Fermentable Carbohydrate Intake Research Articles

Dietary contributors to fermentable carbohydrate intake in healthy American college students

Objective The study explored food items that contribute most toward increased fermentable carbohydrate (FC) intake and its association with diet quality in college students. Method This cross-sectional study included 571 consented college students (≥18 years) with reported energy intakes (500–3500 kcal/day for women; 800–4000 kcal/day for men). FC intake and healthy eating index-2015 (HEI-2015) scores were assessed by diet history questionnaire-II. Data were analyzed by unadjusted bivariate linear regression and Pearson correlation tests. Results The mean intakes of total FC (β = 1.24; 95% Confidence Interval: 1.02, 1.47) significantly predicted HEI-2015 scores. Positive correlations were found between FC intake and red and orange vegetables (r = 0.62), whole fruits (r = 0.63), and dark green vegetables (r = 0.58). Conclusions: Higher FC intake was associated with higher diet quality; vegetables and fruits are primary contributors to FC content. Efforts are required to promote these food items to improve diet quality and FC intake to shape eating choices in college students.

Histamine production by the gut microbiota induces visceral hyperalgesia through histamine 4 receptor signaling in mice.

The gut microbiota has been implicated in chronic pain disorders, including irritable bowel syndrome (IBS), yet specific pathophysiological mechanisms remain unclear. We showed that decreasing intake of fermentable carbohydrates improved abdominal pain in patients with IBS, and this was accompanied by changes in the gut microbiota and decreased urinary histamine concentrations. Here, we used germ-free mice colonized with fecal microbiota from patients with IBS to investigate the role of gut bacteria and the neuroactive mediator histamine in visceral hypersensitivity. Germ-free mice colonized with the fecal microbiota of patients with IBS who had high but not low urinary histamine developed visceral hyperalgesia and mast cell activation. When these mice were fed a diet with reduced fermentable carbohydrates, the animals showed a decrease in visceral hypersensitivity and mast cell accumulation in the colon. We observed that the fecal microbiota from patients with IBS with high but not low urinary histamine produced large amounts of histamine in vitro. We identified Klebsiella aerogenes, carrying a histidine decarboxylase gene variant, as a major producer of this histamine. This bacterial strain was highly abundant in the fecal microbiota of three independent cohorts of patients with IBS compared with healthy individuals. Pharmacological blockade of the histamine 4 receptor in vivo inhibited visceral hypersensitivity and decreased mast cell accumulation in the colon of germ-free mice colonized with the high histamine-producing IBS fecal microbiota. These results suggest that therapeutic strategies directed against bacterial histamine could help treat visceral hyperalgesia in a subset of patients with IBS with chronic abdominal pain.

Diets Composed of Tifton 85 Grass Hay (Cynodon sp.) and Concentrate on the Quantitative and Qualitative Traits of Carcass and Meat from Lambs

The high intake of fermentable carbohydrates may cause nutritional disorders and negatively affect animal performance. Thus, the research study aimed to determine the better roughage:concentrate ratio to improve the carcass traits and physicochemical quality of meat from feedlot-finished Santa Ines lambs. Diets were composed of Tifton 85 grass hay (Cynodon sp.) and concentrate (soybean meal, corn meal, urea, and mineral mixture) and consisted of five roughage:concentrate ratios of 88:12 (C12), 69:31 (C31), 50:50 (C50), 31:69 (C69), and 12:88 (C88). After 63 days the animals were slaughtered and carcass traits, the yield of commercial cuts, and physicochemical properties of meat were evaluated. The higher percentage of concentrate on roughage provided higher DM intake, better feed conversion, higher conformation, finishing, and carcass yield that resulted in heavier commercial cuts with higher fat content in the meat. The addition of 50% concentrate to the roughage improved the carcass traits, commercial cuts, and physicochemical parameters of the meat in a similar way to the diet with 88% concentrate, but with leaner meats, meeting the demands of the current consumer market.

