Dietary patterns and root caries risk

描述(由申请者提供)：美国人口正在老龄化，与前几代人相比，个人在老年时保留了更多的牙齿。这些趋势表明，根面龋病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面龋病风险。关于龋齿的饮食危险因素，特别是糖类，我们的大部分知识来自于对冠状(釉质)龋齿的研究，主要是在儿童中，在氟化物普及之前进行的。目前尚不清楚这些研究与目前老年人根面龋齿问题的相关性有多大。根面龋齿可以在酸性较弱的环境中形成，而不是冠状龋齿。与年轻群体相比，老年人往往摄入更少的糖。因此，需要研究其他饮食因素的作用，包括致龋性和保护性。饮食和根面龋齿的研究是复杂的，因为各种营养素的摄入量高度相关。饮食模式分析是研究饮食和其他慢性病的一种方法学方法。这项研究的目的是利用两个研究人群的现有数据来调查与根面龋病风险相关的饮食模式。第一个人群是针对成年男性的预期VA牙科纵向研究(DLS)，该研究收集了20年来关于根面龋齿和修复、饮食和其他口腔健康、生活方式和医学变量的数据。这些人不是退伍军人事务部的患者，而是退伍军人事务部一项研究的志愿者，他们从私营部门接受医疗和牙科护理。根面龋病患病率和发病率将从563名在过去20年中参加过两次或两次以上牙科检查的DLS受试者中进行估计。我们的主要假设是，在遵循高水果、蔬菜、低脂乳制品和全谷物饮食模式的老年男性中，根部龋齿的患病率、发病率和严重程度都会降低，即使是在中等糖摄入量的情况下也是如此。为了解决这一假设，我们将使用聚类分析从DLS中的食物频率问卷中确定与降低根面龋病风险相关的饮食模式。我们将使用多变量Logistic、存活率和泊松回归分析来估计与饮食模式相关的原发和继发根面龋患病率、发病率和严重程度。所有模型都将控制重要的混杂因素。饮食模式将在2003-04年进行的第二个人群--NHANES横断面调查中得到验证。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。尽管NHANES只提供根面龋病患病率的衡量标准，但样本权重可用于得出具有全国代表性的对整个人口和特定性别和种族亚群的疾病估计。这项研究的一个重要结果是有可能为患者和公众创造一套一致的饮食建议，将口腔健康纳入整体健康促进战略。 与公共健康相关：随着人们寿命的延长和牙齿的保留，根腐烂在美国老年人中预计将成为一个日益严重的问题。这项研究将在一组老年男性和具有全国代表性的成年男性和女性样本中确定与根部腐烂有关的饮食模式。这些发现可能有助于定义健康的饮食模式，降低根部腐烂的风险。

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.