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Our objective is to retrospectively describe longitudinal beverage intakes and anthropometric measures according to adolescent beverage patterns. Data were collected from Iowa Fluoride Study participants ( n = 369) using beverage questionnaires at ages 2⁻17 years. Weight and height were measured at ages 5, 9, 13 and 17 years. Cluster analyses were used to identify age 13- to 17-year beverage patterns. Treating age and beverage cluster as explanatory factors, sex-specific generalized linear mixed models were used to identify when differences in beverage intakes and anthropometric measures began. Predominant beverage intakes were higher in each of the corresponding clusters by 9⁻12.5 years; females with high milk intakes during adolescence and males with high 100% juice or sugar-sweetened beverage intakes during adolescence reported higher intakes of that beverage beginning at 2⁻4.7 years. Females and males in the 100% juice cluster had lower weights than other clusters beginning at 13 years, while females and males in the neutral cluster were shorter beginning at 13 years. Females in the water/sugar-free beverage cluster had higher body mass indices (BMIs) beginning at 9 years. Females and males in the 100% juice cluster had lower BMIs beginning at 5 and 9 years, respectively. Childhood beverage intakes and growth patterns differ according to adolescent beverage patterns.

Background: Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood., Objective: Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years., Design: We conducted a cross-sectional analyses of longitudinally collected data., Participants/setting: Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included., Exposure: Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB., Outcomes: Weight, height, and body mass index (BMI; calculated as kg/m 2 ) at age 17 years were analyzed., Statistical Analyses: We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ 2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables., Results: Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For members of the juice cluster, mean BMI was lower than for members of the milk cluster (by 2.4 units), water/sugar-free beverage cluster (3.5 units), neutral cluster (2.2 units), and SSB cluster (3.2 units) (all P<0.05)., Conclusions: Beverage patterns at ages 13 to 17 years were associated with anthropometric measures and BMI at age 17 years in this sample. Beverage patterns might be characteristic of overall food choices and dietary behaviors that influence growth., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: The results of several studies conducted in the United States show no association between intake of 100 percent fruit juice and early childhood caries (ECC). The authors examined this association according to poverty and race/ethnicity among U.S. preschool children., Methods: The authors analyzed data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) for 2,290 children aged 2 through 5 years. They used logistic models for caries (yes or no) to assess the association between caries and intake of 100 percent fruit juice, defined as consumption (yes or no), ounces (categories) consumed in the previous 24 hours or usual intake (by means of a statistical method from the National Cancer Institute)., Results: The association between caries and consumption of 100 percent fruit juice (yes or no) was not statistically significant in an unadjusted logistic model (odds ratio [OR], 0.76; 95 percent confidence interval [CI], 0.57-1.01), and it remained nonsignificant after covariate adjustment (OR, 0.89; 95 percent CI, 0.63-1.24). Similarly, models in which we evaluated categorical consumption of 100 percent juice (that is, 0 oz; > 0 and ≤ 6 oz; and > 6 oz), unadjusted and adjusted by covariates, did not indicate an association with ECC., Conclusions: Our study findings are consistent with those of other studies that show consumption of 100 percent fruit juice is not associated with ECC.

Purpose: Currently, research is lacking regarding the use of spill-proof beverage containers (SPBCs). The purpose of this study was to assess the relationship between daytime SPBCs use for sugared beverages, caries, socioeconomic status, and other covariates in high-caries risk 12- to 49-month-old children attending a Women, Infants and Children (WIC) program., Methods: Data were analyzed using baseline information from 415 Iowa WIC-enrolled children who participated in a psychoeducational study. Mothers completed a series of detailed questionnaires regarding their SES and their child's beverage consumption. Dental examinations using d1d2.3 (noncavitated and cavitated carious lesions) criteria were completed for the children. Bivariate relationships for consumption of any sugared beverage using SPBCs were assessed and followed by multivariable modeling using logistic regression (alpha=0.05)., Results: Only 18 children (four percent) reported using SPBCs for any sugared beverage during the night versus 290 (70 percent) during the day. Daytime consumption of sugared beverages from SPBCs was less likely to be reported in older children (P<.001) and in African American children when compared to both Hispanics (P>.001) and Caucasians (P=.001)., Conclusions: Iowa WIC children primarily consume sugared beverages using spill-proof beverage containers during the day; children who were younger and Hispanic or Caucasian were more likely to use SPBCs to consume sugared beverages.

