DOI QR코드

DOI QR Code

Association between consumption of milk and dairy products, calcium and riboflavin, and periodontitis in Korean adults: Using the 2007-2010 Korea National Health and Nutrition Examination Surveys

한국 성인의 우유 및 유제품과 칼슘 및 리보플라빈 섭취량과 치주염 간의 연관성: 2007~2010년 국민건강영양조사 자료를 이용하여

  • Koo, Sang Mi (Graduate School of Clinical Health Sciences, Ewha Womans University) ;
  • Seo, Deog-Gyu (Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Park, Yoon Jung (Department of Nutritional Science & Food Management, College of Health Science, Ewha Womans University) ;
  • Hwang, Ji-Yun (Nutrition Education Major, Graduate School of Education, Sangmyung University)
  • 구상미 (이화여자대학교 임상보건과학대학원 임상보건학과) ;
  • 서덕규 (서울대학교 치의학대학원) ;
  • 박윤정 (이화여자대학교 건강과학대학 식품영양학과) ;
  • 황지윤 (상명대학교 교육대학원 영양교육전공)
  • Received : 2014.05.09
  • Accepted : 2014.08.12
  • Published : 2014.08.31

Abstract

Purpose: The current study was designed to investigate the relationship of dietary calcium and riboflavin and their main dietary source (milk and dairy products) with the risk of periodontitis using data from 2007 to 2010 Korea National Health and Nutrition Examination Surveys. Methods: A total of 1,690 adults aged ${\geq}40$ years were included. We used results of dental examination regarding all sextant information on probing depth of at least two index teeth, nutritional assessment by a single 24-hour dietary recall, and demographic and medical information. The periodontitis group was defined as those who had 3-4 points, and the normal group was defined as those who had 0 points of Community Periodontal Index at all locations of six examination sites using a probe. Results: Using multiple logistic regression analysis, after adjustment for age, body mass index, energy intake, income, smoking, and alcohol drinking, we found an inverse relationship between consumption of dairy products and risk for periodontitis (OR: 0.465, 95% CI: 0.224-0.964) and between dietary riboflavin intake more than the estimated average requirements and risk for periodontitis (OR: 0.535, 95% CI: 0.300-0.954) in males. Conclusion: Adequate intake of milk dairy products and riboflavin may be recommended for prevention of periodontitis in the Korean male population.

본 연구에서는 2007~2010년 국민건강영양조사에 참여한 40세 이상 남녀 중 건강설문조사, 구강검진 및 영양조사 자료가 모두 존재하는 1,690명을 대상으로 한국인에게 부족한 영양소인 칼슘 및 리보플라빈, 그리고 칼슘과 리보플라빈의 주요급원식품인 우유 및 유제품 섭취량과 치주염과의 연관성을 파악하고자 하였다. 통계분석은 SAS 9.3 프로그램을 이용하여 분석하였고, 다음과 같은 결과를 얻었다. 1) 인구 사회학적, 건강 관련, 신체계측 변수와 치주질환과의 상관성을 분석한 결과 여성의 경우 연령대가 높을수록 (p < 0.0001) 치주염 유병률이 높았으며, 치주염군에서 평균연령 (p < 0.0001)과 체질량지수 (p < 0.0001)가 높았으나 남성의 경우 이와 같은 차이가 없었다. 남녀 모두 교육수준이 낮을수록 (p < 0.0001), 월평균 소득수준이 낮을수록 (남성 p < 0.0001, 여성 p = 0.0044) 비흡연자에 비해 흡연자에서 (남성 p < 0.0001, 여성 p = 0.0180) 치주질환 유병률이 높았으며, 음주횟수가 많을수록 (남성 p = 0.0036, 여성 p = 0.0075) 치주질환 유병률이 높았다. 2) 남성의 경우 정상군에 비해 치주염군에서 우유 및 유제품, 칼슘 및 리보플라빈 섭취량이 낮았다. 연령, 체질량지수, 에너지 섭취량, 소득수준, 흡연상태, 음주정도의 교란변수 보정 후 우유 및 유제품 섭취를 안했을 경우에 비해 섭취하였을 경우 치주염 유병률이 감소하였으나 (p = 0.0396), 칼슘 섭취량과 치주염 유병률 간의 연관성은 유의하지 않았다 (P-trend = 0.3504). 반면 리보플라빈 섭취량의 1사분위에 비해 3사분위에서 치주염에 이환될 확률이 2.91배 감소 (OR: 0.344, 95% CI: 0.153-0.773)하였으나 섭취량 증가에 따른 치주염 간의 상관성은 일관되게 나타나지 않았으며 (P-trend = 0.0855) 리보플라빈 섭취량을 한국인 영양섭취기준의 해당 성, 연령별 권장 섭취량 기준으로 미만 섭취하였을 경우보다 이상 섭취한 경우 치주염 유병 가능성이 1.87배 감소하였다 (OR: 0.535, 95% CI: 0.300-0.954). 여성의 경우 정상군에 비해 치주염군에서 리보플라빈 섭취량이 낮게 나타났으나 (p = 0.0067) 두 군간 우유 및 유제품, 칼슘 섭취량과는 유의적인 차이가 없었으며 섭취량과 치주염 유병률 간의 연관성 분석결과 통계적으로 유의하지 않았다. 이상의 결과에서 남성의 경우 우유 및 유제품, 리보플라빈 섭취량과 치주염과의 밀접한 연관성이 있음을 알 수 있으며, 이에 따라 개별적인 구강위생관리와 함께 식이섭취의 중요성을 강조하여 치주염 예방 관리를 권고할 것을 제언한다.

