title: Whole-grain and fiber intakes and periodontitis risk in men.
abstract: BACKGROUND
  Diabetes and hyperglycemia increase periodontitis risk, severity, and extent. Increased whole-grain and fiber intakes are associated with improved insulin sensitivity and may therefore affect periodontitis risk.
  
  
  OBJECTIVE
  The objective was to examine the associations between whole-grain and fiber intakes and periodontitis risk.
  
  
  METHODS
  We prospectively followed 34,160 male US health professionals aged 40-75 y at the outset. We updated medical and lifestyle information biennially with questionnaires and diet every 4 y by using a validated food-frequency questionnaire. We excluded men reporting periodontitis, myocardial infarction, stroke, and hypercholesterolemia before 1986 and those with incomplete dietary data. All diabetics were excluded. Periodontitis was determined by a report of professionally diagnosed disease and validated by a diagnosis of periodontitis by a periodontist from a blinded review of radiographs.
  
  
  RESULTS
  Men in the highest quintile of whole-grain intake were 23% less likely to get periodontitis than were those in the lowest quintile (multivariate RR: 0.77; 95% CI: 0.66, 0.89; P for trend < 0.001) after adjustment for age, smoking, body mass index, alcohol intake, physical activity, and total energy intake. Periodontitis was not associated with refined-grain intake (multivariate RR comparing extreme quintiles of intake: 1.04; 95% CI: 0.89, 1.23; P for trend = 0.37). Cereal fiber was inversely related to periodontitis risk (multivariate RR comparing extreme quintiles of intake: 0.85; 95% CI: 0.73, 0.99; P for trend = 0.03), but the association was not significant after adjustment for whole-grain intake.
  
  
  CONCLUSIONS
  Increasing whole grain in the diet without increasing total energy intake may reduce periodontitis risk.
authors.affiliation: Population Health Research Institute and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. anwar.merchant@post.harvard.edu
authors.forename: Anwar T
authors.initials: AT
authors.lastname: Merchant
authors.forename: Waranuch
authors.initials: W
authors.lastname: Pitiphat
authors.forename: Mary
authors.initials: M
authors.lastname: Franz
authors.forename: Kaumudi J
authors.initials: KJ
authors.lastname: Joshipura
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D004043:Dietary Fiber / Q000008:administration & dosage / Q000627:therapeutic use*; D002523:Edible Grain; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000517:prevention & control*; D012307:Risk Factors