Purpose: To measure the pH, titratable acidity, fluoride concentration and erosive potential of brewed teas., Methods: Bag teas were purchased to represent black, green, citrus, fruity, and floral tea flavors from Tulsi, Bigelow, HyVee, Tazo, and Yogi brands and brewed (1 bag/240 ml) in boiling water for 3 minutes. The pH, titratable acidity, and fluoride concentrations were measured. Following these measurements, a representative tea from each flavor was selected for investigation of erosion potential. Six extracted human molars were randomly assigned to each tea. Teeth were painted with fingernail polish to expose a 1 x 4 mm window and then soaked in tea for a total of 25 hours with teas refreshed every 5 hours. Teeth were then sectioned using a microtome and photographed using a polarized light microscope. Lesion depths (i.e., eroded surfaces) were measured using Image Pro Plus software. Differences in physiochemical properties and lesion depths between beverages were investigated using one-way ANOVA with post-hoc Tukey's HSD test. Relationships among lesion depths and physiochemical properties were evaluated using the Pearson correlation test., Results: pH, titratable acidity and fluoride concentrations differed between tea flavors (P < 0.05) and between brands (P < 0.05). Lesion depths produced by the citrus tea (83.1 +/- 10.3 microm) were greater than those produced by the fruity tea (56.5 +/- 6.1 microm); both teas produced greater depths than black (30.1 +/- 7.4 microm), floral (25.0 +/- 3.2 microm) or green (22.3 +/- 6.3 microm) teas (P < 0.05). pH (r = -0.96; P = 0.009) was inversely and titratable acidity (r = 0.97; P = 0.006) was positively associated with lesion depths.

Background: Dietary intake of sugar-sweetened beverages (SSBs) has increased during the past 30 years, and SSB intake is associated with caries., Conclusions: SSBs vary in the quantity and nature of sugars they contain; however, all of the sugars are fermentable by oral bacteria and potentially cariogenic., Practical Implications: Oral health care practitioners should assess patients' SSB intakes by asking questions regarding the quantity, frequency and duration of SSB intake. In response to individual behaviors, practitioners should tailor recommendations when providing anticipatory guidance to help patients decrease their exposure to SSBs for caries prevention. In light of the association between SSB intake and caries risk, as well as the increased consumption of SSBs, all dental practices should assess patients' SSBs intake.

Objective: Our objective was to compare the physiochemical properties and erosion potentials between beverages available in the UK and the US., Methods: The physiochemical properties (pH, titratable acidity and fluoride concentration) and erosion potential on enamel surfaces of beverages available in the UK were compared to similar beverages from the US. Enamel windows were exposed to beverages for 25h. Teeth were sectioned through the windows, and lesion depths were defined as the average distance between the original tooth structure and the base of demineralization., Results: The pH was lower in UK apple juice, orange juice, Diet Pepsi and Sprite Zero (p<0.05), and higher in UK orange soda and diet orange soda than in similar US beverages (p<0.05). Titratable acidities were higher in UK apple juice, orange juice, orange soda, diet orange soda and Sprite (p<0.01), and lower in UK Sunny D than in the US counterpart (p<0.001). Fluoride concentrations were lower in UK apple juice, orange juice, Coke, and Diet Coke, Sprite and Sprite Zero (p<0.001), and higher in UK orange soda, diet orange soda, Pepsi and Diet Pepsi than in their US counterparts (p<0.001). Lesion depths were higher in UK apple juice, orange juice, Diet Coke, Sprite and Sprite Zero than in their US counterparts (p<0.05). Lesion depths were associated with pH (p=0.010) and country of origin (p=0.002)., Conclusions: Under similar laboratory conditions, the physiochemical properties and erosion potentials on enamel surfaces differed between some, but not all, beverages available in the UK and the US., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Background: The authors conducted a study to test the hypothesis that high consumption of soft drinks, relative to milk and 100 percent fruit juice, is a risk factor for dental caries in low-income African-American children in Detroit., Methods: Trained dentists and interviewers examined a representative sample of 369 children, aged 3 to 5 years, in 2002-2003 and again two years later. The authors used the 2000 Block Kids Food Frequency Questionnaire (NutritionQuest, Berkeley, Calif.) to collect dietary information. They assessed caries by using the International Caries Detection and Assessment System., Results: Soft drinks, 100 percent fruit juice and milk represented the sugared beverages consumed by the cohort. A cluster analysis of the relative proportion of each drink at baseline and follow-up revealed four consumption patterns. Using zero-inflated negative binomial models, the authors found that children who changed from being low consumers of soft drinks at baseline to high consumers after two years had a 1.75 times higher mean number of new decayed, missing and filled tooth surfaces compared with low consumers of soft drinks at both time points., Conclusion: Children who consumed more soft drinks, relative to milk and 100 percent fruit juice, as they grew older were at a greater risk of developing dental caries., Clinical Implications: Health promotion programs and health care providers should emphasize to patients and caregivers the caries risk associated with consumption of soft drinks.

