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      Intake of Dairy Products in Relation to Periodontitis in Older Danish Adults

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          Abstract

          This cross-sectional study investigates whether calcium intakes from dairy and non-dairy sources, and absolute intakes of various dairy products, are associated with periodontitis. The calcium intake (mg/day) of 135 older Danish adults was estimated by a diet history interview and divided into dairy and non-dairy calcium. Dairy food intake (g/day) was classified into four groups: milk, cheese, fermented foods and other foods. Periodontitis was defined as the number of teeth with attachment loss ≥3 mm. Intakes of total dairy calcium (Incidence-rate ratio (IRR) = 0.97; p = 0.021), calcium from milk (IRR = 0.97; p = 0.025) and fermented foods (IRR = 0.96; p = 0.03) were inversely and significantly associated with periodontitis after adjustment for age, gender, education, sucrose intake, alcohol consumption, smoking, physical activity, vitamin D intake, heart disease, visits to the dentist, use of dental floss and bleeding on probing, but non-dairy calcium, calcium from cheese and other types of dairy food intakes were not. Total dairy foods (IRR = 0.96; p = 0.003), milk (IRR = 0.96; p = 0.028) and fermented foods intakes (IRR = 0.97; p = 0.029) were associated with reduced risk of periodontitis, but cheese and other dairy foods intakes were not. These results suggest that dairy calcium, particularly from milk and fermented products, may protect against periodontitis. Prospective studies are required to confirm these findings.

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          Most cited references36

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          Case definitions for use in population-based surveillance of periodontitis.

          Many definitions of periodontitis have been used in the literature for population-based studies, but there is no accepted standard. In early epidemiologic studies, the two major periodontal diseases, gingivitis and periodontitis, were combined and considered to be a continuum. National United States surveys were conducted in 1960 to 1962, 1971 to 1974, 1981, 1985 to 1986, 1988 to 1994, and 1999 to 2000. The case definitions and protocols used in the six national surveys reflect a continuing evolution and improvement over time. Generally, the clinical diagnosis of periodontitis is based on measures of probing depth (PD), clinical attachment level (CAL), the radiographic pattern and extent of alveolar bone loss, gingival inflammation measured as bleeding on probing, or a combination of these measures. Several other patient characteristics are considered, and several factors, such as age, can affect measurements of PD and CAL. Accuracy and reproducibility of measurements of PD and CAL are important because case definitions for periodontitis are based largely on either or both measurements, and relatively small changes in these values can result in large changes in disease prevalence. The classification currently accepted by the American Academy of Periodontology (AAP) was devised by the 1999 International Workshop for a Classification of Periodontal Diseases and Conditions. However, in 2003 the Centers for Disease Control and Prevention and the AAP appointed a working group to develop further standardized clinical case definitions for population-based studies of periodontitis. This classification defines severe periodontitis and moderate periodontitis in terms of PD and CAL to enhance case definitions and further demonstrates the importance of thresholds of PD and CAL and the number of affected sites when determining prevalence.
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            Oral health surveys, basics methods

            (1997)
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              The bioavailability of dietary calcium.

              This update focuses on the bioavailability of dietary calcium for humans. Fundamentals of calcium metabolism, intestinal absorption, urinary excretion and balance are recalled. Dietary factors, especially lactose and other milk components, influencing calcium bioavailability at intestinal and renal levels are reviewed. A critical examination of all the methods used for evaluating calcium bioavailability is made. This includes in vitro assays, classical and isotopic balances, urinary excretion, isotope labeling in the urine, plasma and bones, long term evaluation of bone mineralization and the use of biological bone markers. Importance and advantages of animal models are discussed. The state of the art in the comparative bioavailability of calcium in foods is detailed including a comparison of sources of calcium (dairy products and calcium salts) in human studies and in some animal studies, casein phosphopeptides, proteins, lactose and lactase and their relation with calcium bioavailability (in humans and rats). An update on the consumption of dairy products and bone mass is presented. Emphasis on peculiarities and advantages of calcium in milk and dairy products is given.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                04 September 2012
                September 2012
                : 4
                : 9
                : 1219-1229
                Affiliations
                [1 ]Research Unit for Dietary Studies, Institute of Preventive Medicine, Frederiksberg Hospital, Copenhagen, DK-2000, Denmark; Email: blh@ 123456ipm.regionh.dk
                [2 ]Department for Community Dentistry, School of Dentistry, Faculty of Health Science, University of Copenhagen, Copenhagen, DK-2200, Denmark; Email: lbch@ 123456sund.ku.dk
                [3 ]Copenhagen Gerontological Oral Health Research Centre, School of Dentistry, Faculty of Health Science, University of Copenhagen, Copenhagen, DK-2200, Denmark; Email: holmp@ 123456sund.ku.dk
                [4 ]Department of Public Health, Section of Social Medicine, and Center for Healthy Aging, University of Copenhagen, Copenhagen, DK-1014, Denmark; Email: kiav@ 123456sund.ku.dk
                [5 ]Danish Aging Research Center, Universities of Aarhus, Southern Denmark and Copenhagen, Aarhus, DK-5000, Denmark
                [6 ]Centre for Diabetes, Bart’s & The London School of Medicine & Dentistry, Queen Mary University of London, London, E1 2AT, UK; Email: bboucher@ 123456doctors.org.uk
                Author notes
                [* ] Author to whom correspondence should be addressed; Email: AAR@ 123456ipm.regionh.dk ; Tel.: +45-3338-3772; Fax: +45-3816-3119.
                Article
                nutrients-04-01219
                10.3390/nu4091219
                3475232
                23112910
                ce6844a9-4740-4015-a97c-6c1c38ccd63a
                © 2012 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                : 12 June 2012
                : 23 July 2012
                : 14 August 2012
                Categories
                Article

                Nutrition & Dietetics
                periodontitis,calcium,oral health,vitamin d,elderly,dairy products
                Nutrition & Dietetics
                periodontitis, calcium, oral health, vitamin d, elderly, dairy products

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