Keywords

References

  1. Health Policy Institute. Korea national oral health survey 2010: II. Survey report. Seoul: Ministry of Health and Welfare; 2011.
  2. Lee SK, Lee KW, Chang KW. Reasons for extracted permanent teeth in Korean population. J Korean Acad Dent Health 2001; 25(2): 139-163.
  3. Esfahanian V, Shamami MS, Shamami MS. Relationship between osteoporosis and periodontal disease: review of the literature. J Dent (Tehran) 2012; 9(4): 256-264.
  4. Beck JD, Offenbacher S. The association between periodontal diseases and cardiovascular diseases: a state-of-the-science review. Ann Periodontol 2001; 6(1): 9-15. https://doi.org/10.1902/annals.2001.6.1.9
  5. Genco R, Offenbacher S, Beck J. Periodontal disease and cardiovascular disease: epidemiology and possible mechanisms. J Am Dent Assoc 2002; 133 Suppl: 14S-22S. https://doi.org/10.14219/jada.archive.2002.0375
  6. Borgnakke WS, Ylostalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol 2013; 84(4 Suppl): S135-S152. https://doi.org/10.1902/jop.2013.1340013
  7. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005; 366(9499): 1809-1820. https://doi.org/10.1016/S0140-6736(05)67728-8
  8. Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol 2008; 79(8 Suppl): 1560-1568. https://doi.org/10.1902/jop.2008.080213
  9. Amaliya, Timmerman MF, Abbas F, Loos BG, Van der Weijden GA, Van Winkelhoff AJ, Winkel EG, Van der Velden U. Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis. J Clin Periodontol 2007; 34(4): 299-304. https://doi.org/10.1111/j.1600-051X.2007.01053.x
  10. Enwonwu CO. Interface of malnutrition and periodontal diseases. Am J Clin Nutr 1995; 61(2): 430S-436S. https://doi.org/10.1093/ajcn/61.2.430S
  11. Neiva RF, Steigenga J, Al-Shammari KF, Wang HL. Effects of specific nutrients on periodontal disease onset, progression and treatment. J Clin Periodontol 2003; 30(7): 579-589. https://doi.org/10.1034/j.1600-051X.2003.00354.x
  12. Boyd LD, Madden TE. Nutrition, infection, and periodontal disease. Dent Clin North Am 2003; 47(2): 337-354. https://doi.org/10.1016/S0011-8532(02)00103-9
  13. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Cheongwon: Korea Centers for Disease Control and Prevention;2013.
  14. Park KI, Lee JY, Hwang DS, Kim YD, Kim GC, Shin SH, Kim UK, Chung IK. Effect of calcium and vitamin D supplementation on bone formation around titanium implant. J Korean Assoc Oral Maxillofac Surg 2007; 33(2): 131-138.
  15. Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M, Genco RJ. Calcium and the risk for periodontal disease. J Periodontol 2000; 71(7): 1057-1066. https://doi.org/10.1902/jop.2000.71.7.1057
  16. Petti S, Cairella G, Tarsitani G. Nutritional variables related to gingival health in adolescent girls. Community Dent Oral Epidemiol 2000; 28(6): 407-413. https://doi.org/10.1034/j.1600-0528.2000.028006407.x
  17. Omarov IA, Bolevich SB, Savateeva-Liubimova TN, Silina EV, Sivak KV. Oxidative stress and combined antioxidant energy correction in the treatment of periodontitis. Stomatologiia (Mosk) 2011; 90(1): 10-17.
  18. Charbeneau TD, Hurt WC. Gingival findings in spontaneous scurvy. A case report. J Periodontol 1983; 54(11): 694-697. https://doi.org/10.1902/jop.1983.54.11.694
  19. Neiva RF, Al-Shammari K, Nociti FH Jr, Soehren S, Wang HL. Effects of vitamin-B complex supplementation on periodontal wound healing. J Periodontol 2005; 76(7): 1084-1091. https://doi.org/10.1902/jop.2005.76.7.1084
  20. Tomlinson TH Jr. Oral pathology in monkeys in various experimental dietary deficiencies. Public Health Rep 1939; 54(11): 431-439. https://doi.org/10.2307/4582825
  21. Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M, Genco RJ. Dietary vitamin C and the risk for periodontal disease. J Periodontol 2000; 71(8): 1215-1223. https://doi.org/10.1902/jop.2000.71.8.1215
  22. Koo SM, Park YJ, Hwang JY. Association between consumption of fruits and vitamin c and generalized periodontitis in Korean adults: the 2007-2010 Korean National Health and Nutrition Examination Surveys. J Korean Soc Dent Mater 2013; 40(2): 77-85.