Increased fermentable carbohydrate intake alters colonic mucus barrier function through glycation processes and increased mast cell counts.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder for which dietary interventions can be a useful treatment. In recent years, the low-FODMAP approach is gaining traction in this regard. The fermentation of these non-absorbed carbohydrates by the gut microbiota can generate toxic glycating metabolites, such as methylglyoxal. These metabolites can have harmful effects by their role in the generation of advanced glycation end products (AGEs), which activates Receptor for AGEs (AGER). Mast cells can be stimulated by AGEs and play a role in IBS. We have treated mice with lactose or fructo-oligosaccharides (FOS), with or without co-administration of pyridoxamine and investigated the colonic mucus barrier. We have found that an increased intake of lactose and fructo-oligosaccharides induces a dysregulation of the colonic mucus barrier, increasing mucus discharge in empty colon, while increasing variability and decreasing average thickness mucus layer covering the fecal pellet. Changes were correlated with increased mast cell counts, pointing to a role for the crosstalk between these and goblet cells. Additionally, AGE levels in colonic epithelium were increased by treatment with the selected fermentable carbohydrates. Observed effects were prevented by co-treatment with anti-glycation agent pyridoxamine, implicating glycation processes in the negative impact of fermentable carbohydrate ingestion. This study shows that excessive intake of fermentable carbohydrates can cause colonic mucus barrier dysregulation in mice, by a process that involves glycating agents and increased mucosal mast cell counts.

Nutritional and Botanical Approaches for Inflammatory Bowel Disease

Nutritional and Botanical Approaches for Inflammatory Bowel Disease

Abortion in Captive Gray Brocket Deer (Mazama gouazoubira) Associated with Colloid Goiter, Hemonchosis and Necrotizing Rumenitis

Background: The gray brocket deer (Mazama gouazoubira) is a specie that shows great adaptability in different habitats and it is the most abundant deer specie in South America. The present work describes for the first time a case of abortion followed by death associated with colloid goiter, massive hemonchosis and necrotizing rumenitis in a captive female gray brocket deer. Case: A 4-year-old female gray brocket deer (M. gouazoubira) raised in captivity had a history of abortion during the last third of gestation. The animal was kept in an enclosure together with 3 other gray brockets deers, being 1 male of the same age and 2 juvenile brocket deer of approximately 1 and 2 years old. The animals were fed with concentrated used as cattle feed and dewormed annually with 1% Ivermectin. The animals' enclosure had vegetation cover formed by grasses and soil. The animals appeared healthy with no behavioral changes. The day after the stillbirth, the mother was found dead in the enclosure and sent to the animal pathology sector of the University of Vila Velha (UVV), Brazil. Necropsy revealed that thyroid lobules were highly increased in volume and histopathological findings were compatible with colloid goiter. A large number of nematodes were found in the abomasal content,totalizing 11,626 helminths, which were morphologically characterized as Haemonchus contortus. Grossly, the serous and ruminal mucosa exhibited an extensively reddish focal area with irregular contour, surface ulceration and a firm consistency. Microscopically, a severe necrotizing rumenitis was diagnosed. The liver showed pale multifocal areas on the subcapsular surface,friable to the touch which deepened when cut. Histopathological analysis revealed an accentuated multifocal panlobular coagulative necrosis, characterizing an acute liver necrosis.Discussion: Iodine is a mineral of great importance for thyroid hormones synthesis and your requirements are higher during pregnancy and lactation. Diets deficient in iodine causes a reduction in the basal activity of the hormones triiodothyronine (T3) and thyroxine (T4) and over-stimulation of the thyroid by thyroid stimulating hormone (TSH), resulting in goiter. In the present case, it is possible that the shortage of iodine in diet caused a goiter and, as a consequence, triggered the abortion. Haemonchus contortus is a pathogenic nematode of small ruminants, leading to decreased productivity and death in some cases as a result of anemia and hypoxia. The contact between domestic and wild animals, resulting in the emergence of infectious diseases and the spread of pathogens among species. In the present case, manual counting accounted for 11,626 H. contortus larvae, characterizing a massive infection and justifying the condition of severe anemia. The high parasitic load shown in this case points out this parasite's importance related to this species in captivity. In general, inflammatory lesions in the rumen are results of excessive intake of fermentable carbohydrates, which leads to a considerable decrease in ruminal pH and leads to a high proliferation of lactic acid bacteria. This lesion has been previously reported in cervids. This case of comorbidities demonstrates that failures in nutritional and health handling, may cause simultaneous multiple diseases leading to death. Preventive measures for helminth parasite control and a proper feeding management with an adequate diet must be provided in order to preserve the species in captivity. Keywords: colloid goiter, abortion, cervids, Haemonchus contortus.

