| dc.description.abstract | Abstract
Background: Being physically active and maintaining normal weight contribute to better general health, but there is a paucity of knowledge on their impact on oral diseases mainly periodontitis. Therefore, this study aimed to assess the independent and combined associations of physical activity (PA) and body mass index (BMI) on periodontitis by stages and grades. Methods: A total of 2601 individuals (aged ≥20 years) participating in the Trøndelag Health Study (HUNT) with exposure data on PA and BMI at HUNT3 (2006-2008), and their 11-year follow-up data on the outcome periodontitis at HUNT4 (2017-2019) were included in the analyses. Periodontitis stages/grades were categorized according to the 2017 Classification of Periodontal and Peri-Implant Diseases and Conditions. Physical Activity Score (PAS) was constructed using frequency, intensity, and duration and divided into tertiles to assess PA levels (inactive/low: PAS = 0-1.5, medium: PAS = 1.875-3.75, high: PAS = 3.8-15). BMI (kg/m2) was classified as normal weight (18.5-24.9), overweight (25-29.9), and obese (≥30) according to the World Health Organization guidelines. Odds Ratios (OR) with corresponding 95% confidence intervals were computed to assess the association between PA, BMI, and periodontitis in both the unadjusted and adjusted models including potential confounders such as age, sex, education, smoking status, snus consumption, fruit and vegetable intake, alcohol intake, history of diabetes, osteoporosis, depression, and myocardial infarction and two variables for blood pressure were included: systolic, and diastolic blood pressure. Results: There was no evidence of an association between BMI, PA levels, and risk of developing severe-advanced periodontitis (Stage III-IV) among adults when compared to individuals with healthy/non-severe periodontitis (Stage 0, I-II) in the adjusted models. For BMI (OROverweight 0.99, 95% CI 0.78-1.28: ORObese 0.97, 95% CI 0.71-1.32). For PA levels (ORMedium 1.01, 95% CI 0.79-1.29; ORHigh 1.07, 95% CI 0.79-1.44). Likewise, no association was observed with moderate-rapid rate of periodontitis progression (Grades B-C) compared to those with no or slow rate of progression (Grades 0-A) in the adjusted models. For BMI (OROverweight 0.94, 95% CI 0.74-1.20; ORObese, 0.79, 95% CI 0.58-1.07). For PA (ORMedium 1.13, 95% CI 0.88-1.43; ORHigh, 1.28, 95% CI 0.96-1.69). Further, no clear combined association of BMI and PA was observed with periodontitis severity or grades among adults who are overweight-obese and physically inactive when compared to individuals with normal weight and physically active in the adjusted models. For stages (OR 0.95, 95% CI 0.69-1.31), while for grades (OR 0.77, 95% CI 0.57-1.05). Conclusion: This longitudinal study suggests that there is neither an independent nor combined association of BMI and PA with periodontitis by stages or grades. Future large prospective cohort studies are warranted to replicate our findings. Keywords: Obesity, periodontitis, physical activity, body mass index, periodontitis stages, periodontitis grades, the 2017 Classification of Periodontal and Peri-Implant Diseases and Conditions | |