Sugar-containing Foods Research Articles

Anticariogenic complexes of amorphous calcium phosphate stabilized by casein phosphopeptides: A review

Using laboratory, animal, and human in situ caries models, investigators have shown that casein phosphopeptide amorphous calcium phosphate complexes (CPP-ACP) exhibit an anticariogenic activity. The casein phosphopeptides (CPP) are produced from a tryptic digest of the milk protein casein by aggregation with calcium phosphate and purification by ultrafiltration. The CPP have a remarkable ability to stabilize calcium phosphate in solution and substantially increase the level of calcium phosphate in dental plaque. Through their multiple phosphoseryl residues, the CPP bind to forming clusters of amorphous calcium phosphate (ACP) in metastable solution, preventing their growth to the critical size required for nucleation and precipitation. The proposed mechanism of anticariogenicity for the CPP-ACP is that they localize ACP in dental plaque, which buffers the free calcium and phosphate lon activities, thereby helping to maintain a state of supersaturation with respect to tooth enamel depressing demineralization and enhancing remineralization. The CPP-ACP, unlike fluoride, can be added to sugar-containing foods and therefore have commercial potential as an additive to foods as well as to toothpastes and mouthwashes for the control of dental caries.

Nutritional support for patients with intellectual disability and nutrition/dysphagia disorders in community care

Patients with intellectual disability and neurological handicaps associated with swallowing difficulties are vulnerable to dehydration and undernutrition. Some patients are severely undernourished, a condition which is usually associated with recurrent food aspiration and respiratory infections. Underweight patients are usually provided with adequate dietary protein by carers: their low energy intakes reflect inadequate intakes of fat and carbohydrate. Many patients gain weight following the provision of easily assimilated energy-dense fat- and sugar-containing foods. Where these measures fail, the provision of a percutaneous endoscopic gastrostomy (PEG) tube may be life-saving. Optimal supervision of patients with severe nutrition/dysphagia problems requires a support network linking carers at home or in community care facilities with the primary health care team and the local district general hospital.

Associations between dietary intake, dental caries experience and salivary bacterial levels in 12-year-old english schoolchildren

A population of 328 12-yr-old English schoolchildren, consuming their normal diets, was investigated in a cross-sectional study to determine the interactions between caries experience, oral hygiene status as gingival index (GI), dietary intake (as number of eating events per day and the number of eating events per day at which sugar-containing foodstuffs, confectionery or starch-containing foods were consumed) and salivary levels of caries-associated micro-organisms (mutans streptococci, lactobacilli and yeasts). The mean (±SD) decayed, missing and filled surfaces (DMFS) (excluding precavitation lesions) score was 3.05 ± 3.85 and 5.72 ± 5.00 (including precavitation lesions). The DMFS scores were significantly related to the salivary levels of caries-associated micro-organisms and to the number of eating events per day for total number of eating events and the number of eating events at which sugar-containing foods or confectionery were consumed. These associations were apparent in both bivariate and partial correlation coefficients with the caries-associated micro-organisms and GI controlled. The total daily intakes of food types, except for starch, were not associated with caries experience. No significant correlations were found between intake of food types and salivary levels of caries-associated micro-organisms except that the mean number of confectionery-eating events was correlated with lactobacillus levels ( r = 0.136, p < 0.01). The salivary levels of mutans streptococci, lactobacilli and yeasts were significantly correlated with GI scores. These data do not indicate simple associations between dietary intake, caries and levels of caries-associated micro-organisms. Poor oral hygiene, in children consuming unrestricted diets, may influence the salivary levels of mutans streptococci, lactobacilli and yeasts irrespective of the frequency or amount of sugar consumed. Multiple regression analyses revealed that three variables-GI (probably an indicator of toothbrushing behaviour with a fluoride-containing toothpaste), salivary concentration of lactobacilli and frequency of ingestion of confectionery/sugary foods-were independently and positively related to caries experience.

Fluoride and sugar intake among adults and youth in Mauritius: preliminary results.

