Skip to main content Accessibility help

BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children – the IDEFICS Sweden study

  • Louise Arvidsson (a1), Dowen Birkhed (a2), Monica Hunsberger (a1), Anne Lanfer (a3), Lauren Lissner (a1), Kirsten Mehlig (a1), Staffan Mårild (a4) and Gabriele Eiben (a1)...



The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children’s weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children.


Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children.


West Sweden.


Children (n 271) aged 4–11 years.


Medium–high counts of MS were positively associated with higher BMI Z-score (OR=1·6; 95 % CI 1·1, 2·3). Positive associations were also found between medium–high counts of MS and more frequent meals per day (OR=1·5; 95 % CI 1·1, 2·2), greater percentage of sugar-rich foods consumed (OR=1·1; 95 % CI 1·0, 1·3) and female sex (OR=2·4; 95 % CI 1·1, 5·4). A negative association was found between medium–high counts of MS and longer sleep duration (OR=0·5; 95 % CI 0·3, 1·0).


BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.


Corresponding author

* Corresponding author: Email


Hide All
1. Bagramian, RA, Garcia-Godoy, F & Volpe, AR (2009) The global increase in dental caries. A pending public health crisis. Am J Dent 22, 38.
2. Hayden, C, Bowler, JO, Chambers, S et al. (2013) Obesity and dental caries in children: a systematic review and meta-analysis. Community Dent Oral Epidemiol 41, 289308.
3. Costacurta, M, DiRenzo, L, Sicuro, L et al. (2014) Dental caries and childhood obesity: analysis of food intakes, lifestyle. Eur J Paediatr Dent 15, 343348.
4. Te Morenga, L, Mallard, S & Mann, J (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 346, 7492.
5. Kawashita, Y, Kitamura, M & Saito, T (2011) Early childhood caries. Int J Dent 2011, 725320.
6. Moynihan, P & Petersen, PE (2004) Diet, nutrition and the prevention of dental diseases. Public Health Nutr 7, 201226.
7. Touger-Decker, R & van Loveren, C (2003) Sugars and dental caries. Am J Clin Nutr 78, 881892.
8. Hense, S, Pohlabeln, H, De Henauw, S et al. (2011) Sleep duration and overweight in European children: is the association modified by geographic region? Sleep 34, 885890.
9. Seegers, V, Petit, D, Falissard, B et al. (2011) Short sleep duration and body mass index: a prospective longitudinal study in preadolescence. Am J Epidemiol 173, 621629.
10. Gallant, AR, Lundgren, J & Drapeau, V (2012) The night-eating syndrome and obesity. Obes Rev 13, 528536.
11. Lundgren, JD, Smith, BM, Spresser, C et al. (2010) The relationship of night eating to oral health and obesity in community dental clinic patients. Gen Dent 58, e134e139.
12. Pieper, K, Dressler, S, Heinzel-Gutenbrunner, M et al. (2012) The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior. Int J Public Health 57, 207215.
13. Harris, R, Nicoll, AD, Adair, PM et al. (2004) Risk factors for dental caries in young children: a systematic review of the literature. Community Dent Health 21, 7185.
14. Bradshaw, DJ & Lynch, RJ (2013) Diet and the microbial aetiology of dental caries: new paradigms. Int Dent J 63, Suppl. 2, 6472.
15. Barkeling, B, Linné, Y, Lindroos, AK et al. (2002) Intake of sweet foods and counts of cariogenic microorganisms in relation to body mass index and psychometric variables in women. Int J Obes Relat Metab Disord 26, 12391244.
16. Barkeling, B, Andersson, I, Lindroos, AK et al. (2001) Intake of sweet foods and counts of cariogenic microorganisms in obese and normal-weight women. Eur J Clin Nutr 55, 850855.
17. Vågstrand, K, Lindroos, AK, Birkhed, D et al. (2008) Associations between salivary bacteria and reported sugar intake and their relationship with body mass index in women and their adolescent children. Public Health Nutr 11, 341348.
18. Tong, HJ, Rudolf, MC, Muyombwe, T et al. (2013) An investigation into the dental health of children with obesity: an analysis of dental erosion and caries status. Eur Arch Paediatr Dent 15, 203210.