Fermentable carbohydrate intake and food avoidance behaviour in elderly patients with irritable bowel syndrome: A case report

Background: Fermentable carbohydrates or FODMAPs (Fermentable Oligo-, Di-, Monosaccharides, and Polyols) are short-chained, poorly absorbed carbohydrates which trigger gastrointestinal symptoms causing pain, bloating, distension, diarrhea, and constipation in Irritable Bowel Syndrome (IBS) patients. This debilitating condition has an impact on the quality of life of patients. In addition, due to lack of dietary intervention, it can result in food restriction to alleviate symptoms as patients avoid a wide variety of food and beverages. Objective: To compare FODMAP and nutrient intake, food avoidance behavior and quality of life in 2 long standing patients with IBS. Methods: Patients were selected on the basis of being diagnosed with IBS by a gastroenterologist. A 24-hour dietary recall with multiple pass method was used to assess intake. FODMAP intake was determined using published data. Symptom severity and quality of life was measured using a validated questionnaire. Meanwhile, food avoidance was assessed using a dietary trigger piloted questionnaire. Results: Two female Chinese patients with severe gastrointestinal symptoms were selected for this case series. Patient 1 was a 75-year-old female presenting with constipation-predominant IBS and patient 2 was a 61-year-old presenting with diarrhea-predominant IBS. Patient 1 had a higher energy intake: 2198 kcal, and FODMAP intake 10.6g/d, compared to patient 2 with an energy and FODMAP intake of 1800 kcal and 3.6g/d respectively. Both patients avoided a wide of range of food groups including cereals and grains, animal products, dairy and spicy foods. They also reported reduced scores for quality of life. Conclusion: Both patients had low intake of calcium as a result of food avoidance. This highlights the importance of appropriate and timely dietary intervention to this group of patients, to promote improved symptom management without compromising nutrient intake.

Consumption of a Fermented Milk Product Containing Bifidobacterium lactis CNCM I-2494 in Women Complaining of Minor Digestive Symptoms: Rapid Response Which Is Independent of Dietary Fibre Intake or Physical Activity.

Background. Minor digestive symptoms are common and dietary approaches such as probiotic administration or fibre and fermentable carbohydrate intake adjustments are often recommended. A Fermented Milk Product (FMP) containing Bifidobacterium animalis subsp. lactis CNCM I-2494 and lactic acid bacteria has been shown to improve digestive symptoms after 4 weeks of consumption, but the speed of onset of this effect and its dependence on fibre intake or physical activity is unknown. To answer these questions, data from two previously published trials on FMP for minor digestive symptoms were combined. Methods. In total, 538 participants provided weekly assessments of bloating, abdominal pain/discomfort, flatulence, borborygmi/rumbling stomach from which a composite score was calculated. At baseline in one study (n = 336), dietary fibre consumption was recorded and physical activity classified as high, moderate or low. The speed of the FMP’s effect was assessed by a repeated measure analysis of variance measuring the change from baseline for the composite score of digestive symptoms. Results. FMP consumption resulted in a significant decrease in the composite score of symptoms after only 2 weeks in both studies and the pooled data at week 1 (−0.35 [−0.69, 0.00]; p = 0.05), week 2 (−0.66 [−1.04, −0.27]; p < 0.001), week 3 (−0.49 [−0.89, −0.10]; p = 0.01) and week 4 (−0.46 [−0.88, −0.04]; p = 0.03). The interactions fibre intake-by-product group, physical activity-by-product group and time-by-product group were not statistically significant. Conclusion. FMP consumption leads to a rapid improvement in symptoms which is likely to encourage adherence to this dietary intervention. This effect is independent of dietary fibre and physical activity.