The potential use of different vehicles for delivering fluoride to prevent dental caries has been discussed recently in Mauritius. Water fluoridation was found not to be feasible, and extending the fluoride tablet program would not be easy. Thus, sugar fluoridation as one possibility was considered. For these purposes, the average fluoride and sugar intake was estimated in Mauritius. The results are based on two studies--a Survey on Diet, Health and Lifestyle of Youth in Mauritius (1990) and the Mauritius Diet and Health Survey. Information was collected by trained interviewers using food-frequency and 24-hour-recall questionnaires. The daily total sugar intake, manufactured and natural, was found to be 62 g per day in young people and 50 g per day in adults. In the younger groups, daily frequencies of raw sugar, sweets, and biscuit (cookie) consumption were 1.5, 0.2, and 0.2 times a day, respectively. For adults, the mean daily frequency of consuming sugar-containing foods was 2.6 (SD = 1.3). The daily sucrose intake was rather high, representing about 10% of the daily energy intake. The fluoride levels of foods were calculated by use of Finnish and other available fluoride tables. The mean fluoride intakes per day were 0.64, 0.72, and 0.62 mg per day for 8-17-year-, 18-24-year-, and 30-64-year-old groups, respectively. The median fluoride intake for the oldest group was 0.62 mg/day. The estimated fluoride intake from food did not correspond with the proposed level for the prevention of caries (Murray, 1986) except for the 18-24-year-olds, where it might have been just above the lower recommended limit. However, further data based on analysis of the fluoride contents of Mauritian food samples, especially of whole daily diet, are needed.

Longitudinal study of caries, cariogenic bacteria and diet in children just before and after starting school

Fifty 5-yr-old preschool children living in Akranes, a small community in West Iceland known to have a high caries prevalence, were investigated with respect to caries, salivary counts of mutans streptococci and lactobacilli, and consumption of cariogenic foods. Fifteen months later, after being in school for half a year, 43 of the 50 children were reexamined and investigated as before. Mean dmfs scores rose from 7.1 to 9.0, but the scores including initial caries rose from 9.7 to 15.3. Mutans streptococci were carried by 84% of children on both occasions with a mean count 2.1 and 3.6 x 10(5) cfu/ml. Lactobacillus carriage increased from 29 to 38% and the mean count from 5.1 to 13 x 10(3) cfu/ml at 6 yr. The frequency of consumption of sugar-containing foods increased from 4.2 to 5.2 intakes per day and between-meal snacks rose from 3.0 to 3.7 per day. Children classified as "misusing" sugar were 59% at 5 yr and 83% at 6 yr. The mean caries score at 6 yr for children "misusing" sugar was 10.7 but only 2.0 for those not misusing sugar. Thus the deterioration in dental health appears, in these children, to be associated with the increased consumption of sweets and other cariogenic between-meal snacks after starting school.

Prevalence of dental caries in school children of the province of Granada (Spain).

A sample of 3,347 students between 5 and 14 years of age was selected from the entire student population in the province of Granada (Spain) to study the prevalence of dental caries and several risk factors for the disease. Decay was ascertained in the study population by means of the following indices: df, DMF, and DMFS. Risk factors considered were the level of oral hygiene, number of between-meal sugar-containing food, and flouride concentration in drinking water. The indices mentioned showed a clear relationship to the age of the participants in the study. The level of oral hygiene did not show a clear association with dental caries measured through the df and DMF indices. Curiously, a higher correlation was noted between the disease in deciduous teeth and fluoride concentration than between the disease in permanent teeth and the latter factor.

Effect of sugar price policy on U.S. imports of processed sugar-containing foods

The relationship between U.S. and world sugar prices, and U.S. import demand for four categories of sugar-containing products is examined. Results from econometric estimation indicate that U.S. intervention in the sugar market has helped to increase U.S. imports of some sugar-containing products, but that increased disposable income has played a more important role. Although some developing countries have benefitted from U.S. sugar policy by increasing their exports of sugar-containing products to the United States, U.S. sugar policy has helped imports from developed countries proportionately more than those from developing countries as a whole.

Clinical aspects of sucrose and fructose metabolism.

The per capita consumption of sugars in the United States accounts for approximately 21% of total calorie intake. Most Americans eat and enjoy sugar-containing foods every day, but the use of sugars in the diabetic diet has traditionally been proscribed for fear of aggravating hyperglycemia. However, short-term and most longer-term studies demonstrate that dietary sucrose does not cause a greater postprandial rise in plasma glucose than isocaloric amounts of other common carbohydrates. The available evidence suggests that sucrose has a glycemic effect similar to that of bread, potatoes, and rice. Dietary fructose, in contrast, may produce a lesser postprandial rise in plasma glucose than other common carbohydrates. There is considerable controversy about the effects of dietary sucrose and fructose on serum lipids, and their effects on other metabolic events, such as the nonenzymatic glycosylation of proteins, are uncertain. Nevertheless, it is reasonable to allow diabetic patients to consume sugar-containing foods as long as they do so in a controlled fashion.

