Could dietary restrictions affect periodontal disease? A systematic review

Giuseppe Mainas, Pasquale Santamaria, Mark Ide, Valter Longo, Manlio Vinciguerra, Jose Nart, Luigi Nibali, Giuseppe Mainas, Pasquale Santamaria, Mark Ide, Valter Longo, Manlio Vinciguerra, Jose Nart, Luigi Nibali

Abstract

Objective: This review aimed at evaluating the possible benefits that caloric restriction (CR) may provide to periodontal disease progression and response to treatment.

Material and methods: Electronic search on Medline, Embase and Cochrane, and manual search were performed to identify pre-clinical and on human studies reporting the consequences of CR on clinical and inflammatory parameters related to periodontitis. Newcastle Ottawa System and SYRCLE scale were used to assess the risk of bias.

Results: Four thousand nine hundred eighty articles were initially screened, and a total of 6 articles were finally included, consisting of 4 animal studies and 2 studies in humans. Due to the limited number of studies and heterogeneity of the data, results were presented in descriptive analyses. All studies showed that, compared to the normal (ad libitum) diet, CR might have the potential to reduce the local and systemic hyper-inflammatory state as well as disease progression in periodontal patients.

Conclusions: Within the existing limitations, this review highlights that CR showed some improvements in the periodontal condition by reducing the local and systemic inflammation related to the periodontitis and by improving clinical parameters. However, the results should be interpreted with caution since robust research such as randomized clinical trials is still missing.

Clinical relevance: This review shows that some dietary/caloric restrictions approaches may have the potential to improve periodontal conditions and, in addition, highlights a need for human studies with a robust methodology in order to draw stronger evidence-based conclusions.

Keywords: Caloric restriction; Diet; Fasting; Inflammation; Periodontitis; Systematic review.

Conflict of interest statement

VL declares that he has equity interest in L-Nutra, a company making medical food. All other authors declare that they have no competing interests.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
PRISMA flow-chart

References

    1. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1):S159–s172. doi: 10.1002/jper.18-0006.
    1. Hujoel PP, Lingström P. Nutrition, dental caries and periodontal disease: a narrative review. J Clin Periodontol. 2017;44(Suppl 18):S79–s84. doi: 10.1111/jcpe.12672.
    1. Mattison JA, Roth GS, Beasley TM, Tilmont EM, Handy AM, Herbert RL, Longo DL, Allison DB, Young JE, Bryant M, Barnard D, Ward WF, Qi W, Ingram DK, de Cabo R. Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study. Nature. 2012;489:318–321. doi: 10.1038/nature11432.
    1. Mattison JA, Colman RJ, Beasley TM, Allison DB, Kemnitz JW, Roth GS, Ingram DK, Weindruch R, de Cabo R, Anderson RM. Caloric restriction improves health and survival of rhesus monkeys. Nat Commun. 2017;8:14063. doi: 10.1038/ncomms14063.
    1. Chapple IL, Milward MR, Ling-Mountford N, Weston P, Carter K, Askey K, Dallal GE, De Spirt S, Sies H, Patel D, Matthews JB. Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT. J Clin Periodontol. 2012;39:62–72. doi: 10.1111/j.1600-051X.2011.01793.x.
    1. Dietrich T, Nunn M, Dawson-Hughes B, Bischoff-Ferrari HA. Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation. Am J Clin Nutr. 2005;82:575–580. doi: 10.1093/ajcn.82.3.575.
    1. Krall EA, Wehler C, Garcia RI, Harris SS, Dawson-Hughes B. Calcium and vitamin D supplements reduce tooth loss in the elderly. Am J Med. 2001;111:452–456. doi: 10.1016/s0002-9343(01)00899-3.
    1. Navarro Hortal MD, Bernal-Moreno C, Varela López A (2018) Macronutrient effect on animal models of periodontal disease: a systematic revie. Ars Pharm 59(4): 235-250. 10.30827/ars.v59i4.7317
    1. Woelber JP, Bremer K, Vach K, König D, Hellwig E, Ratka-Krüger P, Al-Ahmad A, Tennert C. An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study. BMC Oral Health. 2016;17:28. doi: 10.1186/s12903-016-0257-1.
    1. Woelber JP, Gärtner M, Breuninger L, Anderson A, König D, Hellwig E, Al-Ahmad A, Vach K, Dötsch A, Ratka-Krüger P, Tennert C. The influence of an anti-inflammatory diet on gingivitis. A randomized controlled trial. J Clin Periodontol. 2019;46:481–490. doi: 10.1111/jcpe.13094.
    1. Alhassani AA, Hu FB, Li Y, Rosner BA, Willett WC, Joshipura KJ. The associations between major dietary patterns and risk of periodontitis. J Clin Periodontol. 2021;48:2–13. doi: 10.1111/jcpe.13380.
    1. Jeong J, Kim H-S, Lee D, Kim K, Kim Y-H. Association between four dietary patterns and the risk of periodontal diseases: a systematic review and meta-analysis. Nutrients. 2022;14:4362. doi: 10.3390/nu14204362.
    1. Li A, Chen Y, Schuller AA, van der Sluis LWM, Tjakkes GE. Dietary inflammatory potential is associated with poor periodontal health: a population-based study. J Clin Periodontol. 2021;48:907–918. doi: 10.1111/jcpe.13472.
    1. Longo VD, Di Tano M, Mattson MP, Guidi N. Intermittent and periodic fasting, longevity and disease. Nat Aging. 2021;1:47–59. doi: 10.1038/s43587-020-00013-3.
    1. Park HS, Nam HS, Seo HS, Hwang SJ. Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: a pilot study. BMC Oral Health. 2015;15:109. doi: 10.1186/s12903-015-0094-7.
    1. Pappe CL, Steckhan N, Hoedke D, Jepsen S, Rauch G, Keller T, Michalsen A, Dommisch H. Prolonged multimodal fasting modulates periodontal inflammation in female patients with metabolic syndrome: A prospective cohort study. J Clin Periodontol. 2021;48:492–502. doi: 10.1111/jcpe.13419.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. doi: 10.1371/journal.pmed.1000097.
    1. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:n71. doi: 10.1136/bmj.n71.
    1. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4:1–6. doi: 10.1902/annals.1999.4.1.1.
    1. American Academy of Periodontology (1989) Proceedings of the World Workshop in Clinical Periodontics. The World workshop in clinical periodontics – Proceedings, (I/23–I/24). Chicago: The American Academy of Periodontology
    1. Bales CW, Kraus WE. Caloric restriction: implications for human cardiometabolic health. J Cardiopulm Rehabil Prev. 2013;33:201–208. doi: 10.1097/HCR.0b013e318295019e.
    1. Hooijmans CR, Rovers MM, de Vries RB, Leenaars M, Ritskes-Hoitinga M, Langendam MW. SYRCLE’s risk of bias tool for animal studies. BMC Med Res Methodol. 2014;14:43. doi: 10.1186/1471-2288-14-43.
    1. Branch-Mays GL, Dawson DR, Gunsolley JC, Reynolds MA, Ebersole JL, Novak KF, Mattison JA, Ingram DK, Novak MJ. The effects of a calorie-reduced diet on periodontal inflammation and disease in a non-human primate model. J Periodontol. 2008;79:1184–1191. doi: 10.1902/jop.2008.070629.
    1. Ebersole JL, Steffen MJ, Reynolds MA, Branch-Mays GL, Dawson DR, Novak KF, Gunsolley JC, Mattison JA, Ingram DK, Novak MJ. Differential gender effects of a reduced-calorie diet on systemic inflammatory and immune parameters in nonhuman primates. J Periodontal Res. 2008;43:500–507. doi: 10.1111/j.1600-0765.2008.01051.x.
    1. Reynolds MA, Dawson DR, Novak KF, Ebersole JL, Gunsolley JC, Branch-Mays GL, Holt SC, Mattison JA, Ingram DK, Novak MJ. Effects of caloric restriction on inflammatory periodontal disease. Nutrition. 2009;25:88–97. doi: 10.1016/j.nut.2008.07.003.
    1. Wulansari K, Kaboosaya B, Khan M, Takahashi M, Nakata H, Kuroda S, Aoki K, Kasugai S. Beneficial effects of fasting regimens on periodontal tissues in experimental periodontitis mice model. J Int Dent Med Res. 2018;11:362–369.
    1. Ingram DK, Cutler RG, Weindruch R, Renquist DM, Knapka JJ, April M, Belcher CT, Clark MA, Hatcherson CD, Marriott BM. Dietary restriction and aging: the initiation of a primate study. J Gerontol. 1990;45:B148–B163. doi: 10.1093/geronj/45.5.B148.
    1. Michalsen A, Li C. Fasting therapy for treating and preventing disease - current state of evidence. Forsch Komplementmed. 2013;20:444–453. doi: 10.1159/000357765.
    1. Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev. 2017;39:46–58. doi: 10.1016/j.arr.2016.10.005.
    1. Parveen S. (2021) Impact of calorie restriction and intermittent fasting on periodontal health. Periodontol. 2000;87:315–324. doi: 10.1111/prd.12400.
    1. Wei M, Brandhorst S, Shelehchi M, Mirzaei H, Cheng CW, Budniak J, Groshen S, Mack WJ, Guen E, Di Biase S, Cohen P, Morgan TE, Dorff T, Hong K, Michalsen A, Laviano A, Longo VD (2017) Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease. Sci Transl Med 9. 10.1126/scitranslmed.aai8700
    1. Bartke A, Wright JC, Mattison JA, Ingram DK, Miller RA, Roth GS (2002) Dietary restriction and life-span. Science 296:2141–2; author reply 2141–2. 10.1126/science.296.5576.2141
    1. Merry BJ. Molecular mechanisms linking calorie restriction and longevity. Int J Biochem Cell Biol. 2002;34:1340–1354. doi: 10.1016/s1357-2725(02)00038-9.
    1. Weber-Mzell D, Kotanko P, Hauer AC, Goriup U, Haas J, Lanner N, Erwa W, Ahmaida IA, Haitchi-Petnehazy S, Stenzel M, Lanzer G, Deutsch J. Gender, age and seasonal effects on IgA deficiency: a study of 7293 Caucasians. Eur J Clin Invest. 2004;34:224–228. doi: 10.1111/j.1365-2362.2004.01311.x.
    1. Scheingraber S, Dobbert D, Schmiedel P, Seliger E, Dralle H. Gender-specific differences in sex hormones and cytokines in patients undergoing major abdominal surgery. Surg Today. 2005;35:846–854. doi: 10.1007/s00595-005-3044-1.
    1. Abe T, Hajishengallis G. Optimization of the ligature-induced periodontitis model in mice. J Immunol Methods. 2013;394:49–54. doi: 10.1016/j.jim.2013.05.002.
    1. Brandhorst S, Choi IY, Wei M, Cheng CW, Sedrakyan S, Navarrete G, Dubeau L, Yap LP, Park R, Vinciguerra M, Di Biase S, Mirzaei H, Mirisola MG, Childress P, Ji L, Groshen S, Penna F, Odetti P, Perin L, Conti PS, Ikeno Y, Kennedy BK, Cohen P, Morgan TE, Dorff TB, Longo VD. A periodic diet that mimics fasting promotes multi-system regeneration, enhanced cognitive performance, and healthspan. Cell Metab. 2015;22:86–99. doi: 10.1016/j.cmet.2015.05.012.
    1. Cheng CW, Adams GB, Perin L, Wei M, Zhou X, Lam BS, Da Sacco S, Mirisola M, Quinn DI, Dorff TB, Kopchick JJ, Longo VD. Prolonged fasting reduces IGF-1/PKA to promote hematopoietic-stem-cell-based regeneration and reverse immunosuppression. Cell Stem Cell. 2014;14:810–823. doi: 10.1016/j.stem.2014.04.014.
    1. Cheng CW, Villani V, Buono R, Wei M, Kumar S, Yilmaz OH, Cohen P, Sneddon JB, Perin L, Longo VD. Fasting-mimicking diet promotes Ngn3-Driven β-cell regeneration to reverse diabetes. Cell. 2017;168:775–788.e12. doi: 10.1016/j.cell.2017.01.040.
    1. Choi IY, Piccio L, Childress P, Bollman B, Ghosh A, Brandhorst S, Suarez J, Michalsen A, Cross AH, Morgan TE, Wei M, Paul F, Bock M, Longo VD. A diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms. Cell Rep. 2016;15:2136–2146. doi: 10.1016/j.celrep.2016.05.009.
    1. Rangan P, Choi I, Wei M, Navarrete G, Guen E, Brandhorst S, Enyati N, Pasia G, Maesincee D, Ocon V, Abdulridha M, Longo VD. Fasting-mimicking diet modulates microbiota and promotes intestinal regeneration to reduce inflammatory bowel disease pathology. Cell Rep. 2019;26:2704–2719.e6. doi: 10.1016/j.celrep.2019.02.019.
    1. Xin B, Liu CL, Yang H, Peng C, Dong XH, Zhang C, Chen AF, Xie HH. Prolonged fasting improves endothelial progenitor cell-mediated ischemic angiogenesis in mice. Cell Physiol Biochem. 2016;40:693–706. doi: 10.1159/000452581.
    1. Katare RG, Kakinuma Y, Arikawa M, Yamasaki F, Sato T. Chronic intermittent fasting improves the survival following large myocardial ischemia by activation of BDNF/VEGF/PI3K signaling pathway. J Mol Cell Cardiol. 2009;46:405–412. doi: 10.1016/j.yjmcc.2008.10.027.
    1. Chapple IL, Bouchard P, Cagetti MG, Campus G, Carra MC, Cocco F, Nibali L, Hujoel P, Laine ML, Lingstrom P, Manton DJ, Montero E, Pitts N, Rangé H, Schlueter N, Teughels W, Twetman S, Van Loveren C, Van der Weijden F, Vieira AR, Schulte AG. Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol. 2017;44(Suppl 18):S39–s51. doi: 10.1111/jcpe.12685.
    1. Dommisch H, Kuzmanova D, Jönsson D. Grant M and Chapple I (2018) Effect of micronutrient malnutrition on periodontal disease and periodontal therapy. Periodontol. 2000;78:129–153. doi: 10.1111/prd.12233.
    1. Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, Sculean A, Tonetti MS. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47(Suppl 22):4–60. doi: 10.1111/jcpe.13290.

Source: PubMed

3
Tilaa