CARIOGENIC EFFECT OF DIETARY HABITS AMONG CARIES FREE AND EARLY CHILDHOOD CARIES CHILDREN

INTRODUCTION: Early Childhood Caries (ECC) remains an important childhood disease affecting a considerable portion of young children. ECC has been associated with inappropriate feeding patterns and excess consumption of fermentable carbohydrates. OBJECTIVES: The purpose of this study was to compare children affected by ECC and S-ECC and those who are caries free regarding their dietary habits. MATERIALS AND METHODS: Thirty children aged 2-6 years free from any systemic disease were selected for this study. Children were recruited from those attending the outpatient clinic at the Faculty of Dentistry, Alexandria University. The children were divided into three groups. Group 1 consisted of 10 children who had ECC. Group 2 consisted of 10 children presenting with S-ECC, while Group 3 included 10 children who were caries free serving as the control group. After clinical examination, the children's parents were asked to complete a standardized 3-day food diary form where they reported all the foods, beverages and snacks the child consumed over a 3-day period. Finally, a fermentable carbohydrate analysis was performed to determine the average number of exposures per day. RESULTS: Significant associations were found between the increasing severity of caries and the feeding habits of the children. The total carbohydrate scores for the caries free, ECC, and S-ECC groups were 90.00 ± 17.71, 104.56 ± 38.33, and 161.33 ± 24.12 respectively. There was a statistically significant difference among the three groups (P<0.0001). CONCLUSIONS: The increase in fermentable carbohydrate intake is associated with Early Childhood Caries.

Effect of Fermentable Carbohydrate Intake on Body Fat and Metabolic Criteria in US College Students

Indigestible, fermentable carbohydrates (IFCHO) are bioactive dietary carbohydrates not digested by human enzymes but are fermented into short chain fatty acids and gases by colonic bacteria. IFCHO display prebiotic effects and may influence body fat percent (BF%) and impact metabolic syndrome (MetS) criteria. Intake of an IFCHO subclass, oligosaccharides (OS), and OS subclasses fructans (FS) and galactooligosaccharides (GOS), have not been explored in the general US population. The purpose of this cross‐sectional study was to observe the effect of OS, FS and GOS intake on BF% and MetS criteria in US college students (n=151, BF%=23.7±9.0%, mean number of MetS criteria=0.8±0.9). Intake of OS, FS and GOS was quantified via the Comprehensive Nutrition Assessment Survey. BF% was measured via BodPod, blood lipids and blood glucose via Cholestech, waist circumference and blood pressure via standardized protocols. Median split was used to classify subjects with high and low intakes of OS, FS, and GOS and were analyzed via ANOVA. Subjects consuming less OS and GOS had higher BF% than those with higher intake (25.4±9.8 vs. 22.0±7.9%; p=.029 and 25.6±9.2 vs. 21.8±8.5%; p=.014 respectively). Subjects consuming less GOS had more MetS criteria compared to those with higher GOS intake (1.0±1.0 vs. 0.6±0.8 factors; p=.004). Significant difference in BF% and MetS criteria were not seen in high vs low FS intake. These results show that higher OS and GOS intake may impact BF% and MetS criteria in US college students. Randomized control trials are needed to further assess potential relationships.

