Public Health Nutrition

Nutrition and health

Dietary antioxidants and periodontal disease in community-based older Japanese: a 2-year follow-up study

Masanori Iwasakia1 c1, Paula Moynihana2, Michael C Manza3, George W Taylora4, Akihiro Yoshiharaa5, Kanako Muramatsua6, Reiko Watanabea6 and Hideo Miyazakia1

a1 Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-Dori, Chuo-Ku, Niigata 951-8514, Japan

a2 Institute for Ageing and Health/Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK

a3 Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA

a4 Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA, USA

a5 Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

a6 Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan


Objective To investigate the longitudinal relationship between the intake of dietary antioxidants and periodontal disease in community-dwelling older Japanese.

Design A retrospective cohort study, with a follow-up of 2 years (2003–2005). Intakes of dietary antioxidants (vitamin C, vitamin E, α-carotene and β-carotene) were assessed with a validated FFQ. Participants were classified by tertile of antioxidant intake. Full-mouth periodontal status, measured as the clinical attachment level, was recorded at baseline and follow-up examinations. Periodontal disease progression was considered as loss of attachment of 3 mm or greater over the study period at the interproximal site for each tooth. Finally, the number of teeth with periodontal disease progression per person was calculated and was used as the outcome. Poisson regression analysis was conducted, with dietary antioxidants as the main exposure, to estimate their influence on the number of teeth with periodontal disease progression.

Setting Niigata City (Japan).

Subjects Dentate individuals aged 75 years in 2003, for whom data were available, were included in the analyses (n 264).

Results A higher intake of dietary antioxidants was inversely associated with the number of teeth with periodontal disease progression, controlling for other variables. The multivariate-adjusted incidence rate ratios in the first, second and third tertiles were 1·00, 0·76 (95 % CI 0·60, 0·97) and 0·72 (95 % CI 0·56, 0·93) for vitamin C; 1·00, 0·79 (95 % CI 0·62, 0·99) and 0·55 (95 % CI 0·42, 0·72), for vitamin E; and 1·00, 1·02 (95 % CI 0·81, 1·29) and 0·73 (95 % CI 0·56, 0·95) for β-carotene.

Conclusions The study results suggest that higher intake of antioxidants may mitigate periodontal disease in community-dwelling older Japanese.

(Received November 16 2011)

(Revised March 23 2012)

(Accepted March 30 2012)

(Online publication May 22 2012)


  • Dietary antioxidants;
  • Periodontal disease;
  • Longitudinal study;
  • Elderly


c1 Corresponding author: Email