Acidic beverages are thought to increase the potential for dental erosion. We report pH and titratable acidities (ie, quantity of base required to bring a solution to neutral pH) of beverages popular in the United States and lesion depths in enamel and root surfaces after beverage exposure, and we describe associations among pH, titratable acidity, and both enamel and root erosive lesion depths. The pH of 100% juices, regular sodas, diet sodas, and sports drinks upon opening and the titratable acidity both upon opening and after 60 minutes of stirring were measured. Enamel and root surfaces of healthy permanent molars and premolars were exposed to individual beverages (4 enamel and 4 root surfaces per beverage) for 25 hours, and erosion was measured. Statistical analyses included 2-sample t tests, analyses of variance with post hoc Tukey studentized range test; and Spearman rank correlation coefficients. All beverages were acidic; the titratable acidity of energy drinks was greater than that of regular and diet sodas that were greater than that of 100% juices and sports drinks (P < .05). Enamel lesion depths after beverage exposures were greatest for Gatorade, followed by those for Red Bull and Coke that were greater than those for Diet Coke and 100% apple juice (P < .05). Root lesion depths were greatest for Gatorade, followed by Red Bull, Coke, 100% apple juice, and Diet Coke (P < .05). Lesion depths were not associated with pH or titratable acidity. Beverages popular in the United States can produce dental erosion.

Objective: Food frequency questionnaires are commonly developed and subsequently used to investigate relationships between dietary intake and disease outcomes; such tools should be validated in the population of interest. We investigated the relative validities of the Iowa Fluoride Study targeted nutrient semi-quantitative questionnaire and Block Kids' Food Questionnaire in assessing beverage, calcium, and vitamin D intakes using 3-day diaries for reference., Design: Cross-sectional., Subjects: Children who completed Iowa Fluoride Study nutrient questionnaire at age 9.0+/-0.7 years (n=223) and/or the Block Kids' Food Questionnaire at age 8.3+/-0.3 years (n=129) and 3-day diaries during similar time periods., Main Outcomes: Intakes of beverages, calcium, and vitamin D., Statistical Analyses: Spearman correlation coefficients, weighted kappa statistics, and percentages of exact agreement were used to estimate relative validities., Results: Correlations between milk intakes (r=0.572) reported on diaries and the Iowa Fluoride Study nutrient questionnaires were higher than correlations for 100% juice, juice drinks, soda pop, and water (r=0.252 to 0.379). Correlations between milk intakes (r=0.571) and 100% juice intakes (r=0.550) reported on diaries and Block Kids' Food Questionnaires were higher than correlations for other beverages (r=0.223 to 0.326). Correlations with diaries for calcium (r=0.462) and vitamin D (r=0.487) intakes reported on Iowa Fluoride Study nutrient questionnaires were similar to correlations with diaries for calcium (r=0.515) and vitamin D (r=0.512) reported on Block Kids' Food Questionnaires. Weighted kappa statistics were similar between the Iowa Fluoride Study nutrient questionnaires and the Block Kids' Food Questionnaires for milk, 100% juice, and vitamin D, but were higher on the Iowa Fluoride Study nutrient questionnaires than on the Block Kids' Food Questionnaires for calcium. Percentages of exact agreement were higher for calcium, but lower for vitamin D for intakes reported on the Iowa Fluoride Study nutrient questionnaires compared to the Block Kids' Food Questionnaires relative to diaries., Conclusions: Both the Iowa Fluoride Study nutrient questionnaire and the Block Kids' Food Questionnaire provide reasonable estimates of milk, calcium, and vitamin D intakes when compared to 3-day diaries.