Transition nutrition

Veterinarians and nutritionists should discuss diet formulation, feeding management, and health issues regarding transition cows with one another to help dairy herd managers achieve their goals. By working together and providing different perspectives and experiences, they can help identify areas of opportunity or provide solutions to problems in the transition program. Some areas of transition nutrition to focus on, based on recent research, include intake of fermentable carbohydrates, physically effective fiber, and energy and supply of metabolizable protein and limiting amino acids. Too frequently, transition nutrition failures result from poor delivery of the formulated diet(s) or non-nutritional stressors such as overcrowding, inappropriate moving or grouping of cows, or environmental stress. Veterinarians and nutritionists working together should be able to help motivate farmers to make management changes to achieve transition goals.

Gut hormone release and appetite regulation in healthy non-obese participants following oligofructose intake. A dose-escalation study

Prevention of weight gain in adults is a major public health target. Animal experiments have consistently demonstrated a relationship between fermentable carbohydrate intake, such as oligofructose, anorectic gut hormones, and appetite suppression and body weight control. This study was designed to determine the dose of oligofructose which would augment the release of anorectic gut hormones and reduce appetite consistently in non-obese humans. Twelve non-obese participants were recruited for a 5-week dose-escalation study. Following a 9–14-day run-in, participants increased their daily oligofructose intake every week from 15, 25, 35, 45, to 55g daily. Subjective appetite and side effects were monitored daily. Three-day food diaries were completed every week. Appetite study sessions explored the acute effects of 0, 15, 35, and 55g oligofructose on appetite-related hormones, glycaemia, subjective appetite, and energy intake. In the home environment, oligofructose suppressed hunger, but did not affect energy intake. Oligofructose dose-dependently increased peptide YY, decreased pancreatic polypeptide and tended to decrease ghrelin, but did not significantly affect appetite profile, energy intake, glucose, insulin, or glucagon-like peptide 1 concentrations during appetite study sessions. In conclusion, oligofructose supplementation at ⩾35g/day increased peptide YY and suppressed pancreatic polypeptide and hunger; however, energy intake did not change significantly.

P236 High intake of fermentable carbohydrates and food sugars associated with increased disease activity in inflammatory bowel disease

P236 High intake of fermentable carbohydrates and food sugars associated with increased disease activity in inflammatory bowel disease

Diet Intake and Caries Prevalence in Four-Year-Old Children Living in a Low-Prevalence Country

Preventive measures have dramatically decreased the prevalence of dental caries in children. However, risk factors for the disease in children living in low-prevalence areas remain elusive. In the present study we evaluated associations between dental caries, saliva levels of mutans streptococci and lactobacilli, and diet with special emphasis on the intake of fermentable carbohydrates and dairy products in 4-year-old children living in an area where the overall caries prevalence was low. Dietary intake was recorded in 234 infants as part of the Study of Infant Nutrition in Umeå, Sweden (SINUS). Of these the parents of 124 children gave consent to participate in a follow-up at 4 years of age. Dietary intake, height and weight, dental caries, oral hygiene, including tooth brushing habits, presence of plaque and gingival inflammation, fluoride habits and numbers of mutans streptococci and lactobacilli in saliva were recorded. Using multivariate stepwise logistic regression, caries experience was negatively associated with intake frequency of cheese (OR = 0.67; 95% CI = 0.44–0.98) and positively associated with the salivary level of mutans streptococci (OR = 1.57; 95% CI = 1.21–2.03). Caries experience was not correlated with intake frequency or amounts of carbohydrate-containing foods, with any other particular food, or with daily intake of energy, carbohydrate or any other macro- or micronutrient. We conclude that cheese intake may have a caries-protective effect in childhood populations where the overall caries prevalence and caries experience are low and the children are regularly exposed to fluoride from toothpaste.

