Research findings by scientists indicate that, in children, higher dietary cholesterol intake at ages 3-5 years is associated with an increased risk of early childhood caries (ECC) and caries activity (CA). This cross-sectional study was conducted by Siting Ma and colleagues and published in the journal BMC Pediatrics. This important finding underscores the importance of dietary counseling in the prevention of ECC development among young children, especially in regions where diets are rich in cholesterol.
ECC, or early childhood caries, is an extremely prevalent and very difficult dental problem that young children of the world go through. This has been of great concern to pediatric dentists, particularly because dietary factors are suspected to have some effect on the occurrence and severity of ECC. Specifically, while a number of studies have focused on various dietary factors contributing to ECC, little attention has been paid to the potential link between dietary nutrient intake, specific to Chinese diets, and the development of ECC. This study was, therefore, conducted to determine the correlation of dietary nutrients with ECC incidence and caries activity in children aged 3-5 years and to provide some valuable dietary guidance on the deceleration of the caries process of ECC.
This research work was a cross-sectional study conducted in 2022, involving 155 children aged 3-5 years. The subjects were, furthermore, divided according to their dental status into a caries-free group of 17 children, an ECC group of 39 children, and a SECC group of 99 children. After this, they were divided into three groups according to the value of the Caries Activity Test: the low CA group with 33, the middle CA group with 36, and the high CA group with 86. Each child's dietary intake over 24 hours was recorded using a mobile phone APP and the nutrient intake calculated with reference to the "China Food Composition Tables".
Key Findings
• The result of the study showed that dietary cholesterol intake was significantly associated with an increased risk for ECC. The OR of cholesterol intake in this model was found to be 1.005, indicating that the higher the consumption of cholesterol, the higher the risk for ECC.
• Similar to ECC, the risk of developing SECC was positively associated with cholesterol intake. The result may thus imply that cholesterol is a constant factor across different degrees of caries severity with an OR of 1.003.
• Magnesium intake was associated with an increased ECC risk, expressed by OR = 1.026, while iron seemed to decrease the risk of ECC, expressed by OR = 0.770. This will show how very complex interactions of different nutrients may influence dental health.
• The intake of cholesterol was also associated with increased risk of H-CA, with an OR of 1.002, which further confirmed that cholesterol is a core dietary factor in the development of caries.
• In this study, it was shown that combined application had a larger predictive value for ECC, with an area under the ROC curve of 0.741 concerning dietary intakes of total calories, carbohydrates, cholesterol, sodium, magnesium, and selenium.
• It suggests that taking a holistic monitoring approach to these dietary components may yield better prediction and management of ECC.
These findings point to the central role of dietary cholesterol in the development of ECC and caries activity in young children. Pediatric health care providers and parents should, therefore, be aware of total intake of cholesterol in children's diets, especially in populations with diet habits characterized by foods with high levels of this nutrient. The results found in this study on magnesium and iron intake add more information to the understanding of how nutrient balance influences dental health.
It can be concluded that those with higher dietary intake of cholesterol, compared with those consuming lower amounts, had an increased risk of early childhood caries and caries activity. The results therefore underline the need for dietary management in the prevention of ECC, especially when it comes to high-cholesterol diets. Combinational assessment of key dietary nutrients may hence be a predictor of ECC, thereby leading to efficient preventive strategies.
Reference:
Ma, S., Ma, Z., Wang, X., Lei, M., Zhang, Y., Lin, X., & Shi, H. (2024). Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3–5 years—a cross-sectional study. BMC Pediatrics, 24(1). https://doi.org/10.1186/s12887-024-04984-9