Background: Calcium in acidic beverages can decrease a person's risk of experiencing dental erosion. The authors compared the pHs and titratable acidities of commercially available calcium-fortified and unfortified 100 percent juices, and enamel and root surface lesion depths after they were exposed to different juices., Methods: The authors measured the pH and titratable acidity of calcium-fortified and unfortified 100 percent juices. They exposed enamel and root surfaces to different 100 percent juices for 25 hours and measured lesion depths. They used the Spearman rank correlation test and the two-sample t test to identify associations between the juices' properties and lesion depths and to compare lesion depths between fortified and unfortified juices., Results: The authors found that fortifying apple, orange and grapefruit juices with calcium prevented enamel erosion and decreased root surface erosion (P < .01). They also found that fortifying white grape juice with calcium decreased enamel erosion (P < .001) but not root surface erosion. They observed that mean lesion depths were greater in root surfaces than in enamel surfaces after exposure to unfortified orange juice and all fortified juices (P < .001)., Conclusions: Calcium concentrations in commercially available, calcium-fortified 100 percent juices are sufficient to decrease and prevent erosion associated with extended exposure to a beverage., Clinical Implications: People at risk of experiencing erosion could decrease their erosion risk by consuming calcium-fortified juices.

Background: Replacement of milk with sugar-containing beverages could affect calcium intake and overall diet quality., Objective: To describe dairy food, 100% juice and added sugar beverage intakes, contributions of dairy foods to diet quality, and effects of beverages on diet quality in young children., Methods: We surveyed participants in the Iowa Fluoride Study (n = 645) at ages 1, 2, 3, 4 and 5 years and calculated intakes for 1-5 years (i.e. weighted averages). Nutrient, dairy food and beverage intakes were obtained from 3-day diaries; nutrient adequacy ratios were calculated as the nutrient intake to Recommended Dietary Allowance/Adequate Intake ratio; and dairy-dependent percentages were calculated as fractions of total diet nutrient adequacy ratios (truncated at 1) not met by non-dairy foods., Results: Milk intakes were inversely associated with intakes of juice drinks (2, 4, 5 and 1-5 years), soda pop (2, 3, 4, 5 and 1-5 years) and added sugar beverages (2, 3, 4, 5 and 1-5 years). Dairy dependent fractions of 1-5 year nutrient adequacy ratios were 68% for calcium and 61% for vitamin D. Higher 1-5 year calcium adequacy was predicted by higher energy, higher other dairy and lower added sugar beverage intakes while higher vitamin D adequacy was predicted by higher energy and higher other dairy intakes. Overall diet quality was predicted by higher energy, higher other dairy, lower 100% juice and lower added sugar beverage intakes., Conclusions: Dairy foods remain an important source of calcium and vitamin D, while added sugar beverages and, to a lesser extent, 100% juice decrease diet quality of young children.

Objective: We describe associations between primary tooth fluorosis status and intakes of beverages and fluoride from these beverages during infancy., Methods: Subjects (n = 677) are members of the Iowa Fluoride Study, a cohort of young children followed from birth. Food and nutrient intakes were obtained from 3-day diet records. Diets were analyzed at 6 weeks, 3, 6, 9, 12 and 16 months and cumulatively for 6 weeks through 16 months of age. Primary tooth fluorosis was assessed at 4.5-6.9 years of age and defined as present or absent. Multiple logistic regression analyses were used to develop models to predict fluorosis status., Results: Water-based beverage intakes were higher in subjects with fluorosis than in those without. Specifically, higher intakes of water used to reconstitute formulas at 3, 6 and 9 months; any intake of water as a beverage at 16 months; and higher intakes of combined 100% juice and miscellaneous beverages at 16 months were positively associated with fluorosis (p < 0.05). Fluoride intakes from water sources were also higher in subjects with fluorosis than in those without. Specifically, higher intakes of fluoride from water used to reconstitute formulas at 3, 6, 9 and 12 months and for 6 weeks through 16 months, and higher intakes of fluoride from water as a beverage at 16 months and for 6 weeks through 16 months were positively associated with fluorosis (p < 0.05)., Conclusion: Infant beverages, particularly infant formulas prepared with fluoridated water, can increase the risk of fluorosis in primary teeth.

