Dietary patterns and root caries risk

描述（由申请人提供）：美国人口正在老龄化，与前几代人相比，个人将更多的牙齿保留到老年。这些趋势表明，根龋的患病率和治疗费用将继续上升。需要更多的研究来更好地了解饮食如何影响根龋风险。我们对龋齿的饮食风险因素，特别是糖的了解，大多来自于对冠（釉质）龋的研究，主要是在儿童中进行的，并且在氟化物广泛使用之前进行。目前尚不清楚这些研究与老年人根龋问题的相关性。根龋可以在比冠龋酸性小的环境中发展。老年人往往比年轻人摄入更少的糖。因此，其他饮食因素的作用，无论是致龋和保护，需要加以研究。饮食和根龋的研究是复杂的，因为各种营养素的摄入量高度相关。饮食模式分析是一种方法学方法，已用于饮食和其他慢性疾病的研究。本研究的目的是调查饮食模式与根龋风险使用现有的数据从两个研究人群。第一个人群是成年男性的前瞻性VA牙科纵向研究（DLS），该研究收集了20年来有关根龋和龋齿、饮食和其他口腔健康、生活方式和医疗变量的数据。这些人不是退伍军人管理局的病人，而是退伍军人管理局研究中的志愿者，他们从私营部门接受医疗和牙科护理。根龋患病率和发病率将估计从563 DLS受试者谁参加了两个或两个以上的牙科检查，在过去的20年。我们的主要假设是，根龋的患病率，发病率和严重程度降低老年男性谁遵循的饮食模式是高的水果，蔬菜，低脂奶制品和全谷物，即使在存在适度的糖摄入量。为了解决这一假设，我们将使用聚类分析，以确定饮食模式，从食物频率问卷在DLS与根龋的风险降低。我们将使用多变量logistic、生存和Poisson回归分析来估计与饮食模式相关的乳牙和继发根龋患病率、发病率和严重程度。所有模型均将控制重要混杂因素。饮食模式将在第二个人口中得到验证，即2003- 2004年进行的全国健康和营养状况调查。在这项调查中，5122名成年人接受了牙科检查，并完成了食物频率问卷。虽然NHANES仅提供根龋患病率的测量，但样本权重可用于获得整个人口以及特定性别和种族亚组的全国代表性疾病估计。这项研究的一个重要成果是有可能为患者和公众创建一套一致的饮食建议，将口腔健康纳入整体健康促进战略。 公共卫生相关性：随着美国人寿命的延长和牙齿的保存，牙根腐烂预计将成为美国老年人日益严重的问题。这项研究将确定与一组老年男性和一个全国代表性的成年男性和女性样本中的根腐烂相关的饮食模式。这一发现可能有助于确定健康的饮食模式，以减少牙根腐烂的风险。

DESCRIPTION (provided by applicant): The US population is aging and individuals are keeping more of their teeth into old age compared to previous generations. These trends suggest the prevalence of root caries and expenditures to treat them will continue to rise. More research is needed to better understand how diet affects root caries risk. Most of our knowledge about dietary risk factors for caries, particularly sugars, comes from studies of coronal (enamel) caries, primarily in children, and conducted prior to the widespread availability of fluoride. It is not clear how relevant these studies are to the current problem of root caries in older adults. Root caries can develop in a less acidic environment than coronal caries. Older adults tend to consume less sugar than younger age groups. Therefore, the roles of other dietary factors, both cariogenic and protective, need to be examined. The study of diet and root caries is complex because intakes of various nutrients are highly correlated. Analysis of dietary patterns is a methodological approach that has been used in the study of diet and other chronic diseases. The aim of this research is to investigate dietary patterns that are associated with root caries risk using existing data from two study populations. The first population is the prospective VA Dental Longitudinal Study (DLS) of adult men which has collected 2 decades of data on root caries and restorations, diet, and other oral health, lifestyle, and medical variables. The men are not VA patients, but are volunteers in a VA study who receive medical and dental care from the private sector. Root caries prevalence and incidence will be estimated from 563 DLS subjects who have participated in two or more dental examinations in the past 20 years. Our primary hypothesis is that root caries prevalence, incidence and severity are reduced among older men who follow a dietary pattern that is high in fruits, vegetables, low-fat dairy and whole grains, even in the presence of moderate sugar intake. To address this hypothesis, we will use cluster analysis to identify dietary patterns from food frequency questionnaires in the DLS that are associated with reduced risk of root caries. We will use multivariable logistic, survival and Poisson regression analyses to estimate the primary and secondary root caries prevalence, incidence and severity associated with the dietary patterns. All models will control for important confounders. The dietary patterns will be validated in the second population, the cross-sectional NHANES survey conducted in 2003-04. In this survey, 5122 adults received dental examinations and completed food frequency questionnaires. Although NHANES only provides measures of root caries prevalence, sample weights can be used to derive nationally representative estimates of disease in the population as a whole and in gender- and ethnic-specific subgroups. An important result of this research is the potential for creating a consistent set of dietary recommendations for patients and the public that integrates oral health into overall health promotion strategies. PUBLIC HEALTH RELEVANCE: Root decay is expected to be a growing problem among older adults in the US as people live longer and keep more of their teeth. This study will identify dietary patterns that are associated with root decay in a group of older men and in a nationally representative sample of adult men and women. The findings may help to define healthy eating patterns that reduce the risk of root decay.