TY  - JOUR
T1  - Relationship between nutrition and periodontitis in the Turkish population: a pilot study
TT  - Türk popülasyonunda beslenme ve periodontitis arasındaki ilişkinin incelenmesi: bir pilot çalışma
AU  - Öner, Fatma
PY  - 2025
DA  - July
Y2  - 2025
DO  - 10.32322/jhsm.1688176
JF  - Journal of Health Sciences and Medicine
JO  - J Health Sci Med /JHSM /jhsm
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2636-8579
SP  - 536
EP  - 541
VL  - 8
IS  - 4
LA  - en
AB  - Aims: Periodontitis is a chronic, multifactorial inflammatory disease affecting the tooth-supporting structures and is influenced by lifestyle-related risk factors, including nutrition. This pilot study aimed to evaluate the relationship between nutritional and periodontal status of Turkish population using the Mini Nutritional Assessment® (MNA) tool. Methods: A total of 50 systemically healthy, non-smoking individuals were enrolled, of whom 25 were periodontally healthy, and 25 had periodontitis. Participants underwent full-mouth periodontal examinations. Nutritional status was assessed using the MNA questionnaire, individuals were categorized as having normal nutrition, being at risk of malnutrition, or malnourished. Statistical analyses were performed using tests appropriate to data distribution, including T tests, Mann-Whitney U, Kruskal-Wallis H, Chi-square, and Fisher’s exact tests, with normality assessed via Shapiro-Wilk, histograms, skewness, and kurtosis.Results: 56% of the participants had normal nutritional status, while 44% were at risk of malnutrition. A higher percentage of individuals at risk were observed in the periodontitis group (52%) compared to the control group (36%), though the difference was not statistically significant. Daily intake of dairy products (p=0.235) and meat/fish/poultry (p=0.345) were more common in the control group, while fruit and vegetable (p=0.762) consumption were more in periodontitis group. Notably, 69.6% of participants who perceived their nutrition as adequate were in the control group, compared to only 30.4% in the periodontitis group (p=0.028), suggesting a link between perceived nutrition quality and periodontal health. Although no significant differences in clinical periodontal parameters were observed based on specific dietary components or MNA scores, the overall trend suggested that individuals with better nutritional status had healthier periodontal conditions. Conclusion: This study highlights the potential role of nutrition, particularly the intake of animal proteins and dairy products, in maintaining periodontal health. The MNA tool may serve as a valuable adjunct for determining the nutritional status and integrating dietary evaluation into personalized periodontal care. Further large-scale, multi-center studies incorporating biochemical markers and gender-specific analyses are recommended to validate and build upon these findings.
KW  - Periodontitis
KW  - nutrition
KW  - MNA score
KW  - Turkish population
N2  - Amaç:Periodontitis, diş destek dokularını etkileyen, kronik inflamatuar bir hastalıktır. Periodontitisin oluşması ve ilerlemesi beslenme dâhil olmak üzere yaşam tarzıyla ilişkili birçok risk faktörü tarafından etkilenmektedir. Bu pilot çalışmada, Mini Nutritional Assessment® (MNA) ölçeği kullanılarak Tǔrk popülasyonda beslenme durumu ile periodontitis arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.Yöntemler:Sistemik olarak sağlıklı ve sigara içmeyen toplam 50 birey çalışmaya dahil edilmiştir; bunların 25’i periodontal olarak sağlıklı, 25’i ise periodontitis hastasıdır. Katılımcıların periodontal muayenesi yapılmış, beslenme