Energy and macronutrient intake in relation to dental caries incidence in urban black South African preschool children in 1991 and 1995: the Birth-to-Ten study

Abstract

Objective: To study energy and macronutrient intake in relation to dental caries incidence among urban black South African children at the ages of 1 and 5 years. Design and subjects: Food frequency questionnaires and WHO caries diagnostic criteria were used. The study sample of 1639 urban black children with nutrition and dental information from the 1991 and/or 1995 Birth-to-Ten (BTT) Study interceptions comprised true longitudinal (n = 259) and cross-sectional (n = 1216 for 1991 and n = 164 for 1995) subjects. For the longitudinal group true dmfs (decayed, missing, ®lled surfaces) incidence and average intakes of energy and macronutrients between 1991 and 1995 were calculated. Setting: South Africa. Results: Median macronutrient intakes were not signi®cantly different between the cross-sectional and longitudinal samples. Dental caries prevalences at age 1 were 1.2% and 1.5% for the cross-sectional and longitudinal samples, respectively. By age 5 these values were 60.4% and 62.2%, respectively. The median dmfs score at age 1 was 0. At 5 years this was 2 for all children and 5 for those with caries. Statistical analysis for trend at age 5 showed a signi®cant increase in caries prevalence with increasing energy, carbohydrate and added sugar in the cross-sectional sample only. The only signi®cant changes in dmfs scores were seen for energy and added sugar for the whole sample. The r values between log(dmfs incidence 0.3) and the average nutrient log variables were low, and a general linear models analysis showed no statistically signi®cant effects on log(dmfs incidence 0.3) of any of the log nutrient variables. Conclusions: For the relationship between macronutrient intake and caries (prevalence and incidence), a cross-sectional and true longitudinal study gave similar results.

Variety and total number of food items recorded by a true longitudinal group of urban black South African children at five interceptions between 1995 and 2003: the Birth-to-Twenty (Bt20) Study

“…Although people eat more than one type of fruit and vegetables45-47, consumption of fruits such as apples, banana and oranges decreased in this study but this could have been replaced by other fruits, which were not picked up because of the cut-off point used46. Low intakes of fruits and vegetables were also reported in other studies on different South African communities8,10,45-48.…”

Early childhood caries and its associations with sugar consumption, overweight and exclusive breastfeeding in low, middle and high-income countries: an ecological study

“…The association between per capita sugar consumption and the prevalence of ECC was positive globally, in MICs and HICs but not in LICs. Perhaps there is a dose response association between sugar consumption and ECC ( Van Loveren, 2019 ) beyond which other factors have stronger impact, such as access to health care or healthful foods such as fruits, vegetables and milk ( Moynihan & Petersen, 2004 ; MacKeown, Cleaton-Jones & Edwards, 2000 ; Mayén et al, 2014 ). This possibility should be studied further and supports the call to avoid generalization of results obtained from studies in one setting to another.…”

Effect on Caries of Restricting Sugars Intake

“…At the lower level of sugars intake (7.5% E, 22.9 g/day), 1 dmfs/yr developed. MacKeown et al, 2000 Primary 259 South African children aged 1 yr at baseline. Change in caries incidence and prevalence between 1 and 5 yrs was not significantly associated with added sugars intake.…”