Abstract
The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food.
Highlights
The global “nutrition transition” describes the shift from a traditional, whole-food diet to a highly-processed diet high in sugar, fat, and salt, often referred to as the “Western diet” [1]
Studies have demonstrated an association between severe caries and malnutrition in some low-income contexts, with caries contributing to mouth pain and chronic inflammation which disrupt normal eating, sleep, and growth [29,30,31,32,33]; associations with obesity in high-income contexts due to shared dietary risk factors [34,35]; and no associations in other studies [36]
Trained Jevaia field staff, who were experienced in conducting oral health promotion in Nepal, provided verbal explanation of the study to participating parents/caregivers and children, obtained written informed consent from adults for their own and their children’s participation, and obtained verbal assent from children according to their developmental ability
Summary
The global “nutrition transition” describes the shift from a traditional, whole-food diet to a highly-processed diet high in sugar, fat, and salt, often referred to as the “Western diet” [1]. Sugar consumption is a common risk factor for dental caries, malnutrition, and obesity [10,24,28]. Studies have demonstrated an association between severe caries and malnutrition in some low-income contexts, with caries contributing to mouth pain and chronic inflammation which disrupt normal eating, sleep, and growth [29,30,31,32,33]; associations with obesity in high-income contexts due to shared dietary risk factors [34,35]; and no associations in other studies [36]. This study aims to explore the associations between Nepali children’s dietary consumption habits and dental caries and between severe caries and nutritional status
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