Anja Weirsøe Dynesen

Sociodemographic differences in dietary habits described by food frequency questions — results from Denmark

Objectives: To investigate whether a modest number of food frequency questions are sufficient to describe sociodemographic differences in dietary habits, and to identify sociodemographic characteristics of subjects adhering to food-based dietary guidelines operationalised in a ‘healthy-diet index’.Design: Cross-sectional population survey.Subjects: A total of 480 men, 515 women, aged 15–90 y. Random sample of private telephone numbers drawn from regional telephone records, geographically stratified. Participation rate 62%.Methods: Computer-assisted telephone interviews, including six food frequency questions, a question on type of fat spreads used on bread, questions on seven sociodemographic variables.Results: The summary of the healthy-diet index showed that the subjects who adhered to food-based dietary guidelines (top quintile) compared to those who did not (bottom quintile) were most often women (odds ratio (OR)=6.07; confidence interval (CI): 3.91–9.43, women vs men), of older age (OR=9.72; CI: 3.02–31.31, old age vs young), highly educated (OR=3.69; CI: 1.53–8.92, high education vs low) and living in multiperson households including children (OR=4.66; CI: 2.47–8.80, multiperson household vs single household). The results also showed that gender difference in dietary habits is associated with other sociodemographic variables.Conclusions: The selected food frequency questions proved sufficient to describe sociodemographic differences in dietary habits, and this method may be a valuable supplement to traditional quantitative dietary surveys in monitoring sociodemographic changes in eating patterns. The results also underline the influence of sociodemographic status on dietary habits.Sponsorship: The Danish Nutrition Council funded the study.

Salivary changes and dental erosion in bulimia nervosa.

OBJECTIVE Our aim was to study if bulimia nervosa (BN) has an impact on salivary gland function and if such changes are related to dental erosion. STUDY DESIGN Twenty women with BN and twenty age- and gender-matched controls participated. Flow rate and composition of whole and glandular saliva, as well as feeling of oral dryness were measured. Dental erosion was measured on casts. RESULTS Compared with control subjects, unstimulated whole saliva (UWS) flow rate was reduced in persons with BN, primarily owing to intake of medication (P = .007). No major compositional salivary changes were found. In the BN group, the dental erosion score was highest and complaints of oral dryness were more frequent. CONCLUSIONS The BN persons had impaired UWS, mainly owing to medication; increased feeling of oral dryness; and more dental erosion. Dental erosion was related to the duration of eating disorder, whereas no effect of vomiting frequency or intake of acidic drinks on reduced UWS was observed.

Eating disorders: Experiences of and attitudes towards oral health and oral health behaviour

It is well known that early signs of eating disorders (EDs), such as dental erosion and enlarged salivary glands, may be recognized in the dental clinic. Dentists acknowledge that approaching a patient to discuss the suspicion of an ED is difficult. However, little is known about how persons with EDs experience and manage dental visits. Therefore, this study aimed to uncover knowledge, experience, and attitude of oral health and oral health behavior among persons with EDs. The study design was cross-sectional and 260 persons with EDs completed an electronic questionnaire. The participants were generally concerned about their teeth. Some participants had anxiety around having severely and irreversibly damaged teeth, and many were overly occupied with oral hygiene procedures. One-third of participants had good experiences regarding communication with a dentist, and about half of the participants wanted the dentist to address their EDs in the clinic. However, participants with less-positive experiences stated that there is a need for dentists with specialized knowledge about EDs and communication skills that emphasize an open, empathic, recognition approach from the dentist toward patients with EDs. In addition, it may be advantageous to integrate dental advice and treatment as part of the treatment of EDs in line with psychological and medical therapy.

Oral Dryness, Dietary Intake, and Alterations in Taste

Xerostomia and decreased salivary secretion may give rise to a number of oral complications. These include dry, atrophic and tender oral mucosa; impaired mastication, food bolus formation, and swallowing; altered sensation of taste; as well as increased risk of developing dental caries and erosion that could be followed by tooth loss. These are all complications that theoretically may have a negative impact on dietary intake. Although the literature does not present a direct association between decreased salivary secretion and malnutrition, it is concluded that salivary gland dysfunction may add to the conditions that make it difficult to maintain an adequate dietary intake in some individuals. Also, the opposite can occur. Thus, persons with an inadequate dietary intake may present with xerostomia and decreased salivary secretion. Therefore, clinical recommendations for counseling of dry mouth patients should draw attention to the impact of an unbalanced diet on salivary secretion and emphasize that oral dryness may have a negative impact on food consumption.