title: Relationship Between Dietary Sugar Intake and Dental Caries Among Japanese Preschool Children with Relatively Low Sugar Intake (Japan Nursery School SHOKUIKU Study): A Nationwide Cross-Sectional Study.
abstract: OBJECTIVE
  The WHO has recently proposed to halve the recommendation for free sugar intake from 10 to 5 % of energy intake to reduce the incidence of diseases such as obesity and dental caries. The Japanese population is suitable to confirm the appropriateness of this proposal, because dietary sugar intake in Japan is exceptionally low among developed countries. We sought to establish a method to estimate dietary sugar intake in Japan and to examine the relationship between sugar and the number of dental caries using data obtained from the Japan Nursery School SHOKUIKU study.
  
  
  METHODS
  Dietary intake during the preceding month and the number of caries was examined in children aged 5-6 years using a brief-type self-administered diet history questionnaire for Japanese preschool children completed by their guardians and another questionnaire on lifestyle. Multivariate Poisson regression models were used for the analysis.
  
  
  RESULTS
  When subjects were ranked into quintiles by the proportion of energy from free sugar, those in higher quintiles had more caries than those in the lowest quintile. On close analysis, the number of caries among children with a relatively small proportion of energy intake from free sugar (3.18-3.77 %) was not significantly different from that in the lowest group (0.95-3.17 %).
  
  
  CONCLUSIONS
  The recent proposition of WHO might be valid, because the adverse effect of relatively small proportion (approximately less than 5 %) of energy intake from free sugar on caries was not detected among the subjects in this study. However, more study will be necessary to reach a conclusion.
authors.affiliation: Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. doomiyu@m.u-tokyo.ac.jp.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Saido
authors.affiliation: Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. jzf01334@nifty.ne.jp.|Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan. jzf01334@nifty.ne.jp.
authors.forename: Keiko
authors.initials: K
authors.lastname: Asakura
authors.affiliation: Ikurien Special Nursing Home for the Elderly, Ibaragi, Japan. masayasu@ikurien.com.
authors.forename: Shizuko
authors.initials: S
authors.lastname: Masayasu
authors.affiliation: Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. stssasak@m.u-tokyo.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000208:ethnology* / Q000209:etiology*; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D009749:Nutrition Surveys; D012578:Schools, Nursery; D011795:Surveys and Questionnaires
chemical_list: D019422:Dietary Sucrose
keywords: Dental caries; Japan; Preschool children; Prevention; Sugar intake