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Dietary antioxidants and periodontal disease in community-based older Japanese: a 2-year follow-up study

  • Masanori Iwasaki (a1), Paula Moynihan (a2), Michael C Manz (a3), George W Taylor (a4), Akihiro Yoshihara (a5), Kanako Muramatsu (a6), Reiko Watanabe (a6) and Hideo Miyazaki (a1)...



To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese.


A retrospective cohort study, with a follow-up of 2 years (2003–2005). Intakes of dietary antioxidants (vitamin C, vitamin E, α-carotene and β-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3 mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression.


Niigata City (Japan).


Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264).


A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1·00, 0·76 (95 % CI 0·60, 0·97) and 0·72 (95 % CI 0·56, 0·93) for vitamin C; 1·00, 0·79 (95 % CI 0·62, 0·99) and 0·55 (95 % CI 0·42, 0·72), for vitamin E; and 1·00, 1·02 (95 % CI 0·81, 1·29) and 0·73 (95 % CI 0·56, 0·95) for β-carotene.


The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.

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1.Petersen, PE & Ogawa, H (2005) Strengthening the prevention of periodontal disease: the WHO approach. J Periodontol 76, 21872193.
2.Locker, D, Ford, J & Leake, JL (1996) Incidence of and risk factors for tooth loss in a population of older Canadians. J Dent Res 75, 783789.
3.Iwasaki, M, Yoshihara, A, Hirotomi, Tet al. (2008) Longitudinal study on the relationship between serum albumin and periodontal disease. J Clin Periodontol 35, 291296.
4.Taylor, GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol 6, 99112.
5.Axelsson, P, Paulander, J & Lindhe, J (1998) Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals. J Clin Periodontol 25, 297305.
6.Chapple, IL & Matthews, JB (2007) The role of reactive oxygen and antioxidant species in periodontal tissue destruction. Periodontol 2000 43, 160232.
7.Sies, H (1991) Oxidative stress: introduction. In Oxidative Stress: Oxidants and Antioxidants, pp. 1521 [H Sies, editor]. London: Academic Press.
8.Chapple, IL (1996) Role of free radicals and antioxidants in the pathogenesis of the inflammatory periodontal diseases. Clin Mol Pathol 49, M247M255.
9.Chapple, IL (1997) Reactive oxygen species and antioxidants in inflammatory diseases. J Clin Periodontol 24, 287296.
10.Waddington, RJ, Moseley, R & Embery, G (2000) Reactive oxygen species: a potential role in the pathogenesis of periodontal diseases. Oral Dis 6, 138151.
11.Lee, NK, Choi, YG, Baik, JYet al. (2005) A crucial role for reactive oxygen species in RANKL-induced osteoclast differentiation. Blood 106, 852859.
12.Maritim, AC, Sanders, RA & Watkins, JB 3rd (2003) Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol 17, 2438.
13.Ozkan, Y, Yardym-Akaydyn, S, Sepici, Aet al. (2007) Oxidative status in rheumatoid arthritis. Clin Rheumatol 26, 6468.
14.Wolfram, R, Oguogho, A, Palumbo, Bet al. (2005) Enhanced oxidative stress in coronary heart disease and chronic heart failure as indicated by an increased 8-epi-PGF(2 alpha). Eur J Heart Fail 7, 167172.
15.Hertog, MG, Feskens, EJ, Hollman, PCet al. (1993) Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet 342, 10071011.
16.Institute of Medicine (1998) Dietary Reference Intakes. Proposed Definition and Plan for Review of Dietary Antioxidant and Related Compounds. Washington, DC: National Academy Press.
17.Knekt, P, Ritz, J, Pereira, MAet al. (2004) Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. Am J Clin Nutr 80, 15081520.
18.Rock, CL, Jacob, RA & Bowen, PE (1996) Update on the biological characteristics of the antioxidant micronutrients: vitamin C, vitamin E, and the carotenoids. J Am Diet Assoc 96, 693702.
19.Thurnham, DI (1994) Carotenoids: functions and fallacies. Proc Nutr Soc 53, 7787.
20.Nishida, M, Grossi, SG, Dunford, RGet al. (2000) Dietary vitamin C and the risk for periodontal disease. J Periodontol 71, 12151223.
21.Chapple, ILC, Milward, MR & Dietrich, T (2007) The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations. J Nutr 137, 657664.
22.Brock, GR, Butterworth, CJ, Matthews, JBet al. (2004) Local and systemic total antioxidant capacity in periodontitis and health. J Clin Periodontol 31, 515521.
23.Sculley, DV & Langley-Evans, SC (2003) Periodontal disease is associated with lower antioxidant capacity in whole saliva and evidence of increased protein oxidation. Clin Sci (Lond) 105, 167172.
24.Chapple, IL, Brock, GR, Milward, MRet al. (2007) Compromised GCF total antioxidant capacity in periodontitis: cause or effect? J Clin Periodontol 34, 103110.
