Obesity, dental caries and periodontal diseases are among major public health concerns which may affect children's growth and development. This study seeks any clustering between obesity, oral health and life-style factors among school children in Istanbul, Turkey. A cross-sectional study of children, 10- to 12-year-olds, from a public and a private school was undertaken with questionnaires for children and their mothers and child oral health data, in Istanbul (n = 611). DMFS (number of decayed, missing and filled surfaces of permanent teeth), CPI (Community Periodontal Index), body mass index (BMI) and life-style factors (tooth-brushing frequency, milk consumption at breakfast and bedtimes on school nights) of children were examined. Data analysis included factor analysis, Student's t test and Chi-square tests by cross-tabulation. Public school children were more dentally diseased but less obese than were those in private school (P < 0.001). They more frequently had calculus (62%) and reported non-recommended tooth-brushing (68%) than did those in private school (37%, 56%; P < 0.05). Principal component analysis revealed that DMFS, CPI and BMI shared the same cluster among all children. A need exists for addressing obesity, oral health and nutrition jointly in health promotion strategies to improve children's well-being and empower good life-style factors.

Background: Health coaching (HC) is based on 'partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential' to adopt healthy lifestyles through 'building awareness and empowerment'. This study's objective is to assess, for the first time to our knowledge, the effectiveness of HC compared with health education (HE) using clinical and subjective measures among type 2 diabetes (DM2) patients in Turkey and Denmark. Methods: This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010)(2011)(2012) and in Denmark (n = 116) (DK) (2012)(2013)(2014). Participants were assigned to HC or HE groups. Selected outcomes were HbA1c, periodontal treatment need index (CPI), health behaviours and anthropometric measures. The study duration was 12 months (6 months initiation-maintenance, 6 months follow-up). Results: At baseline, there were no statistically significant differences between the HC and HE groups. Post-intervention, a reduction of HbA1c in the HC groups was observed (TR: 0.8%; DK: 0.4%, P < 0.01) but not in the HE groups. The HC patients had a higher reduction in CPI than the HE group (P < 0.01). Principal component analysis showed that HbA1c, CPI and 'behaviour change' compose one cluster in the HCTR and HETR groups. Three clusters were formed for the HCDK; respectively HbA1c and CPI, lean mass and body fat percentage, 'behaviour change'. Conclusions: The results indicate that HC has a greater impact on DM management and health outcomes. There is a need for common health promotion strategies with behavioural interventions such as health coaching for the management of type 2 diabetes that focus on multidisciplinary approaches including oral health.Key words: Health coaching, oral health, HbA1C, health education, diabetes type 2 INTRODUCTIONGlobally nearly 400 million people have diabetes and that prevalence will be 600 million by 2035 1 . Moreover 90% of adults living with diabetes have diabetes type 2 (DM2) 2 , associated with more unhealthy lifestyles. Diabetes is expected to be the 7th leading cause of death in 2030 2 . A recent meta-analysis showed that periodontal diseases (PDs) may influence poor metabolic control and its complications 3 . This work amongst others suggests that there is bidirectional association between DM2 and PD; DM2 increases the risk for and severity of PD 4 , individuals that have been diagnosed with PD are more likely to have DM2 and/or poor glycaemic control [5][6][7] . Additionally longitudinal observational studies report that severe periodontitis has a significant adverse effect on risk for poor glycaemic control 8,9 . DM2 and PDs share common pathophysiological mechanisms [10][11][12] that are influenced by lifestyle behaviours such as poor diet, tobacco use and lack of exercise 13,14 . International health organisations such as the WHO and International Diabetes Federation emphasise that oral health promotion focusing on behavioural interventions should be integ...

The present findings imply that HC has a significantly higher impact on better management of diabetes and oral health when compared to formal HE. This calls for the use of HC by dentists, physicians, and diabetes educators in order to improve quality of life of DM2 patients by facilitating better oral health and diabetes self-management.