0.53–0.97). Of the different food groups, only fruits that were good to excellent sources of fiber were associated with lower risk of progression of ABL (HR = 0.86 per serving, 95% CI = 0.78–0.95), PPD (HR = 0.95, 95% CI = 0.91–0.99), and tooth loss (HR = 0.88, 95% CI = 0.78–0.99). No significant associations were seen in men younger than 65.

Conclusion

Benefits of higher intake of high-fiber foods, especially fruits, on slowing periodontal disease progression are most evident in men aged 65 and older.

Ancillary