Association between composite dietary antioxidant index and the prevalence of periodontitis: results from NHANES 2009-2014

Abstract

Background: The antioxidant system of periodontal tissue is unbalanced in periodontitis, and appropriate supplementation of antioxidants can effectively prevent or alleviate periodontal tissue damage. However, a dearth of research exists on the association between dietary antioxidant intake and the prevalence of periodontitis.

Methods: Six dietary antioxidants (vitamins A, C, and E, zinc, selenium, and carotenoids) were extracted from two 24-h recall interviews utilizing data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2014. The composite dietary antioxidant index (CDAI) made calculations using data on the intake of these six dietary antioxidants. Periodontitis severity was categorized into mild, moderate, and severe classifications based on established consensus criteria. Additionally, a restricted cubic spline (RCS) regression model was applied to evaluate the potential non-linear dose-response relationship between CDAI and periodontitis prevalence.

Results: A total of 9,378 adults were included in this analysis, of which 4,755 had periodontitis. Individuals within the highest CDAI quartile demonstrated a diminished prevalence of total periodontitis compared to those in the lowest quartile (OR = 0.70 [0.53-0.93], P_trend = 0.012). When moderate/severe periodontitis served as the outcome variable, those within the fourth CDAI quartile exhibited a 32% reduced prevalence compared to those in the first quartile (OR = 0.68 [0.52-0.88], P_trend = 0.006). RCS regression showed that CDAI was linearly and negatively related to the prevalence of periodontitis (both total and moderate/severe periodontitis). In subgroup analysis by gender, a significant association between CDAI and total periodontitis was discerned solely among females (OR = 0.60 [0.42-0.85], P_interaction = 0.015).

Conclusion: Elevated dietary antioxidant intake is associated with a diminished prevalence of periodontitis. These findings underscore the potential role of antioxidants in periodontal health.

Keywords: Antioxidants; CDAI; Dietary intake; NHANES; Periodontitis.

Fig. 1

The exposure–response association of the composite dietary antioxidant index (CDAI) with the prevalence of periodontitis by restricted cubic spline (RCS). A Total periodontitis. B Moderate/severe periodontitis. Analyses were adjusted for covariates age (continuous), sex (male or female), race (Mexican American, Other Hispanic, Non-Hispanic White, Non-Hispanic Black or Other), education level (below high school, high school, or above high school), family income-to-poverty ratio (≤ 1.0, 1.1–3.0, or > 3.0), smoking status (never smoker, former smoker, or current smoker), drinking status (nondrinker, low-to-moderate drinker, or heavy drinker), BMI (< 25.0, 25.0–29.9, or > 29.9), energy intake levels (in quartiles), physical activity (inactive, insufficiently active, or active), diabetes (yes or no), hypertension (yes or no), CVD (yes or no), and cancer (yes or no)