Key messages:
- Low adherence to the Mediterranean diet is associated with more severe periodontitis, especially with frequent red meat consumption.
- Higher levels of interleukin-6 (IL-6), a key inflammatory marker, are linked to worse periodontal health.
- Diets rich in plant-based foods are associated with lower levels of various inflammatory markers.
- Following a balanced, Mediterranean diet may reduce the risk of periodontal disease and systemic inflammation.
- Further studies with larger groups are needed to confirm these findings.
Introduction
Periodontitis is a disease driven by microbes and mediated by the host, resulting in local inflammation and loss of periodontal attachment and bone, ultimately leading to tooth loss. Additionally, periodontitis can contribute to systemic inflammation and is associated with various systemic diseases.
The activation of the immune system caused by microbial infection leads to the production of inflammatory biomarkers. One such biomarker, C-reactive protein (CRP), is typically found in higher levels in individuals with periodontal disease compared to those who are periodontally healthy. Several studies have indicated that CRP serves as a marker of the association between periodontitis and systemic diseases, with inflammation a common factor.
Mediterranean diet mainly consists of a high consumption of vegetables, fruits, legumes, whole grains, and nuts, with olive oil as the primary source of fat, moderate intake of chicken, dairy, fish, eggs, and wine (especially red wine, during meals), low intake of red meat and processed meat, and limited sweets and processed foods.
Higher adherence to the Mediterranean diet is associated with lower risk of developing noncommunicable diseases, including cardiovascular diseases, neurodegenerative disorders, and certain cancers. In contrast, a lifestyle with low adherence to the Mediterranean diet significantly increases the risk of periodontitis.
Objective
This cross-sectional study investigated the association between adherence to a Mediterranean-type diet, periodontitis severity, and systemic inflammatory markers.
Methods
Two hundred participants underwent a complete periodontal assessment and provided blood samples. Adherence to a Mediterranean-type diet was assessed using a food frequency questionnaire. Serum levels of high-sensitivity C-reactive protein (hs-CRP), matrix metalloproteinase-8 (MMP-8), interleukin (IL)-1α, IL-1β, IL-6, IL-10, and IL-17 were analyzed. Correlation and multivariate logistic regression analyses were used to determine the relationships between dietary factors, inflammatory biomarkers, and clinical data.
Results
A total of 195 participants had complete data, with 112 categorized as highly adherent to the Mediterranean diet. Multivariate analysis indicated that low adherence to the Mediterranean diet was associated with stage III–IV periodontitis. Higher red meat consumption was independently associated with a more severe periodontitis stage. Periodontal disease severity showed moderate associations with IL-6 after adjusting for confounding factors. Consumption of various plant-derived food groups was significantly inversely related to elevated levels of hs-CRP, IL-1α, IL-6, IL-10, and IL-17.
Conclusions
This study indicates that low adherence to the Mediterranean diet and higher consumption of red meat may be associated with severe periodontitis. Associations were also found between the severity of periodontal disease, dietary factors, and biomarkers of inflammation. Therefore, these elements should be considered when evaluating periodontitis and inflammation. Future studies with larger sample sizes are needed to clarify these findings.