We describe beverage intakes during the transition stage of infant nutrition. Mean daily intakes of infant formula, cow's milk, combined juice and juice drinks, water, and other beverages estimated from a beverage frequency questionnaire were analyzed cross-sectionally at ages six through 24 months (n=701). Most children (97%) consumed human milk, infant formula, or cows' milk at each age studied. Mean daily intakes of combined infant formula and cows' milk declined from 28.0 oz at six months to 12.1 oz at 24 months. The percentage of children consuming juice and/or juice drinks increased with age, and mean daily consumption peaked at 9.1 oz at 20 months. Combined formula and cows' milk intakes were inversely associated with juice and juice drink intakes at all ages (-0.25 < r < 0; P<.01). Juice and juice drinks appear to replace formula and milk intakes during the transition stage of infant nutrition.

Objective: To determine the relative validity of a quantitative beverage frequency questionnaire in assessing beverage, calcium, and vitamin D intakes using 3-day food diaries for reference., Design: Parents were asked to complete questionnaires for the preceding week and diaries for the following week for their children. Calcium and vitamin D intakes were estimated from human milk, infant formulas, and cow's milk ("beverages") for questionnaires and diaries and from "all foods and beverages" for diaries. Data collected at 6 and 12 months and 3 and 5 years of age as part of the Iowa Fluoride Study (N=700) were analyzed cross-sectionally., Subjects: Children (N=240); 60 randomly selected from each quartile of energy intake at 6 months of age., Statistical Analyses: Spearman correlation coefficients, weighted kappa statistics, and percentages of exact agreement were used to assess associations between tools., Results: Correlations between mean daily beverage intakes estimated from questionnaires and diaries ranged from 0.95-0.99 for human milk, 0.84-0.85 for infant formula, 0.63-0.86 for cow's milk, 0.54-0.69 for juice/drinks, 0.26-0.59 for liquid soft drinks, 0.35-0.74 for powdered soft drinks and 0.54-0.70 for water. Correlations between mean daily nutrient intakes estimated from questionnaires and diaries "beverages" ranged from 0.64-0.74 for calcium and 0.60-0.80 for vitamin D; and between questionnaires and diaries "all foods and beverages" ranged from 0.41-0.63 for calcium and 0.43-0.80 for vitamin D., Applications: A quantitative beverage frequency questionnaire can provide a relative estimate of beverage, calcium, and vitamin D intakes.

Purpose: To assess the role of sociodemographic, dietary, and clinical factors in early mutans streptococci (MS) colonization in children aged 6 to 24 months who were followed for 18 months.Materials and Methods: Ninety-four children (mean age: 11.5 ± 4.99 months at baseline) were enrolled in the study from the Women, Infants and Children Supplemental Nutrition Program during 2003-2004. Salivary MS levels of the children were determined at baseline and at 18 months using a semi-quantitative method. Detailed information about the children's beverage consumption pattern, dietary behavior, and clinical information about oral health status was collected at baseline, 9 months, and 18 months. None of the children included in this study had detectable levels of MS at baseline.Results: Of the 94 children at baseline, 36 (38%) had acquired MS by the 18-month follow-up. The presence of >5 teeth [OR = 3.55 (1.46-9.04); p = 0.0062] was a significant risk factor for MS acquisition among the baseline variables. At 9 months, sports drinks consumption [OR = 5.56 (1.39-26.26); p = 0.0143] and presence of caries [OR = 9.36 (2.55-40.90); p < 0.0001] were significantly associated with MS colonization at 18 months. Higher maternal education [OR = 0.3 (0.07-1.36); p = 0.0351] was a protective factor at all the time points.Conclusion: Sugared beverage consumption, tooth-related factors, and lower maternal education can predict MS acquisition in young children. [ABSTRACT FROM AUTHOR]