19. De Henauw, S, Verbestel, V, Marild, S et al. (2011) The IDEFICS community-oriented intervention programme: a new model for childhood obesity prevention in Europe? Int J Obes (Lond) 35, Suppl. 1, S16S23.
20. Ahrens, W, Bammann, K, Siani, A et al. (2011) The IDEFICS cohort: design, characteristics and participation in the baseline survey. Int J Obes (Lond) 35, Suppl. 1, S3S15.
21. Emilson, CG (1983) Prevalence of Streptococcus mutans with different colonial morphologies in human plaque and saliva. Scand J Dent Res 91, 2632.
22. Klock, B & Krasse, B (1979) A comparison between different methods for prediction of caries activity. Scand J Dent Res 87, 129139.
23. Vereecken, CA, Covents, M, Sichert-Hellert, W et al. (2008) Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe. Int J Obes (Lond) 32, Suppl. 5, S26S34.
24. Willett, W (editor) (2013) Nature of variation in diet. In Nutritional Epidemiology, 3rd ed., pp. 3448. New York: Oxford University Press.
25. Svensson, Å, Larsson, C, Eiben, G et al. (2014) European children’s sugar intake on weekdays versus weekends: the IDEFICS study. Eur J Clin Nutr 68, 822828.
26. Lanfer, A, Hebestreit, A, Ahrens, W et al. (2011) Reproducibility of food consumption frequencies derived from the Children’s Eating Habits Questionnaire used in the IDEFICS study. Int J Obes (Lond) 35, Suppl. 1, S61S68.
27. Bel-Serrat, S, Mouratidou, T, Pala, V et al. (2014) Relative validity of the Children’s Eating Habits Questionnaire-food frequency section among young European children: the IDEFICS Study. Public Health Nutr 17, 266276.
28. Lanfer, A, Knof, K, Barba, G et al. (2012) Taste preferences in association with dietary habits and weight status in European children: results from the IDEFICS study. Int J Obes (Lond) 36, 2734.
29. Lissner, L, Lanfer, A, Gwozdz, W et al. (2012) Television habits in relation to overweight, diet and taste preferences in European children: the IDEFICS study. Eur J Epidemiol 27, 705715.
30. Marfell-Jones, M, Olds, T, Stewart, A et al. (2006) International Standards for Anthropometric Assessment. Potchefstroom, South Africa: International Society for the Advancement of Kinanthropometry.
31. Cole, TJ, Bellizzi, MC, Flegal, KM et al. (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 12401243.
32. United Nations Educational, Scientific and Cutlural Organization (2006) International Standard Classification of Education ISCED 1997. (accessed April 2013).
33. Hosmer, DW & Lemeshow, S (2000) Applied Logistic Regression, 2nd ed., pp. 160164. Toronto: Wiley.
34. Vågstrand, KE & Birkhed, D (2007) Cariogenic bacteria as biomarkers for sugar intake. Nutr Rev 65, 111121.
35. Berteus Forslund, H, Lindroos, AK, Sjostrom, L et al. (2002) Meal patterns and obesity in Swedish women-a simple instrument describing usual meal types, frequency and temporal distribution. Eur J Clin Nutr 56, 740747.
36. Law, V, Seow, WK & Townsend, G (2007) Factors influencing oral colonization of mutans streptococci in young children. Aust Dent J 52, 93100.
37. Skinner, JD, Carruth, BR, Bounds, W et al. (2002) Children’s food preferences: a longitudinal analysis. J Am Diet Assoc 102, 16381647.
38. Lytle, LA, Seifert, S, Greenstein, J et al. (2000) How do children’s eating patterns and food choices change over time? Results from a cohort study. Am J Health Promot 14, 222228.
39. Cooke, LJ & Wardle, J (2005) Age and gender differences in children’s food preferences. Br J Nutr 93, 741746.
40. Hagg, U & Taranger, J (1986) Timing of tooth emergence – a prospective longitudinal-study of Swedish urban children from birth to 18 years. Swed Dent J 10, 195206.
41. Del Cojo, MB, Lopez, NEG, Martinez, MRM et al. (2013) Time and sequence of eruption of permanent teeth in Spanish children. Eur J Paediatr Dent 14, 101103.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed