Low adherence to a Mediterranean-type diet was associated with more severe periodontitis in a UK study of 195 patients, with frequent red meat intake independently associated with worse disease. Elevated interleukin-6 (IL-6) remained associated with disease severity after adjusting for confounders, while high-sensitivity C-reactive protein (hs-CRP) did not.
Researchers enrolled 200 consecutive patients between April 2023 and May 2024 at Guy’s and St Thomas’ NHS Foundation Trust in London. Complete dietary, periodontal, and biomarker data were available for 195 patients. The mean age of participants was 48.8 ± 13.9 years, and 66% were female. Participants completed a 37-item food frequency questionnaire to assess adherence to a Mediterranean diet. Based on scores, 112 patients were classified as high adherence and 83 as low adherence. Most participants (170) had periodontitis in total, including 155 with stage III–IV disease, while 16 had gingivitis and 14 were periodontally healthy. Patients with high diet adherence were significantly more likely to be never-smokers.
Comprehensive periodontal examinations measured probing depth, recession, bleeding on probing, and clinical attachment loss at 6 sites per tooth. Patients with high Mediterranean diet adherence had significantly lower mean probing depths (2.83 mm vs 3.29 mm), fewer deep pockets, and lower attachment loss compared with those with lower adherence.
Blood samples were analyzed for hs-CRP, IL-1α, IL-1β, IL-6, IL-10, IL-17, and matrix metalloproteinase-8. Multivariate analysis showed low Mediterranean diet adherence was associated with stage III–IV periodontitis (OR 0.35), while red meat consumption was independently associated with severe disease (OR 2.75). Consumption of vegetables, legumes, and dairy products was inversely correlated with hs-CRP levels, while plant-based foods showed inverse relationships with multiple inflammatory markers.
“Serum levels of IL-6 were increased in patients with periodontitis compared to periodontally healthy individuals, and it may contribute to osteoclastogenesis and alveolar bone resorption, underscoring its dual role in promoting tissue destruction and systemic inflammation,” wrote lead study author Prof. Luigi Nibali of the Centre for Host–Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, and colleagues.
The study had limitations. Its cross-sectional design prevented causal inference. Recruitment from a hospital setting introduced potential selection bias, and no power calculation was performed. Smoking status was uneven between groups, creating the possibility of residual confounding. Dietary intake was self-reported, leaving potential recall bias.
Researchers recommended larger studies with more detailed dietary assessments and caloric intake information to further evaluate these findings.
The authors reported no conflicts of interest. The study was funded by the Faculty of Dental Surgery (Royal College of Surgeons of England) and British Society of Periodontology.
Source: Journal of Periodontology
