title: The relationship between tomato intake and congestive heart failure risk in periodontitis subjects.
abstract: BACKGROUND
  The objective of this study was to investigate the relationship between monthly tomato consumption (MTC) and serum lycopene (sLyco) levels, and a self-reported history of congestive heart failure (CHF) in individuals with periodontitis using data available in the Third National Health and Nutrition Examination Survey (NHANES III).
  
  
  METHODS
  Adult participants in NHANES III were used in this study. Zero to thirty three percent of sites with a periodontal attachment loss (PAL) of >3 mm was considered a healthy periodontium, while greater than >33% of sites with PAL of >3 mm as periodontitis. The outcome variable was the self-reported history of CHF. MTC and sLyco levels were categorized into quartiles. Data was analyzed by Kruskal-Wallis, anova and multivariate analyses using SPSS(R). p<0.05 was used to reject the null hypothesis.
  
  
  RESULTS
  Individuals with periodontitis showed a dose-response relationship between dietary MTC and self-reported CHF risk; moderate MTC (risk ratio (RR), 3.15; 95% confidence interval (CI), 1.03-9.67), low MTC (RR, 3.31; 95% CI, 1.33-8.24) (p<0.05) and very low MTC (RR, 5.10; 95% CI, 1.67-15.57) (p<0.01), adjusting for confounders of both diseases (periodontitis and CHF). The moderate sLyco level-healthy periodontium group showed a significant decrease in CHF risk (RR, 0.25; 95% CI, 0.07-0.84) (p<0.05), adjusting for confounders. Significant inverse dose-response relationships were seen between sLyco and C-reactive protein, and MTC and white blood cell count in periodontitis subjects, respectively (p<0.05). MTC was correlated with sLyco concentration (r=-0.018, p<0.05), adjusting for confounders abolished that significance.
  
  
  CONCLUSIONS
  A relationship exists between periodontitis and CHF risk, and high MTC appears to affect this relationship in a positive direction in periodontitis subjects.
authors.affiliation: Department of Periodontics, University of Mississippi School of Dentistry, Jackson, MS 39216-4505, USA. nwood@sod.umsmed.edu
authors.forename: Nelson
authors.initials: N
authors.lastname: Wood
authors.forename: Roger B
authors.initials: RB
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000975:Antioxidants / Q000627:therapeutic use*; D002338:Carotenoids / Q000097:blood*; D016022:Case-Control Studies; D006333:Heart Failure / Q000150:complications* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D000077276:Lycopene; D018551:Solanum lycopersicum; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D000975:Antioxidants; D002338:Carotenoids; D000077276:Lycopene