Association between inflammatory potential of diet and periodontitis disease risks: Results from a Korean population-based cohort study

Aim: To examine the association between a pro-inflammatory diet, estimated using the energy-adjusted dietary inflammatory index (E-DII), and the risk of periodontitis. Materials and Methods: Study subjects from the Korean Genome and Epidemiology Study Health Examinee (KoGES_HEXA) cohort were included for cross-sectional analysis (n = 168,378) using multivariate logistic regression and prospective analysis (n = 160,397) using Cox proportional hazard models respectively. DII and E-DII scores were calculated based on the intake reported on a validated semi-quantitative food frequency questionnaire (SQ-FFQ). Results: Cox proportional hazard models revealed a significantly increased risk of incident periodontitis in individuals consuming high E-DII (more pro-inflammatory) diets in the total population (HRquartile4vs1 = 1.29; 95% CI: 1.13-1.48; p(trend) <.001) and in both men (HRquartile4vs1 = 1.36; 95% CI: 1.07-1.73; p(trend) = 0.02) and women (HRquartile4vs1 = 1.27; 95% CI: 1.08-1.50; p(trend) =.002). The association remained significant even after excluding cases diagnosed early in the follow-up. In the cross-sectional analysis, a significant association was observed between the E-DII score and the prevalence of periodontitis among all study subjects (ORquartile4vs1 = 1.17; 95% CI: 1.03-1.34; p(trend) = 0.01) and men (ORquartile4vs1 = 1.28; 95%CI: 1.01-1.63; p(trend) <.001); however, the association did not reach statistical significance in women (ORquartile4vs1 = 1.13; 95% CI: 0.96-1.33; p(trend) <.001). Conclusions: Findings from the current study support the hypothesis that diets with high pro-inflammatory potential increase the risk of periodontitis.