durumu ise MNA ölçeği ile değerlendirilmiştir. Buna göre bireyler normal beslenme, malnütrisyon riski taşıyan ve malnütrisyonlu olarak sınıflandırılmıştır. Verilerin dağılımına göre uygun istatistiksel testler kullanılmış; Shapiro-Wilk testi, histogramlar, çarpıklık ve basıklık analizleri ile normallik değerlendirilmiştir. Kullanılan testler arasında t-testi, Mann-Whitney U, Kruskal-Wallis H, Ki-kare ve Fisher’ın kesin testi yer almıştır.Bulgular:Katılımcıların %56’sı normal beslenme durumuna sahipken, %44’ü malnütrisyon riski altındaydı. Malnütrisyon riski taşıyan bireylerin oranı periodontitis grubunda (%52) kontrol grubuna (%36) kıyasla daha yüksekti, ancak bu fark istatistiksel olarak anlamlı değildi. Günlük süt ürünleri (p=0.235) ve et/balık/tavuk (p=0.345) tüketimi kontrol grubunda daha yaygınken; meyve ve sebze tüketimi (p=0.762) periodontitis grubunda daha yüksekti. Beslenmesini yeterli olarak algılayan katılımcıların %69,6’sı kontrol grubunda yer alırken, bu oran periodontitis grubunda yalnızca %30,4’tü (p=0.028); bu da algılanan beslenme kalitesi ile periodontal sağlık arasında bir bağlantı olduğunu düşündürmektedir.Belirli besin öğeleri tüketimi veya MNA skorlarına göre klinik periodontal parametrelerde anlamlı ilişki bulunmamakla birlikte, genel eğilim daha iyi beslenme durumuna sahip bireylerin daha sağlıklı periodontal koşullara sahip olduğunu göstermiştir.Sonuç:Bu çalışma, özellikle hayvansal proteinler ve süt ürünleri tüketiminin periodontal sağlık üzerindeki olası rolünü desteklemektedir. MNA ölçeği, bireylerin beslenme durumlarını belirlemede ve periodontal hastalık ile ilişkisini saptamada faydalı bir araç olabilir. Bu bulguların doğrulanması ve genişletilmesi için biyokimyasal belirteçlere ve cinsiyete özel analizleri içeren daha büyük çaplı, çok merkezli çalışmalara ihtiyaç vardır.
CR  - Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15(1):30-44. doi:10. 1038/nri3785
CR  - 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
CR  - Chapple IL. Potential mechanisms underpinning the nutritional modulation of periodontal inflammation. J Am Dent Assoc. 2009;140(2): 178-184. doi:10.14219/jada.archive.2009.0131
CR  - Sczepanik FSC, Grossi ML, Casati M, et al. Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way. Periodontol 2000. 2020;84(1):45-68. doi:10.1111/prd.12342
CR  - Ritchie CS, Kinane DF. Nutrition, inflammation, and periodontal disease. Nutrition. 2003;19(5):475-476. doi:10.1016/s0899-9007(02)01043-2
CR  - Dattani V, Patel H, Ahmad R, et al. Aspects of nutriment in maintaining gum wellbeing: a literature review. J Appl Pharmaceut Sci. 2024;14(9):76-97.
CR  - Amaliya, Timmerman MF, Abbas F, et al. Java project on periodontal diseases: the relationship between vitamin C and the severity of periodontitis. J Clin Periodontol. 2007;34(4):299-304. doi:10.1111/j.1600-051X.2007.01053.x
CR  - Luo PP, Xu HS, Chen YW, Wu SP. Periodontal disease severity is associated with micronutrient intake. Aust Dent J. 2018;63(2):193-201. doi:10.1111/adj.12606
CR  - Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1065. doi:10.3390/jcm 8071065
CR  - Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature-what does it tell us? J Nutr Health Aging. 2006;10(6):466-485.
CR  - Bauer JM, Kaiser MJ, Anthony P, Guigoz Y, Sieber CC. The Mini Nutritional Assessment-its history, today’s practice, and future perspectives. Nutr Clin Pract. 2008;23(4):388-396. doi:10.1177/0884533608321132
CR  - Hoşcan Y, Yiğit F, Müderrisoğlu H. Adherence to Mediterranean diet and its relation with cardiovascular diseases in Turkish population. Int J Clin Exp Med. 2015;8(2):2860-2866.
