Importance of Severe forms of common chronic oral infections or inflammations is associated with increased cardiovascular risk in adults. To date, the role of childhood oral infections in cardiovascular risk is not known because no long-term studies have been conducted.
Objective To investigate whether signs of oral infections in childhood are associated with cardiovascular risk factors and subclinical atherosclerosis in adulthood.
Design, Setting, and Participants The cohort study (n = 755) was derived from the Cardiovascular Risk in Young Finns Study, an ongoing prospective cohort study in Finland initiated in 1980. Participants underwent clinical oral examinations during childhood, when they were aged 6, 9, or 12 years and a clinical cardiovascular follow-up in adulthood in 2001 at age 27, 30, or 33 years and/or in 2007 at age 33, 36, or 39 years. Cardiovascular risk factors were measured at baseline and during the follow-up until the end of 2007. Final statistical analyses were completed on February 19, 2019.
Main Outcomes and Measures Four signs of oral infections (bleeding on probing, periodontal probing pocket depth, caries, and dental fillings) were documented. Cumulative lifetime exposure to 6 cardiovascular risk factors was calculated from dichotomized variables obtained by using the area-under-the-curve method. Subclinical atherosclerosis (ie, carotid artery intima-media thickness [IMT]) was quantified in 2001 (n = 468) and 2007 (n = 489).
Results This study included 755 participants, of whom 371 (49.1%) were male; the mean (SD) age at baseline examination was 8.07 (2.00) years. In this cohort, 33 children (4.5%) had no sign of oral infections, whereas 41 (5.6%) had 1 sign, 127 (17.4%) had 2 signs, 278 (38.3%) had 3 signs, and 248 (34.1%) had 4 signs. The cumulative exposure to risk factors increased with the increasing number of oral infections both in childhood and adulthood. In multiple linear regression models, childhood oral infections, including signs of either periodontal disease (R2 = 0.018; P = .01), caries (R2 = 0.022; P = .008), or both (R2 = 0.024; P = .004), were associated with adulthood IMT. The presence of any sign of oral infection in childhood was associated with increased IMT (third tertile vs tertiles 1 and 2) with a relative risk of 1.87 (95% CI, 1.25-2.79), whereas the presence of all 4 signs produced a relative risk of 1.95 (95% CI, 1.28-3.00). The associations were more obvious in boys: if the periodontal disease were present, the corresponding estimate was 1.69 (95% CI, 1.21-2.36); if caries, 1.46 (95% CI, 1.04-2.05); and if all 4 signs of oral infections, 2.25 (95% CI, 1.30-3.89). The associations were independent of cardiovascular risk factors.
Conclusions and Relevance Oral infections in childhood appear to be associated with the subclinical carotid atherosclerosis seen in adulthood.
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When was the last time you ate muscovado, panela, rapadura or turbinado? These are some of the more exotic names consumers will see on labels for a basic pantry staple: sugar. In Australia, many people are over-consuming added sugar and may not even realise it. Government intervention is necessary to give Australians tools to make better choices about their food. Fruit, vegetables and dairy products contain intrinsic sugars and have the added benefits of vitamins, other nutrients and dietary fibre. However, sugars added to foods and drinks are devoid of these nutritional benefits and add unnecessary kilojoules to a diet. An estimated 74% of packaged foods in the United States contain added sugars and the situation in Australia is likely similar.1 International health bodies and experts recommend limiting consumption, but in Australia over half the population is exceeding the World Health Organisation’s (WHO) recommendation to limit added sugar consumption to no more than 10% of daily energy intake.2 Added sugars provide empty kilojoules, or kilojoules with little or no associated nutrients.3 Excess intake of added sugar is associated with an increased risk of type 2 diabetes, obesity, dental caries and cardiovascular disease.4 Consumers in Australia have no clear way of knowing how much sugar has been added to a food. The Nutritional Information Panel (NIP) displays total sugars and, while the types of sugars are included in the ingredients list, there are over 43 different names for sugars making identifying added sugar a time-consuming and difficult process. Right now, consumers are struggling to identify if a product has added sugar, let alone how much added sugar is included. The results from this report show that by requiring labels to list added sugar, Australians would have the tools they need to improve their diet. This report looks at six simple food swaps an individual could make throughout the day. These swaps show that an individual could remove 26 teaspoons of unnecessary sugar from their diet in a day and up to 38.3 kilograms of unnecessary sugar over the course of a year.5 The solution is simple. Label added sugars clearly, following the precedent set by the US and Canada. This is a necessary step to allow Australians to take their health in their own hands and make informed choices.
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