Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Abstract Introduction: Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Methods: Individuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures. Results: A total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ±1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects. Conclusion: Our findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.

[Effects of anxiety and depression on periodontal diseases: review article]

Periodontitis does not affect all patients by the same way. There are some risk factors in some people that make them more sensitive to progress of periodontitis. Smoking, uncontrolled diabetes, and special pathogens increase the risk of periodontitis. Other factors such as stress, depression and anxiety, are not crucial risk factors for periodontitis yet. Biologic explanation of this relation is that mental conditions and exposure to stressful situations can alter immune response. The aim of this study was to review the psychological factors of anxiety and depression associated with periodontitis. For this review article, we have searched through internet by the following keywords; periodontal disease, anxiety, depression. We have tried to cover almost all dental-related sites and journals as well as Pubmed from 1990-2010. Most published studies support a positive relationship between periodontitis and several psychosocial factors. Life style, stressful conditions, hormonal changes, nonchalance in oral hygiene, habits such as smoking are predisposing factors in periodontal diseases.

Avaliação quantitativa das citocinas IL-4, IL-6, IL-8, IL-10 e do TGF-β, presentes na saliva de pacientes com periodontite, antes e após a submissão à psicoterapia: análise comparativa com pacientes controles / Quantitative evaluation of the cytokines IL-4, IL-6, IL-8, IL-10 and TGF-β presents in the saliva of patients with periodontitis, before and after submission to psychotherapy: comparative analisys with control patients

Considerando a condição multi-fatorial da etiologia da doença periodontal, em particular a influência do estresse, evidente na literatura, esta pesquisa teve como propósito avaliar 2 grupos de indivíduos com doença periodontal, sendo que um grupo foi submetido à psicoterapia (grupo experimental - N=13) por 3 meses, enquanto o outro grupo serviu como controle(N=13); em ambos os grupos nenhuma intervenção periodontal foi realizada nesse período, seja curativa ou preventiva. Os dados obtidos dos indivíduos de ambos os grupos, no "baseline" e no final do experimento (após 3 meses) incluíram: níveis das citocinas IL-4, IL-6, IL-8, IL-10 e TGF- β (salivares), parâmetros periodontais (profundidade de sondagem-PS, nível de inserção- NI, recessão gengival, índice de placa-IP, índice gengival-IG) e o número de dentes perdidos (NDP). Também o nível de cortisol (NC) e análise psicológica do grau de estresse dos indivíduos que compuseram a amostra, foram importados de GREGHI-2009, para análise conjunta com os demais parâmetros. Os pacientes foram triados seguindo vários critérios de exclusão e inclusão. Na análise dos parâmetros periodontais verificou-se que no grupo experimental houve uma melhora significante do IP e do IG, e no grupo controle ocorreu uma piora significante do IP. A análise laboratorial mostrou que o NC diminuiu de forma significativa no grupo experimental e no grupo controle houve um aumento significativo do nível de IL-6. Cabe destacar que, embora as diferenças entre os níveis iniciais e finais das citocinas analisadas, não tenham sido estatisticamente significantes, no grupo experimental houve uma tendência do aumento das citocinas anti-inflamatórias e diminuição das citocinas pró-inflamatórias. Como conclusão final admitiu-se que o estresse pode repercutir negativamente no controle de placa, que o NC elevado pode aumentar os riscos de comprometimento periodontal, que a psicoterapia pode interferir de forma positiva em alguns parâmetros clínicos...

Considering the multi-factorial etiology of periodontal disease, particularly the evidence based influence of stress, this research aimed at evaluating two groups of individuals with periodontal disease. One of them was subjected to psychotherapy (experimental group N=13) during 3 months while the other served as control group (N=13); none f the groups received any curative or preventive periodontal intervention in the period. The achieved data from both groups of individuals at baseline and at the end of the experiment (3 months) included: cytokines levels IL-4, IL-6, IL-8, IL-10 and TGF- β (salivary), periodontal parameters (probing depth - PS, attachment level - NI, gingival recession, plaque index - IP, gingival index -IG) and number of lost teeth (NDP). The cortisol level (NC) and the psychological analysis of the stress level in the individuals who constituted the sample were imported from GREGHI-2009 for concurrent analysis with the other parameters. The patients were selected by respecting several inclusion and exclusion criteria. The periodontal parameters analysis showed that there was a significant improvement of IP and IG in the experimental group and there was a significant worsening of IP in the control group. The laboratorial analysis showed that the NC diminished significantly in the experimental group and there was a significant magnification in the level of IL-6 in the control group. It is worthwhile to emphasize that even though the differences between the initial and final levels of the analyzed cytokines were not statistically significant, there was a tendency of augmentation in the anti-inflammatory cytokines levels and decrease in the pro-inflammatory cytokines levels in the experimental group. As a final conclusion, it was accepted that the stress can negatively influence the plaque control, the elevated NC can increase the risk for periodontal breakdown, the psychotherapy can positively interfere in some clinical and laboratorial...

