Relationship between dietary diversity and periodontitis: analysis of NHANES 2003-2014.

IF 1.7 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Acta Odontologica Scandinavica Pub Date : 2026-06-26 DOI:10.2340/aos.v85.46079

Qi He, Qianying Guang, Yien Xu, Jian Zhao

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Abstract

Background: Periodontitis is a common chronic oral inflammatory disease with multiple etiologies. The relationship between Dietary Diversity Score (DDS) and periodontitis prevalence remains unclear.

Objective: To elucidate the DDS-periodontitis prevalence association.

Methods: Logistic regression evaluated the linkage between DDS and periodontitis. Restricted cubic spline (RCS) regression assessed non-linear linkage. Interaction tests identified effect-modifying factors. Weighted quantile sum (WQS) regression identified food categories influencing associations. Mediation analysis investigated the mediating roles of body roundness index (BRI) and red blood cell distribution width (RDW).

Results: In the full-adjusted model, higher DDS was linked with lower periodontitis prevalence odds (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.93-0.98; p < 0.001), with an evident dose-response relationship. RCS indicated no significant non-linear association between DDS and periodontitis (p-non- linear = 0.144). WQS showed balanced weight distribution of five main foods (all ~20%), indicating a dietary synergy effect. Subgroup analyses revealed significant interactions between DDS and periodontitis within subgroups of age, smoking, BMI, alcohol consumption, and osteoarthritis (p-interaction < 0.05). RDW (2.26%) and BRI (1.69%) partially mediated the linkage between DDS and the periodontitis prevalence.

Conclusion: Higher DDS is independently associated with reduced prevalence of periodontitis, driven by the synergistic contribution of multiple food categories. Optimizing dietary breadth is important in preventing periodontitis.

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膳食多样性与牙周炎的关系：NHANES 2003-2014的分析。

背景：牙周炎是一种常见的慢性口腔炎症性疾病，有多种病因。膳食多样性评分（DDS）与牙周炎患病率之间的关系尚不清楚。目的：探讨dds -牙周炎患病率的相关性。方法：Logistic回归分析DDS与牙周炎的关系。限制三次样条（RCS）回归评估非线性联系。相互作用试验确定了影响修饰因素。加权分位数和（WQS）回归确定了影响关联的食物类别。中介分析探讨了身体圆度指数（BRI）和红细胞分布宽度（RDW）的中介作用。结果：在全校正模型中，较高的DDS与较低的牙周炎患病率相关（优势比[OR]: 0.95； 95%可信区间[CI]: 0.93-0.98; p < 0.001），且存在明显的剂量-反应关系。RCS显示DDS与牙周炎之间无显著非线性关联（p-非线性= 0.144）。WQS中5种主要食物的体重分布较为均衡（均为20%），表现出膳食协同效应。亚组分析显示，在年龄、吸烟、BMI、饮酒和骨关节炎亚组中，DDS与牙周炎之间存在显著的相互作用（p相互作用< 0.05）。RDW（2.26%）和BRI（1.69%）部分介导了DDS与牙周炎患病率之间的联系。结论：较高的DDS与降低牙周炎患病率独立相关，由多种食物类别的协同贡献驱动。优化饮食宽度对预防牙周炎很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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