The effect of crude protein and fermentable carbohydrate intake on blood metabolite concentrations and fertility in beef heifers

AbstractHigh intakes of crude protein (CP), in particular rumen degradable protein (RDP), have been associated with reduced fertility in cattle. This reduction in fertility has been attributed to putative toxic effects of elevated systemic concentrations of ammonia and, or urea, the by-products of protein metabolism, on gametes and embryos. The objective of the studies reported here was to examine the effect of CP and fermentable carbohydrate intake on various blood metabolites and on fertility, in beef heifers. In the first experiment, 40 heifers were randomly assigned to either low (no urea) or high (240 g urea) RDP, grass silage based diets, supplemented with 1.5 or 3.0 kg dry matter (DM) of either rolled barley (BAR) or molassed sugar beet pulp (MSBP) or no carbohydrate (control). The high RDP diet increased plasma ammonia and urea concentrations. MSBP at 3 kg DM/day was more effective than BAR in reducing ammonia (P&lt;0.05) and urea (P&lt;0.001). In animals fed no urea, MSBP at 3 kg DM/day was also more effective than BAR in reducing systemic ammonia (P&lt;0.001) and urea (P &lt; 0.05). In the second experiment, 83 beef cross-bred heifers were randomly assigned over two replicates to one of 4 treatment groups in a 2 x 2 factorial design. Animals consuming high (85 kg N/ha; HN) or low (0 kg N/ha; LN) nitrogen fertilised pastures were supplemented with either 0 or 3 kg dry matter (DM) MSBP daily as follows: 1) HN only (n=21); 2) HN + 3kg MSBP, (n=22); 3) LN only (n=21); 4) LN + 3kg MSBP (n=19). The HN pastures had higher (P&lt;0.001) CP and lower (P&lt;0.001) water soluble carbohydrate concentrations than LN pastures. Systemic ammonia (P&lt;0.05) and urea (P&lt;0.001) were higher in heifers on the HN pasture. Embryo survival rate was high overall (80%) and was not affected by systemic ammonia or urea concentrations or by supplementation with MSBP. Systemic progesterone, insulin and glucose were not affected by treatment. High CP intake coupled with low fermentable carbohydrate, lead to elevated systemic ammonia and urea concentrations in heifers. However, no adverse effect on fertility was observed.

Survey of Dental Nutrition Knowledge of Wig Nutritionists and Public Health Dental Hygienists

Objective To assess two groups’ knowledge of the role of diet in the etiology of dental caries: nutritionists in the Special Supplemental Food Program for Women, Infants, and Children (WIG) and public health dental hygienists. Design A self-administered survey contained questions about the cause of dental caries, the importance of caries-preventive measures, dietary factors linked to dental caries, dietary advice for patients with active dental caries, and diet-related topics discussed with clients. Subjects Surveys were sent to all WIG nutritionists and public health dental hygienists in Washington, Oregon, and Idaho. Of the 235 surveys mailed, 188 completed surveys composed the final sample. Statistical analyses performed Descriptive tests, means and frequencies, and the χ 2 test were used to measure differences in nutritionists’ and hygienists’ responses. Results One half of the nutritionists and three fourths of the hygienists recognized that dental caries was caused by a bacterial infection. Most dental researchers consider fluoride exposure and dental sealants to be highly effective caries-preventive measures; in contrast, WIG nutritionists and dental hygienists identified oral hygiene as being most important in preventing caries. Frequency of snacking and retentiveness of food in the mouth were accurately rated important dietary factors in the development of dental caries by both groups. However, limiting intake of fermentable carbohydrates between meals was not considered the most important dietary advice for clients. Applications Results suggest that current research about the role of diet in the prevention of dental caries should be included in both nutrition and dental hygiene curriculums and continuing education courses for these professionals. J Am Diet Assoc. 1995; 95: 190-194.