  23. Garcia MN, Hildebolt CF, Miley DD, Dixon DA, Couture RA, Spearie CL, Langenwalter EM, Shannon WD, Deych E, Mueller C, Civitelli R. One-year effects of vitamin D and calcium supplementation on chronic periodontitis. J Periodontol 2011; 82(1): 25-32. https://doi.org/10.1902/jop.2010.100207
  24. Adegboye AR, Christensen LB, Holm-Pedersen P, Avlund K, Boucher BJ, Heitmann BL. Intake of dairy products in relation to periodontitis in older Danish adults. Nutrients 2012; 4(9): 1219-1229. https://doi.org/10.3390/nu4091219
  25. Al-Zahrani MS. Increased intake of dairy products is related to lower periodontitis prevalence. J Periodontol 2006; 77(2): 289-294. https://doi.org/10.1902/jop.2006.050082
  26. Shimazaki Y, Shirota T, Uchida K, Yonemoto K, Kiyohara Y, Iida M, Saito T, Yamashita Y. Intake of dairy products and periodontal disease: the Hisayama Study. J Periodontol 2008; 79(1): 131-137. https://doi.org/10.1902/jop.2008.070202
  27. Staab B, Eick S, Knofler G, Jentsch H. The influence of a probiotic milk drink on the development of gingivitis: a pilot study. J Clin Periodontol 2009; 36(10): 850-856. https://doi.org/10.1111/j.1600-051X.2009.01459.x
  28. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The 4th National Health and Nutrition Examination Raw Data Guidebook 2007-2009. Cheongwon: Korea Centers for Disease Control and Prevention; 2010.
  29. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The 5th National Health and Nutrition Examination Raw Data Guidebook 2010-2012. Cheongwon: Korea Centers for Disease Control and Prevention; 2013.
  30. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. The 5th National Health and Nutrition Examination Guidebook 2010-2012. Cheongwon: Korea Centers for Disease Control and Prevention; 2013.
  31. Inagaki K, Kurosu Y, Yoshinari N, Noguchi T, Krall EA, Garcia RI. Efficacy of periodontal disease and tooth loss to screen for low bone mineral density in Japanese women. Calcif Tissue Int 2005; 77(1): 9-14. https://doi.org/10.1007/s00223-004-0275-x
  32. The Korean Nutrition Society. Dietary reference intakes for Koreans 2010, 1st revision. Seoul: The Korean Nutrition Society;2010.
  33. Freeland JH, Cousins RJ, Schwartz R. Relationship of mineral status and intake to periodontal disease. Am J Clin Nutr 1976; 29(7): 745-749. https://doi.org/10.1093/ajcn/29.7.745
  34. Kim S, Yu A, Yang YJ. Association of food and nutrient intakes with periodontitis by smoking status among Korean adults. Korean J Community Nutr 2014; 19(1): 84-94. https://doi.org/10.5720/kjcn.2014.19.1.84
  35. Adegboye AR, Fiehn NE, Twetman S, Christensen LB, Heitmann BL. Low calcium intake is related to increased risk of tooth loss in men. J Nutr 2010; 140(10): 1864-1868. https://doi.org/10.3945/jn.109.117770
  36. McCaul LK, Jenkins WM, Kay EJ. The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study. Br Dent J 2001; 190(12): 658-662.
  37. Vatanparast H, Dolega-Cieszkowski JH, Whiting SJ. Many adult Canadians are not meeting current calcium recommendations from food and supplement intake. Appl Physiol Nutr Metab 2009; 34(2): 191-196. https://doi.org/10.1139/H09-005

Cited by

  1. Comparison of Calcium Intake Status by Region and Socioeconomic Status in Korea: The 2011-2013 Korea National Health and Nutrition Examination Survey vol.22, pp.3, 2015, https://doi.org/10.11005/jbm.2015.22.3.119
  2. Estimation of Usual Intake and Assessment of Nutrient Intake for Korean Adolescents: Analysis of the 2010-2012 Korea National Health and Nutrition Examination Survey vol.55, pp.4, 2017, https://doi.org/10.6115/fer.2017.028
  3. Is overweight/obesity a risk factor for periodontitis in young adults and adolescents?: a systematic review vol.19, pp.6, 2018, https://doi.org/10.1111/obr.12668
  4. 치주검사와 설문조사를 통한 성인의 구강건강관리행태 및 식이행태와 치주질환과의 관련성 vol.20, pp.6, 2014, https://doi.org/10.13065/jksdh.20200087
  5. 한국 청소년의 우유섭취 빈도에 따른 혈액 생화학적 특성 및 영양 섭취: 2010~2011 국민건강영양조사 자료를 이용하여 vol.25, pp.6, 2014, https://doi.org/10.5720/kjcn.2020.25.6.485