Abstract
BackgroundAssociations between mastication and insufficient nutrient intake, obesity, and glucose metabolism have been shown in previous studies. However, the association between mastication and diabetes has not been clarified. Our objective was to examine the association between mastication, namely masticatory performance or rate of eating, and diabetes in a population-based cohort.MethodsWe conducted a cross-sectional study of the association between mastication and diabetes in the Nagahama Prospective Cohort Study, an ongoing study which recruits citizens of Nagahama City in Shiga Prefecture, central Japan. 2,283 male and 4,544 female residents aged 40–74 years were enrolled from July 2009 to November 2010. Masticatory performance was evaluated by spectrophotometric measurement of color changes after masticating color-changeable chewing gum. Categorical rate of eating (fast, intermediate or slow) was self-assessed using a questionnaire.Results177 males (7.7%) and 112 (2.4%) females were diagnosed with diabetes. We divided participants into four groups by quartile of masticatory performance, namely Q1 (lowest), 2, and 3 and 4 (highest). Compared to the lowest performance group, the multivariable adjusted odds ratio (OR) of diabetes was 0.91 (95% confidence interval (CI), 0.58–1.4) in Q2, 0.77 (95% CI, 0.48–1.2) in Q3, and 0.53 (95% CI, 0.31–0.90) in the highest group in males, and 1.2 (95% CI, 0.73–2.0), 0.95 (95% CI, 0.54–1.6) and 0.56 (95% CI, 0.30–1.0) in females. We also estimated ORs of diabetes by rate of eating. Compared to the fast eating group, ORs in males were 0.87 (95% CI, 0.61–1.2) in the intermediate group and 0.38 (95% CI, 0.16–0.91) in the slow group, and ORs in females were 0.92 (95% CI, 0.59–1.4) and 1.5 (95% CI, 0.73–3.0).ConclusionsThese findings support the hypothesis that higher masticatory performance and slow eating prevent the occurrence of diabetes.
Highlights
Diabetes is a group of metabolic diseases which is characterized by hyperglycemia resulting from defects in insulin secretion, insulin resistance, or both
Eating slowly lead to lower postprandial concentrations of the anorexigenic gut peptides peptide YY and glucagon-like peptide 1 (GLP-1) [14,15]. These findings indicate that adequate eating habits prevent the incidence of diabetes by improving glucose metabolism after meals
The distribution of masticatory performance and prevalence of diabetes in the participants are shown in Appendix S1
Summary
Diabetes is a group of metabolic diseases which is characterized by hyperglycemia resulting from defects in insulin secretion, insulin resistance, or both. People who were unable to fully masticate due to teeth loss or ill-fitting dentures had insufficient daily nutrient intake of dietary fiber, magnesium or calcium [10,11,12], nutrients which may be protective against type 2 diabetes [3,4]. These results suggest that higher masticatory performance may contribute to a lower risk of diabetes. Associations between mastication and insufficient nutrient intake, obesity, and glucose metabolism have been shown in previous studies. Our objective was to examine the association between mastication, namely masticatory performance or rate of eating, and diabetes in a population-based cohort
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