title: Dietary Fiber Intake Is Inversely Associated with Periodontal Disease among US Adults.
abstract: BACKGROUND
  Approximately 47% of adults in the United States have periodontal disease. Dietary guidelines recommend a diet providing adequate fiber. Healthier dietary habits, particularly an increased fiber intake, may contribute to periodontal disease prevention.
  
  
  OBJECTIVE
  Our objective was to evaluate the relation of dietary fiber intake and its sources with periodontal disease in the US adult population (≥30 y of age).
  
  
  METHODS
  Data from 6052 adults participating in NHANES 2009-2012 were used. Periodontal disease was defined (according to the CDC/American Academy of Periodontology) as severe, moderate, mild, and none. Intake was assessed by 24-h dietary recalls. The relation between periodontal disease and dietary fiber, whole-grain, and fruit and vegetable intakes were evaluated by using multivariate models, adjusting for sociodemographic characteristics and dentition status.
  
  
  RESULTS
  In the multivariate logistic model, the lowest quartile of dietary fiber was associated with moderate-severe periodontitis (compared with mild-none) compared with the highest dietary fiber intake quartile (OR: 1.30; 95% CI: 1.00, 1.69). In the multivariate multinomial logistic model, intake in the lowest quartile of dietary fiber was associated with higher severity of periodontitis than dietary fiber intake in the highest quartile (OR: 1.27; 95% CI: 1.00, 1.62). In the adjusted logistic model, whole-grain intake was not associated with moderate-severe periodontitis. However, in the adjusted multinomial logistic model, adults consuming whole grains in the lowest quartile were more likely to have more severe periodontal disease than were adults consuming whole grains in the highest quartile (OR: 1.32; 95% CI: 1.08, 1.62). In fully adjusted logistic and multinomial logistic models, fruit and vegetable intake was not significantly associated with periodontitis.
  
  
  CONCLUSIONS
  We found an inverse relation between dietary fiber intake and periodontal disease among US adults ≥30 y old. Periodontal disease was associated with low whole-grain intake but not with low fruit and vegetable intake.
authors: Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA; snielsen@pitt.edu.
authors: Samara Joy
authors: http://orcid.org/0000-0002-5777-6542
authors: SJ
authors: Nielsen
authors: Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico; and.
authors: Maria Angelica
authors: MA
authors: Trak-Fellermeier
authors: Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico; and.
authors: Kaumudi
authors: http://orcid.org/0000-0003-1964-7579
authors: K
authors: Joshipura
authors: NIH, National Institute of Dental and Craniofacial Research, Bethesda, MD.
authors: Bruce A
authors: BA
authors: Dye
mesh_terms: D000328:Adult; D000368:Aged; D004043:Dietary Fiber / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: NHANES; dietary fiber; epidemiology; nutrition; periodontal disease; whole grains