Sugar consumption and caries experience in 12- and 13-year-old Icelandic children.

Dietary habits with regard to sugar consumption and caries experience were studied in a group of 275 Icelandic children aged 12 and 13 years. The pattern of meals and sugar-containing food intake frequency were assessed by means of a dietary questionnaire. All dental examinations were performed by one examiner, using standardized methods and diagnostic criteria. Only 75% of the children had three regular meals daily. Breakfast and lunch were the most frequently omitted meals. Sweet buns were consumed by 32% of the children with meals and by 58% between meals, whereas soft drinks were consumed by 42% and 46%, respectively. Eighty-three per cent of the children reported eating sweets daily. The most popular products included confectionery, buns, cakes, and soft drinks, which constituted 53% of the intake with meals and 68% of that between meals. A higher caries incidence was associated with frequent intake of buns and cakes with meals and confectionery.

Consumption patterns of some sugar-containing foods among Finnish adolescents in 1981–1985

The aim of the study was to describe the consumption of foods known as indicators of the total sucrose intake, and the distribution of the use of these foods. Three samples (N=4140, 3734 and 3354) of Finnish 12 to 18-year-old boys and girls participated in a mailed survey in 1981, 1983 and 1985. The proportions of frequent users of sweet pastries and sugared coffee decreased clearly during the follow-up time, but socio-economic and regional differences in consumption patterns remained unchanged. Throughout the period of study adolescents from farm families used sweet pastries and sugared coffee significantly more often than did urban adolescents from white-collar families. Consumption of sweetened yogurt increased and was higher in urban areas than in farm families. For sweets, soft drinks and sugared tea, no changes occurred, and father's occupation or educational level were not significant determinants of consumption. The Finnish adolescents are replacing the traditional sugar sources by new ones and changes in the consumption of sugar-containing foods follow the same logic as described in cultural and historical studies.

SUGARS AND DENTAL DECAY

Sugar is the principal cause of the most common disease in industrialised countries, dental caries. The sugars implicated in dental caries, in decreasing order of cariogenicity, are sucrose, glucose, and fructose; brown sugars are as cariogenic as white. The level of sugar consumption at which most of the population will not get dental caries is 15 kg/person/year. The goal should therefore be to reduce consumption to this level and below. The following policies should be introduced to achieve this goal: sugars should not be added to dietary items such as baby foods; a range of acceptable sugar-free snacks and drinks should be developed; non-cariogenic sweeteners should be substituted for added sucrose and glucose in foods, confections, and drinks; sugar-containing foods should be modified to make them less cariogenic; and the levels of added sugars in commonly used foods should be reduced. The transmission to the public of information on sugars and dental health should be improved.

Diet in Crohn's disease two studies of current and previous habits in newly diagnosed patients.

The consumption of sugar and sugar-containing foods in 32 patients with recently diagnosed Crohn's disease was significantly greater than in matched controls; the assessment was made by a questionnaire and depended upon patients recalling their eating habits. In a further study of 16 patients with Crohn's disease, all food eaten over 5 days was weighed and recorded, and no significant difference was found in the consumption of carbohydrate, protein, fats, or sugars, although the consumption of "added sugars" in patients was greater than controls. Patients who participated in both studies significantly reduced their intake of added sugar, and this was not found to correlate with either total intake of monosaccharides and disaccharides or the total carbohydrate consumption. The increased consumption of added sugar in patients with Crohn's disease does not appear to be related to other dietary abnormalities and may simply reflect a deficiency in perception of sweet taste in patients with this condition.

Mother’s involvement in children’s oral hygiene

Mothers of children between 3 and 11 years of age were interviewed about the child's home habits and preventive dental care. Most mothers interviewed at a university pedodontic clinic said they had no problems in home dental care; of those difficulties mentioned, motivation of the child to brush was the most frequent. Mothers rarely checked the thoroughness of brushing. Flossing was used mainly to dislodge food particles. Mothers showed little concern about the contribution to decay made by the consumption of sugar-containing foods or by the frequency of snacking.