Avaliação quantitativa das citocinas IL-4, IL-6, IL-8, IL-10 e do TGF-β, presentes na saliva de pacientes com periodontite, antes e após a submissão à psicoterapia: análise comparativa com pacientes controles / Quantitative evaluation of the cytokines IL-4, IL-6, IL-8, IL-10 and TGF-β presents in the saliva of patients with periodontitis, before and after submission to psychotherapy: comparative analisys with control patients

Considerando a condição multi-fatorial da etiologia da doença periodontal, em particular a influência do estresse, evidente na literatura, esta pesquisa teve como propósito avaliar 2 grupos de indivíduos com doença periodontal, sendo que um grupo foi submetido à psicoterapia (grupo experimental - N=13) por 3 meses, enquanto o outro grupo serviu como controle(N=13); em ambos os grupos nenhuma intervenção periodontal foi realizada nesse período, seja curativa ou preventiva. Os dados obtidos dos indivíduos de ambos os grupos, no "baseline" e no final do experimento (após 3 meses) incluíram: níveis das citocinas IL-4, IL-6, IL-8, IL-10 e TGF- β (salivares), parâmetros periodontais (profundidade de sondagem-PS, nível de inserção- NI, recessão gengival, índice de placa-IP, índice gengival-IG) e o número de dentes perdidos (NDP). Também o nível de cortisol (NC) e análise psicológica do grau de estresse dos indivíduos que compuseram a amostra, foram importados de GREGHI-2009, para análise conjunta com os demais parâmetros. Os pacientes foram triados seguindo vários critérios de exclusão e inclusão. Na análise dos parâmetros periodontais verificou-se que no grupo experimental houve uma melhora significante do IP e do IG, e no grupo controle ocorreu uma piora significante do IP. A análise laboratorial mostrou que o NC diminuiu de forma significativa no grupo experimental e no grupo controle houve um aumento significativo do nível de IL-6. Cabe destacar que, embora as diferenças entre os níveis iniciais e finais das citocinas analisadas, não tenham sido estatisticamente significantes, no grupo experimental houve uma tendência do aumento das citocinas anti-inflamatórias e diminuição das citocinas pró-inflamatórias. Como conclusão final admitiu-se que o estresse pode repercutir negativamente no controle de placa, que o NC elevado pode aumentar os riscos de comprometimento periodontal, que a psicoterapia pode interferir de forma positiva em alguns parâmetros clínicos...

Considering the multi-factorial etiology of periodontal disease, particularly the evidence based influence of stress, this research aimed at evaluating two groups of individuals with periodontal disease. One of them was subjected to psychotherapy (experimental group N=13) during 3 months while the other served as control group (N=13); none f the groups received any curative or preventive periodontal intervention in the period. The achieved data from both groups of individuals at baseline and at the end of the experiment (3 months) included: cytokines levels IL-4, IL-6, IL-8, IL-10 and TGF- β (salivary), periodontal parameters (probing depth - PS, attachment level - NI, gingival recession, plaque index - IP, gingival index -IG) and number of lost teeth (NDP). The cortisol level (NC) and the psychological analysis of the stress level in the individuals who constituted the sample were imported from GREGHI-2009 for concurrent analysis with the other parameters. The patients were selected by respecting several inclusion and exclusion criteria. The periodontal parameters analysis showed that there was a significant improvement of IP and IG in the experimental group and there was a significant worsening of IP in the control group. The laboratorial analysis showed that the NC diminished significantly in the experimental group and there was a significant magnification in the level of IL-6 in the control group. It is worthwhile to emphasize that even though the differences between the initial and final levels of the analyzed cytokines were not statistically significant, there was a tendency of augmentation in the anti-inflammatory cytokines levels and decrease in the pro-inflammatory cytokines levels in the experimental group. As a final conclusion, it was accepted that the stress can negatively influence the plaque control, the elevated NC can increase the risk for periodontal breakdown, the psychotherapy can positively interfere in some clinical and laboratorial...