Usual intake of macronutrients by postmenopausal women: Associations with pathogenic oral bacteria
Gower, Emily Hess
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Background: Periodontal disease is thought to be caused by pathogenic oral bacteria, environmental exposures, and genetics. The presence of oral bacteria may be influenced by usual macronutrient intake. To our knowledge, no study has investigated the relationship between macronutrients and the prevalence of pathogenic oral bacteria. Purpose: We examined the cross-sectional (1997-2000) relationship between usual intake of macronutrients and prevalence of five pathogenic oral bacteria among postmenopausal women in the OsteoPerio ancillary study of the Buffalo center of the Women's Health Initiative. Methods: Subgingival plaque samples were assessed for the presence of Porphyromonas gingivalis, Tannerella forsythensis, Fusobacterium nucleatum, Prevotella intermedia and Campylobacter rectus using indirect immunofluorescent microscopy. Macronutrient intakes were determined using a food frequency questionnaire. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for prevalent pathogenic bacteria by tertile of each macronutrient adjusting for energy intake and assessing age, body mass index, smoking status, number of teeth, frequency of flossing, and whole mouth mean periodontal probing pocket depth as potential confounders. Results: Of the 1,208 participants, there were 752 (62.3%) with detected pathogenic bacteria. Average intakes of macronutrients were not significantly different between women who had bacteria present compared to those who did not, with the exception of alcohol intake [5.06 (±8.67) g/day in women with bacteria present compared to 6.39 (±11.30) g/day who did test positive for bacteria, p=0.02]. There were no statistically significant results for any macronutrient model when comparing the presence of bacteria compared to none. We saw differences in our results when using usual macronutrient energy adjustment compared to a residual adjustment method. Additionally, statistically significant associations were observed between alcohol intake and individual species and complexes of bacteria. The overall associations between macronutrient intake and prevalence of any pathogenic bacteria were not modified by the presence of periodontal disease at the time of exam. Conclusions: This observed lack of association may be due to the species of bacteria assessed, broad macronutrient categories, or a true absence of a relationship between macronutrients and pathogenic oral bacteria.