Prevention of Acidosis and Laminitis Associated with Grain Feeding in Horses

It is well known that if horses consume large quan tities of rapidly fermentable carbohydrate in the form of starch or sugars they may develop laminitis. The pathway linking fermentable carbohydrate intake and damage to the lamellae of the hoof is not well under stood. It is, however, almost certain that the primary effect of high levels of sugars and starches in the gut is a rapid fermentation and the development of acidic conditions particularly in the cecum and colon. Severe acidosis in the gut, characterized by the accumulation of lactic acid and reduced concentration of volatile fatty acids, does not occur uniformly in all animals given an equal amount of grain (Aitchison et al. 1987). This variation between animals in the development of acidosis within the gut in response to high levels of grain is similar to the variation between animals in development of laminitis (Garner et al. 1977) in re sponse to carbohydrate overload. This provides further indirect evidence that gut acidosis may be the primary event leading to laminitis. The accumulation of lactic acid during rapid fer mentation can be controlled by antimicrobial feed ad ditives active against the gram positive bacteria such as Streptococcus bovis and Lactobacillus sp., which are primarily responsible for production of lactic acid at low pH. The feed additive virginiamycin has been shown in vitro (Nagaraja et al. 1987) and in studies in sheep (Godfrey et al. 1992) to be effective in control ling the accumulation of lactic acid. We have devel oped a formulation of virginiamycin for horses that retains its activity in the hindgut and, through its particulate nature, is also retained in the cecum. The aim of the experiment reported here was to investigate the control of laminitis using this formulation in horses given free access to a high-grain diet. Materials and Methods. Twelve standardbred horses weighing an average of 496 ±13 kg (mean ±SE) were used in the experiment. These horses came from a background of training and harness racing and were of unknown age. Before the start of the experiment, all animals were given a detailed clinical and lameness examination and were treated against intestinal par asites. Only animals that were completely sound and in good health were used in the experiment. There were three dietary treatments and four horses per treatment. The three groups were balanced for body weight. The three pelleted diets contained 85% ground maize, 13% soybean meal and 2% minerals and vitamins providing 13.9 MJ/kg digestible energy and 120 g/kg crude protein (Glen Forrest Stockfeeders, Perth, Australia). Two of the diets contained a feed additive containing virginiamycin (as Founderguard™

A clinical evaluation of anterior conventional, microfiller, and hybrid composite resin fillings. A 6-year follow-up study.

Anterior resin fillings of seven composite resin materials--two conventional, two hybrid, and three microfiller--were evaluated over a 6-year period. Extrinsic discoloration, color match, marginal discoloration, marginal adaptation, surface roughness, and recurrent caries were investigated. The individual caries increment was compared with an estimation of the expected caries risk of the individuals. The estimation was based on the net effect of microbial counts, oral hygiene, salivary flow rates, buffer values, and fermentable carbohydrate intake. The variation of the investigated factors within each resin group was too great to enable combination of the results. The individual materials are therefore presented and compared. Unacceptable color match scores after 6 years varied markedly among the brands (3.5%-79.7%). Unacceptable marginal discoloration was seen in 1.7% of the restorations, whereas unacceptable marginal adaptation varied between 13.7% and 37.3% for the brands. Recurrent caries occurred at the margins of 18.9% of the composite fillings (range, 9.3%-29.4%) during the period. The cumulative relative frequencies of replaced fillings for the materials varied between 14.8% and 55.1%. Recurrent caries was the major reason for replacement. Patients with many caries risk factors showed clearly a higher increment of caries.

The Relationship between Cemental Caries, Oral Hygiene Status and Fermentable Carbohydrate Intake

Two groups of patients were evaluated for the presence of active, restored, and recurrent root surface caries. One group of 120 subjects had received treatment for moderate to severe periodontitis. The second group consisted of 124 subjects who were affected by moderate to severe periodontitis but had received no treatment. The two groups were also evaluated for amounts of recession, pocket depth, and the presence of bacterial plaque. In addition, each subject was asked to compile a record of his/her dietary intake for a seven-day period. The treated group was found to brush and floss more frequently than the untreated group and had a lower mean plaque score (45.8), than the untreated group (61.4). There was no difference in the mean plaque scores for the subgroups with and without root surface caries within either the treated groups. The prevalence of root surface caries increased through age 59 in the treated group, then diminished after age 60. In the untreated group the prevalence increased steadily with age. Analysis of the data from the dietary hisories revealed that the subjects in both the treated and the untreated groups who were affected with root surface caries had a significantly higher (P less than 0.01) number of fermentable carbohydrate exposures per week.