The Effect of Dietary Advice Aimed at Increasing Protein Intake on Oral Health and Oral Microbiota in Older Adults: A Randomized Controlled Trial.

Kristina S Fluitman, Tim van den Broek, Ilse Reinders, Hanneke A H Wijnhoven, Max Nieuwdorp, Marjolein Visser, Richard G IJzerman, Bart J F Keijser

Journal: Nutrients 2023;15(21):4567

PMID: 37960220

Plain Language Summary

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It is well-established that nutrition and oral health are closely related. This relationship is especially evident in older adults, in whom both oral health and nutritional status are often compromised. The aim of this study was to evaluate the effect of the intervention on oral health and the oral microbiota composition in community-dwelling older adults. This study was part of the 6-month, multicentre, randomised controlled PROMISS trial which randomly assigned participants into 3 groups. For this study a total of 90 participants were included, 47 from the high protein group and 43 from the control group. Results showed that increasing protein intake from an average of 0.8 g/kg adjusted body weight/day (aBW/d) to 1.2 g/kg aBW/d does not affect self-reported oral health status in older adults. Moreover, whereas moderate effects were observed on the overall microbiota composition based on alpha- and beta-diversity measures, no individual bacterial taxa were found to be specifically affected. Authors concluded that dietary advice aimed at increasing protein intake to at least 1.2 g/kg aBW/d in older adults with habitual low protein intake did not significantly improve self-reported oral health.

Abstract

Nutrition and oral health are closely related, especially in older adults in whom poor nutrition may lead to oral microbial perturbations, exacerbating poor oral health. In a 6-month randomized controlled trial, we evaluated the effects on oral microbiota and on oral health of dietary advice aimed at increasing protein intake to ≥1.2 g/kg adjusted body weight/day (g/kg aBW/d) in community-dwelling older adults with low habitual protein intake (<1.0 g/kg aBW/d). Food intake was measured via 24 h dietary recalls, oral health was measured via questionnaires, and oral microbial composition was assessed via the 16S rRNA sequencing of tongue swabs. Mean baseline protein intake was 0.8 g/kg aBW/day in both groups. In the high protein group ( = 47), participants increased their protein intake to mean 1.2 g/kg aBW/day at the 6-month follow-up. Protein intake in the control group ( = 43) remained at 0.9 g/kg a BW/day. The intervention did not affect self-reported oral health. While it caused moderate shifts in oral microbiota alpha- and beta-diversity measures, abundances of individual bacterial taxa were not affected. In conclusion, our intervention did not affect self-reported oral health within a period of 6 months, nor did it substantially affect the tongue microbiota composition.

Address: Department of Internal Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.; Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.; Department of Microbiology and Systems Biology, TNO Earth, Life and Social Sciences, 3704 HE Zeist, The Netherlands.; Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands.; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.; Department of Internal Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.; Department of Vascular Medicine, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands.; Department of Internal Medicine, Amsterdam University Medical Centers, Location VUmc, 1081 HV Amsterdam, The Netherlands.; Department of Microbiology and Systems Biology, TNO Earth, Life and Social Sciences, 3704 HE Zeist, The Netherlands.; Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, 1081 LA Amsterdam, The Netherlands.

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Physical Environment

Clinical Imbalances

Laboratory Testing

Modifiable Lifestyle Factors

Jadad Score

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