Chemistry Reference
In-Depth Information
Experimental and animal studies suggest that some starch-containing foods and fruits are cario-
genic, but this conclusion is not supported by epidemiological data showing that high intakes of
starchy staple foods, fruits, and vegetables are associated with low levels of dental caries. Following
global recommendations that encourage a diet high in starchy staple foods, fruits, and vegetables
and low in free sugars and fat will protect both oral and general health (Moynihan and Petersen
2004).
The WHO (2003) recommends limiting nonmilk extrinsic sugars (NMES), that is, all mono-
saccharides and disaccharides added to foods by the manufacturer, cook, or consumer, plus sugars
naturally present in honey, syrups, and fruit juices, and consumption to ≤10% energy to reduce the
risk of unhealthy weight gain and dental caries and to restrict the frequency of intake to ≤4 times/
day to reduce the risk of dental caries. Older adults, especially those from low-income backgrounds,
are at increased risk of dental caries, yet there is little information on sugar intake (frequency of
intake and food sources) in this age group. Bradbury et al. (2008) presented baseline data from a
community-based dietary intervention study of older adults from socially deprived areas of North
East England on the quantity and sources of total sugars, NMES, and intrinsic and milk sugars and
on the frequency of NMES intake. Dietary intake was assessed using two 3-day estimated food
diaries, completed by 201 participants (170 females and 31 males), aged 65-85 years [mean 76.7 (SD
5.5) years], recruited from sheltered housing schemes. Total sugars, NMES, and intrinsic and milk
sugars represented 19.6%, 9.3%, and 10.3%, respectively, of the daily energy intake. Eighty-one
participants (40.3%) exceeded the NMES intake recommendation. The mean frequency of NMES
intake was 3.4 times/day. The 53 participants (26.4%) who exceeded the frequency recommendation
(≤4 times/day) obtained a signiicantly greater percentage of energy from NMES compared with
the participants who met the recommendation. The food groups “biscuits and cakes” (18.9%), “soft
drinks” (13.1%), and “table sugar” (11.1%) made the greatest contributions to intakes of NMES. It
was concluded that interventions to reduce NMES intake should focus on limiting the quantity and
frequency of intake of these food groups (Bradbury et al. 2008).
While sugars appear to differ little in acidogenic potential, sucrose has been given special
importance, being the sole substrate for the synthesis of extracellular glucans (Zero 2004). Water-
insoluble glucans might enhance the accumulation of mutans streptococci on smooth tooth surfaces
and appear to enhance virulence by increasing plaque porosity, resulting in greater acid production
immediately adjacent to the tooth surface. Data indicating that the sugar consumption/caries rela-
tionship is now weaker have led to suggestions that recommendations to restrict sugar consumption
are no longer necessary. Clearly, luoride has raised the threshold of sugar intake at which caries
will progress to cavitation, but luoride has its limits, and caries remains a serious problem for dis-
advantaged individuals in many industrialized countries and is a rising problem in many developing
countries. A weakening of the sugar/caries relationship may also be explained by many technical,
biological, behavioral, and genetic factors (Zero 2004).
Other factors such as luoride use and oral hygiene behavior may inluence the incidence of
dental caries. Moynihan (2005b) reported that the consumption of luoridated water coupled with
a reduction in NMES intake is an effective means of caries prevention. However, studies on the
luoride concentration of bottled water suggest that the increased consumption of bottled water, in
preference to luoridated tap water, would lead to a marked decrease in caries protection. Concerns
have been raised about the bioavailability of luoride from artiicially luoridated water compared
with naturally luoridated water. This issue has been addressed in a human experimental study that
has indicated that any differences in luoride bioavailability are small compared with the naturally
occurring variability in luoride absorption (Moynihan 2005b). Recently, Tseveenjav et al. (2011)
assessed the effect of certain oral health-related behaviors on adults' dental health. As part of the
Finnish nationwide Health 2000 Survey, dentate subjects, 30-64 years of age, reported their fre-
quency of consumption of eight sugar- and xylitol-containing products, together with tooth brushing
frequency and the use of luoride toothpaste, and underwent clinical oral examination (
n
= 4361).
Search WWH ::
Custom Search