The association of dietary vitamin C intake with periodontitis among Korean adults: Results from KNHANES Ⅳ

Abstract

BackgroundsThe association of dietary vitamin C (vit C) on periodontitis requires more valid evidence from large representative samples to enable sufficient adjustments. This study aimed to evaluate the association between dietary vit C intake and periodontitis after controlling for various confounders in the representative Korean adult populationMethodA total of 10,930 Korean adults (≥19 years) from the fourth Korean National Health and Nutrition Examination Survey data set were included in this cross-sectional study. Periodontitis was defined as community periodontal index score of 3 or 4. Dietary vit C intake was estimated from a 24-hour dietary record, and categorized into adequate and inadequate according to the Korean Estimated Average Requirement value. Potential confounders included age, sex, income, frequency of tooth brushing, use of floss, dental visit, drinking, smoking, diabetes, hypercholesterolemia, hypertension, and obesity. A multivariable logistic regression analysis and stratified analysis were applied.ResultsThose with inadequate dietary vit C intake were more likely by 1.16 times to have periodontitis than those with adequate dietary vit C intake (adjusted odds ratio [aOR] = 1.16, 95% confidence interval = 1.04–1.29). Lowest and middle-low quartile of dietary vit C intake, compared to highest quartile of dietary vit C intake, showed significant association (aOR = 1.28 and 1.22 respectively), which was in a biological-gradient relationship (trend-p <0.05).ConclusionsOur data showed that inadequate dietary vit C intake was independently associated with periodontitis among Korean adults. Hence, adequate intake of dietary vitamin C could be substantially important on the promotion of periodontal health among Korean adults.

Association of toothbrushing and proximal cleaning with periodontal health among Korean adults: Results from Korea National Health and Nutrition Examination Survey in year 2010 and 2012

“…Selected potential confounders were socio‐demographic factors (age, sex, monthly household income) and general health‐related behaviours (physical activity, alcohol drinking, lifetime cigarette smoking amount) (Han, Lim, Sun, Paek, & Kim, ; Lee, Shin, Kim, Ahn, & Kim, ) and systemic health factors (diabetes, hypercholesterolaemia, hypertension, obesity). Socio‐demographic factors and general health‐related behaviours were collected using standardized self‐administered questionnaires through face‐to‐face interview, while the systemic health factors were evaluated using blood analysis.…”

Possible Involvement of Vitamin C in Periodontal Disease-Diabetes Mellitus Association

“…In a study with 10,930 patients, Lee et al [59] found that in patients with DM between the ages of 30 and 49, there was a significant link between vitamin C intake and periodontitis. In the stratified analysis, the aforementioned association was highlighted among patients with type 2 DM.…”

Relationship between Vitamin C and Periodontal Diseases: A Systematic Review

“…From these 46 potential relevant articles, 31 did not meet the criteria. Finally, 15 publications (7 cross-sectional studies [23][24][25][26][27][28][29], 2 case-control studies [30,31], 2 cohort studies [32,33]), and 4 RCTs [34][35][36][37]) were selected for systematic review, as shown in the flow chart ( Figure 1). Excluding the RCTs, 6 of the remaining 11 studies estimated vitamin C intake from dietary investigation and 6 studies measured blood vitamin C concentration.…”

“…With regard to exposure, 4 cross-sectional studies [23][24][25][26], one case-control study [31] and one cohort study [32] assessed dietary intake. Of these studies, five used dietary recall [23][24][25][26]31], specifically, two studies used multiple dietary recalls [24,31], and three used a single dietary recall [23,25,26]. Since a single 24-h dietary recall could not be considered to reflect one's habitual diet [38], multiple 24-h recalls are desirable and this technique was rated as "satisfactory".…”

“…Four studies analyzed the relation of vitamin C intake to periodontal disease. Two studies used the same subjects (participants in the fourth Korean National Health and Nutrition Examination Survey) [23,25]. Both studies set 2/3 as the cut-off score for the CPI.…”