Obesity and periodontal disease in young, middle-aged, and older adults.

BACKGROUND The growing prevalence of increased body weight and obesity in the United States has raised significant public health concerns. Obesity has been implicated as a risk factor for several chronic health conditions, as well as being associated with increased mortality. Recently, an association between obesity and periodontal disease was found in a Japanese population. The purpose of the present study is to examine the relation between body weight and periodontal disease in a representative United States sample. METHODS Participants in the third National Health and Nutrition Examination Survey (NHANES III) who were > or =18 years and had undergone a periodontal examination were selected for the analysis (n = 13,665). Body mass index (BMI) and waist circumference (WC) were used as measures of overall and abdominal fat content, respectively. Univariable and multivariable logistic regression models were used to estimate the association between increased body weight and periodontal disease. BMI and WC were assessed independently in a multivariable logistic model containing the following variables: gender, race, education, poverty index, smoking, diabetes, and time elapsed since last dental visit. Significant interactions with age were found and analyses were then stratified by age: younger (18 to 34 years old), middle-aged (35 to 59 years old), and older (60 to 90 years old) adults. RESULTS A significant association between the measures of body fat and periodontal disease was found among the younger adults, but not middle or older adults. The adjusted odds ratios (OR) for having periodontal disease were 0.21 (0.080 to 0.565), 1.00 (0.705 to 1.407), and 1.76 (1.187 to 2.612) for subjects with BMI < 18.5 kg/m2, 25-29.9 kg/m2, and > or = 30 kg/m2, respectively. Young subjects with high WC had an adjusted OR of 2.27 (1.480 to 3.487) for having periodontal disease. CONCLUSIONS In a younger population, overall and abdominal obesity are associated with increased prevalence of periodontal disease, while underweight (BMI < 18.5) is associated with decreased prevalence. Obesity could be a potential risk factor for periodontal disease especially among younger individuals. Promotion of healthy nutrition and adequate physical activity may be additional factors to prevent or halt the rate of progression of periodontal disease.

[1]  G. Slade,et al.  Environmental tobacco smoke and periodontal disease in the United States. , 2001, American journal of public health.

[2]  J M Albandar,et al.  Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. , 1999, Journal of periodontology.

[3]  M. Thun,et al.  The effect of age on the association between body-mass index and mortality. , 1998, The New England journal of medicine.

[4]  M. Vanhala,et al.  Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study , 1998, BMJ.

[5]  B. Popkin,et al.  US adolescent food intake trends from 1965 to 1996 , 2000, Archives of disease in childhood.

[6]  T. Saito,et al.  Relationship between Upper Body Obesity and Periodontitis , 2001, Journal of dental research.

[7]  S. Tomar,et al.  Smoking-Attributable Periodontitis in the United States: Findings From NHANES III. , 2000, Journal of periodontology.

[8]  W R Foster,et al.  Health implications of obesity: an NIH Consensus Development Conference. , 1985, Journal of the American Dietetic Association.

[9]  A. Mokdad,et al.  The spread of the obesity epidemic in the United States, 1991-1998. , 1999, JAMA.

[10]  R. Genco,et al.  Current View of Risk Factors for Periodontal Diseases. , 1996, Journal of periodontology.

[11]  F. Speizer,et al.  Body Weight, Weight Change, and Risk for Hypertension in Women , 1998, Annals of Internal Medicine.

[12]  G. Colditz,et al.  The disease burden associated with overweight and obesity. , 1999, JAMA.

[13]  P. Tessari.  Changes in protein, carbohydrate, and fat metabolism with aging: possible role of insulin. , 2009, Nutrition reviews.

[14]  D. Oakley,et al.  Psychosocial factors in inflammatory periodontal diseases. A review. , 1995, Journal of clinical periodontology.

[15]  M. Shipley,et al.  Weight and mortality in the Whitehall Study. , 1982, British medical journal.

[16]  M. Trevisan,et al.  Calcium and the risk for periodontal disease. , 2000, Journal of periodontology.

[17]  N. Bissada,et al.  Influence of obesity and hypertension on the severity of periodontitis in rats. , 1977, Oral surgery, oral medicine, and oral pathology.

[18]  G A Colditz,et al.  Impact of overweight on the risk of developing common chronic diseases during a 10-year period. , 2001, Archives of internal medicine.

[19]  E. Harper.  Changing perspectives on aging and energy requirements: aging, body weight and body composition in humans, dogs and cats. , 1998, The Journal of nutrition.

[20]  R. Genco,et al.  Relationship of stress, distress and inadequate coping behaviors to periodontal disease. , 1999, Journal of periodontology.

[21]  D Spiegelman,et al.  Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. , 1995, American journal of epidemiology.

[22]  K. Zabrucky,et al.  Perceived stress and coping resource availability as predictors of life satisfaction in young, middle-aged, and older adults. , 2001, Experimental aging research.

[23]  R. Sturm,et al.  The effects of obesity, smoking, and drinking on medical problems and costs. , 2002, Health affairs.

[24]  A. Fitzgerald,et al.  Body weight and coronary heart disease mortality: an analysis in relation to age and smoking habit. 15 years follow-up data from the Whitehall Study. , 1992, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[25]  M. Trevisan,et al.  Dietary vitamin C and the risk for periodontal disease. , 2000, Journal of periodontology.

[26]  L. Bandini,et al.  Effect of age on body composition and resting metabolic rate. , 1990, The American journal of physiology.

[27]  M. Carroll,et al.  Overweight and obesity in the United States: prevalence and trends, 1960–1994 , 1998, International Journal of Obesity.

[28]  F Paccaud,et al.  Body mass index, abdominal adiposity and blood pressure: consistency of their association across developing and developed countries , 2002, International Journal of Obesity.