25.Kim, JS, Park, JY, Chung, WYet al. (2004) Polymorphisms in genes coding for enzymes metabolizing smoking-derived substances and the risk of periodontitis. J Clin Periodontol 31, 959964.
26.Sasaki, S (2004) Development and evaluation of dietary assessment methods using biomarkers and diet history questionnaires for individuals. In Research for Evaluation Methods of Nutrition and Dietary Lifestyle Programs Held on Healthy Japan 21. Summary Report, pp. 1044 [H Tanaka, editor]. Tokyo: Ministry of Health, Welfare, and Labour (in Japanese).
27.Murakami, K, Mizoue, T, Sasaki, Set al. (2008) Dietary intake of folate, other B vitamins, and omega-3 polyunsaturated fatty acids in relation to depressive symptoms in Japanese adults. Nutrition 24, 140147.
28.Sasaki, S, Ushio, F, Amano, Ket al. (2000) Serum biomarker-based validation of a self-administered diet history questionnaire for Japanese subjects. J Nutr Sci Vitaminol (Tokyo) 46, 285296.
29.Sasaki, S, Yanagibori, R & Amano, K (1998) Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol 8, 203215.
30.Sasaki, S, Yanagibori, R & Amano, K (1998) Validity of a self-administered diet history questionnaire for assessment of sodium and potassium: comparison with single 24-hour urinary excretion. Jpn Circ J 62, 431435.
31.Science and Technology Agency (2005) Standard Tables of Food Composition in Japan, 5th revised ed. Tokyo: National Printing Bureau (in Japanese).
32.Brown, LF, Beck, JD & Rozier, RG (1994) Incidence of attachment loss in community-dwelling older adults. J Periodontol 65, 316323.
33.Tonetti, MS & Claffey, N (2005) Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol 32, Suppl. 6, 210213.
34.Nordstrom, G, Bergman, B, Borg, Ket al. (1998) A 9-year longitudinal study of reported oral problems and dental and periodontal status in 70- and 79-year-old city cohorts in northern Sweden. Acta Odontol Scand 56, 7684.
35.Burton, GW & Ingold, KU (1984) β-Carotene: an unusual type of lipid antioxidant. Science 224, 569573.
36.Fisher, MA, Taylor, GW, West, BTet al. (2011) Bidirectional relationship between chronic kidney and periodontal disease: a study using structural equation modeling. Kidney Int 79, 347355.
37.Meydani, M (1995) Vitamin E. Lancet 345, 170175.
38.Sen, CK (1995) Oxidants and antioxidants in exercise. J Appl Physiol 79, 675686.
39.Tannenbaum, SR, Wishnok, JS & Leaf, CD (1991) Inhibition of nitrosamine formation by ascorbic acid. Am J Clin Nutr 53, 1 Suppl., S247S250.
40.Weber, P, Bendich, A & Schalch, W (1996) Vitamin C and human health – a review of recent data relevant to human requirements. Int J Vitam Nutr Res 66, 1930.
41.Helmersson, J, Arnlov, J, Larsson, Aet al. (2009) Low dietary intake of β-carotene, α-tocopherol and ascorbic acid is associated with increased inflammatory and oxidative stress status in a Swedish cohort. Br J Nutr 101, 17751782.
42.Grossi, SG, Nowadly, CA, Takemura, Aet al. (2004) Development of an antioxidant supplement for smokers with periodontal disease. J Dent Res 83, 0192.
43.Bates, CJ, Hamer, M & Mishra, GD (2011) Redox-modulatory vitamins and minerals that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of people aged 65 years and over. Br J Nutr 105, 123132.
44.Ervin, RB, Wright, JD, Wang, CYet al. (2004) Dietary intake of selected vitamins for the United States population: 1999–2000. Adv Data issue 339, 14.
45.Katanoda, K & Matsumura, Y (2002) National Nutrition Survey in Japan – its methodological transition and current findings. J Nutr Sci Vitaminol (Tokyo) 48, 423432.
46.Yoshihara, A, Watanabe, R, Hanada, Net al. (2009) A longitudinal study of the relationship between diet intake and dental caries and periodontal disease in elderly Japanese subjects. Gerodontology 26, 130136.
47.Tanaka, K, Miyake, Y, Sasaki, Set al. (2007) Relationship between intake of vegetables, fruit, and grains and the prevalence of tooth loss in Japanese women. J Nutr Sci Vitaminol (Tokyo) 53, 522528.
48.Krall, E, Hayes, C & Garcia, R (1998) How dentition status and masticatory function affect nutrient intake. J Am Dent Assoc 129, 12611269.
49.Yoshihara, A, Watanabe, R, Nishimuta, Met al. (2005) The relationship between dietary intake and the number of teeth in elderly Japanese subjects. Gerodontology 22, 211218.
50.Ministry of Health, Labour and Welfare Japan (2003) National Health and Nutrition Survey. (accessed February 2012).
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Public Health Nutrition
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