CR  - Buyukuslu N, Hizli H, Esin K, Garipagaoglu M. A cross-sectional study: nutritional polyamines in frequently consumed foods of the Turkish population. Foods. 2014;3(4):541-557. doi:10.3390/foods3040541
CR  - Altun E, Walther C, Borof K, et al. Association between dietary pattern and periodontitis-a cross-sectional study. Nutrients. 2021;13(11):4167. doi:10.3390/nu13114167
CR  - Bhatsange A, Kamble SP. Assessment of nutritional status in chronic periodontitis patients: a cross-sectional study. J Indian Soc Periodontol. 2024;28(2):231-243. doi:10.4103/jisp.jisp_263_23
CR  - Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014;93(11):1045-1053. doi:10. 1177/0022034514552491
CR  - Germen M, Baser U, Lacin CC, Fıratlı E, İşsever H, Yalcin F. Periodontitis prevalence, severity, and risk factors: a comparison of the AAP/CDC case definition and the EFP/AAP classification. Int J Environ Res Public Health. 2021;18(7):3459. doi:10.3390/ijerph18073459
CR  - Bartold PM. Lifestyle and periodontitis: the emergence of personalized periodontics. Periodontol 2000. 2018;78(1):7-11. doi:10.1111/prd.12237
CR  - Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-3191. doi:10.1097/00007632-200012 150-00014
CR  - Sarikaya D, Halil M, Kuyumcu ME, Kiliç MK, Yesil Y. A Validity Study of Long and Short (MNA-SF) Forms of Mini Nutritional Assessment (MNA) Test in Geriatric Patients. Presented in the 7th Academic Geriatrics Congress Abstract, Antalya, Turkiye, 2014.
CR  - Akın S, Kesim S, Manav TY, et al. Impact of oral health on nutritional status in community-dwelling older adults in Turkey. Eur J Geriatric Gerontol 2019;1(1):29-35. doi:10.4274/ejgg.galenos.2019.55
CR  - Nazan S, Buket K. Evaluation of nutritional status of elderly patients presenting to the family health center. Pak J Med Sci. 2018;34(2):446-451. doi:10.12669/pjms.342.14936
CR  - Ekici E, Vatansever N, Çolak M, Kozan EH. Validity and reliability of Turkish Self-Mini Nutritional Assessment Scale. Elderly Health J. 2021; 7(1):32-38. doi:10.18502/ehj.v7i1.6549
CR  - Li W, Song J, Chen Z. The association between dietary vitamin C intake and periodontitis: result from the NHANES (2009-2014). BMC Oral Health. 2022;22(1):390. doi:10.1186/s12903-022-02416-7
CR  - Küçük N, Urak F, Bilgic A, Florkowski WJ, Kiani AK, Özdemir FN. Fruit and vegetable consumption across population segments: evidence from a national household survey. J Health Popul Nutr. 2023;42(1):54. doi:10.1186/s41043-023-00382-6
CR  - Farias da Cruz M, Baraúna Magno M, Alves Jural L, et al. Probiotics and dairy products in dentistry: a bibliometric and critical review of randomized clinical trials. Food Res Int. 2022;157:111228. doi:10.1016/j.foodres.2022.111228
CR  - Lee K, Kim J. Dairy Food Consumption is inversely associated with the prevalence of periodontal disease in Korean adults. Nutrients. 2019; 11(5):1035. doi:10.3390/nu11051035
CR  - Buyukuslu N, Hizli H, Esin K, Garipagaoglu M. A cross-sectional study: nutritional polyamines in frequently consumed foods of the Turkish population. Foods. 2014;3(4):541-557. doi:10.3390/foods3040541
CR  - Grzymisławska M, Puch EA, Zawada A, Grzymisławski M. Do nutritional behaviors depend on biological sex and cultural gender? Adv Clin Exp Med. 2020;29(1):165-172. doi:10.17219/acem/111817
CR  - Zhu P, Li A, Cai Q, et al. Sex differences in the association between dual-energy X-Ray absorptiometry-measured body composition and periodontitis. J Periodontol. 2024;95(3):219-232. doi:10.1002/JPER.23-0162
UR  - https://doi.org/10.32322/jhsm.1688176
L1  - https://dergipark.org.tr/tr/download/article-file/4824144
ER  -