Abstract
BACKGROUND: Evidence is emerging about the effects of a balanced nutrition in maintaining periodontal health. The aim of this project was to investigate the association between diet, severity of periodontitis, and periodontal and systemic inflammation. METHODS: Two hundred consecutive hospital patients underwent a full periodontal assessment, had blood samples taken, and filled out a food frequency questionnaire (FFQ). Adherence to a Mediterranean-type diet was assessed through the FFQ. High-sensitivity C-reactive protein (hs-CRP) serum levels of matrix metalloproteinases-8 (MMP-8), interleukin (IL)-1α, IL-1β, IL-6, IL-10, and IL-17 were analyzed. Correlation and multivariate logistic regression analyses were performed to test the relationships between dietary factors, inflammatory biomarkers, and clinical data. RESULTS: A total of 195 patients had complete data, with 112 participants categorized as highly adherent to the Mediterranean diet. Multivariate analysis showed that low adherence to Mediterranean diet was associated to periodontitis stage III-IV (p = 0.055, odds ratio [OR] 0.35, 95% confidence interval [CI]: 0.12-0.89); among individual food groups, more frequent red meat consumption was independently associated with more severe periodontitis stage (p = 0.042, OR 2.75, 95% CI: 1.03-7.41). Periodontal disease severity showed moderate associations with both circulating hs-CRP and IL-6 in the univariate analysis, but only IL-6 association was confirmed after adjusting for confounders. Consumption of several plant-derived food groups was significantly inversely related to increased levels of hs-CRP, IL-1α, IL-6, IL-10, and IL-17. CONCLUSIONS: This study shows that low adherence to Mediterranean diet and higher red meat consumption may be associated with severity of periodontal disease. Studies with a larger sample size are needed to further clarify the current findings. PLAIN LANGUAGE SUMMARY: This study explored how everyday eating habits might impact gum health and overall inflammation. We evaluated 200 hospital patients by performing dental exams, taking blood samples, and asking them about their diets through questionnaires. In particular, we looked at how closely people followed a Mediterranean-style diet, known for its emphasis on fruits, vegetables, whole grains, and healthy fats. Our findings revealed that patients who did not follow the Mediterranean diet as closely tended to have more severe gum disease, especially if they consumed red meat frequently. We also observed that higher levels of a key inflammatory marker, such as interleukin-6 (IL-6), were linked to worse gum health, while diets rich in plant-based foods were associated with lower levels of various inflammatory markers. These results suggest that a balanced, Mediterranean-type diet could be important in reducing gum disease and systemic inflammation. Further studies with larger groups are needed to confirm these promising observations.