title: The roles of meal, snack, and daily total food and beverage exposures on caries experience in young children.
abstract: OBJECTIVE
  This study describes associations among caries experience and meal, snack and daily total exposures to beverages and foods in children.
  
  
  METHODS
  Subjects (n = 634) were members of the Iowa Fluoride Study. Beverage and food exposures were abstracted from 3-day diaries at 1, 2, 3, 4 and 5 years and calculated for 1-5 years. Eating events were defined as 30-minute intervals and categorized as meals or snacks based on time of consumption and nature of the foods. Beverage and food exposures were categorized by carbohydrate content. Dental examinations were conducted at 4.5-6.8 years; caries experience was dichotomized (any vs. none). Logistic regression models were developed to determine if caries experience differed for the fourth vs. first quartile of exposure after adjustment for age at dental exam and fluoride intake.
  
  
  RESULTS
  Higher snack (1, 2, 3, 4, 1-5 years) and daily total (2, 3, 4, 1-5 years) eating events increased caries risk (P < 0.05). Higher exposures to 100% juice at snacks (2 years) and soda pop at meals (2, 1-5 years), snacks (2, 3, 4, 1-5 years) and daily total (2, 3, 4, 1-5 years) increased caries risk (P < 0.05). Higher exposures to food sugars (3, 1-5 years) and starches (4, 5, 1-5 years) at meals decreased caries risk, while higher exposures to sugars (4, 1-5 years) at snacks increased caries risk (P < 0.05).
  
  
  CONCLUSIONS
  Dietary methods used to investigate diet-caries relationships can influence the outcome. The cariogenicity of food, but not beverages, is associated with the timing of exposure.
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry University of Iowa, Iowa City, Iowa, USA. teresa-marshall@uiowa.edu
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Marshall
authors.forename: Barbara
authors.initials: B
authors.lastname: Broffitt
authors.forename: Julie
authors.initials: J
authors.lastname: Eichenberger-Gilmore
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Cunningham
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levy
mesh_terms: D001628:Beverages / Q000009:adverse effects; D002327:Cariostatic Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000209:etiology*; D015930:Diet Records; D004037:Diet, Cariogenic; D004040:Dietary Carbohydrates / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D005459:Fluorides / Q000008:administration & dosage; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011795:Surveys and Questionnaires
chemical_list: D002327:Cariostatic Agents; D004040:Dietary Carbohydrates; D005459:Fluorides