Objective. Associations between food insecurity, meal patterns, beverage intake, and body mass index (BMI) were investigated using data from the Howard Meharry Adolescent Caries Study. Methods. Secondary analyses of food security status used the Wilcoxon rank sum, chi-square, and Fisher's exact tests. Results. The group of adolescents (n=627) was 42.1% male, 14.2±1.9 years, 86.9% African American, and 19.9% food-insecure. Meal frequency, meal structure, most beverage intake, and BMI did not differ by food-security status. Adolescents from Washington, DC were more likely to be food insecure than adolescents from Nashville, TN (P=0.003). Most had unstructured meal patterns and irregular breakfast intake. Median milk intake was below and sugar-sweetened beverage intake above dietary recommendations. Conclusions. This study extends our knowledge concerning food insecurity in urban African American adolescents and suggests public health initiatives designed to encourage meal structure, increase milk intake, and reduce sugar-sweetened beverage intake can improve diet quality of underserved youth. [ABSTRACT FROM AUTHOR]

Sugar-sweetened beverages (SSBs) have been associated with childhood caries; however, associations among lifelong beverage intakes and adolescent caries have received less attention. To investigate associations between beverage intakes during childhood and adolescence and caries experience at 17 years of age, while adjusting for fluoride intakes and toothbrushing. Descriptive model analyses were conducted on data collected from a longitudinal birth cohort study. Participants included Iowa Fluoride Study members (n = 318) recruited at birth between 1992 and 1995 with at least 6 beverage questionnaires completed from ages 1 to 17 years and a caries examination at age 17. Predictors included mean daily milk, juice (100% juice and juice drinks before age 9), SSB (including juice drinks after age 9), and water/sugar-free beverage (SFB) intakes; daily fluoride intakes; and daily toothbrushing frequencies for ages 1 to 17. The outcome was dental caries count at age 17, adjusted for the number of scored tooth surfaces (decayed and filled surfaces attack rate [DFSAR]). Univariable generalized linear models were fit for each predictor and the outcome DFSAR. Multivariable models assessed combined effects of beverage types, fluoride variables, toothbrushing, sex, and baseline socioeconomic status. Based on multivariable models, each 8 oz of additional daily juice and water/SFB decreased expected DFSAR by 53% (95% confidence interval [CI]: 17%-73%) and 29% (95% CI: 7%-46%), respectively, and 8 additional oz SSBs increased expected DFSAR by 42% (95% CI: 5%-92%), after adjustment for other beverage intakes, toothbrushing, total fluoride intake excluding SSB fluoride (non-SSB total fluoride), sex, and baseline socioeconomic status. Each additional daily toothbrushing event decreased expected DFSAR by 43% (95% CI: 14%-62%) after adjustment for beverage intakes, non-SSB total fluoride intake, sex, and baseline SES. Higher juice and water/SFB intakes and more toothbrushing were associated with lower caries at age 17, while higher SSB intakes were associated with higher caries. [ABSTRACT FROM AUTHOR]

Objectives: Dental caries experience, which affects 91% of US adults, is a consequence of a carious process influenced by diet. Although individual foods have been implicated, we hypothesized that dietary patterns might be important predictors of caries presence. Methods: We analysed data from 4467 people ≥18 years old participating in the 2013‐2014 National Health and Nutrition Examination Survey, a nationally representative sample of the US population. Data from 24‐hour dietary recalls were classified into standard food categories and reduced to three dietary patterns using principal components (PCs) analysis. We used regression to model the log‐transformed decayed, missing and filled teeth (DMFT) score and the prevalence of any caries experience by quartiles of PC scores, controlling for potential confounders. Dietary patterns differed by age with respect to dental caries so 18‐30‐year‐olds (n = 1074) and >30‐year‐olds (n = 3393) were analysed separately. Results: Similar dietary patterns existed among individuals aged 18‐30 and >30 years, but the prevalence of DMFT score >0 and the median of DMFT was greater in those >30:78.7% (95% CI: 76.1, 81.3) vs 92.6% (95% CI: 91.4, 93.7) and 4 (95% CI: 4, 5) vs 12 DMFT (95% CI: 11, 13), respectively. In those 18‐30, no dietary pattern was associated with greater prevalence or severity of dental caries experience. Among those >30, the prevalence of DMFT>0 was higher by 2% for those in each subsequent quartile of a diet high in sugar‐sweetened beverages and sandwiches (adjusted PR: 1.02, 95% CI: 1.001, 1.03)—thus, the prevalence of dental caries experience was 6% higher among those in the uppermost quartile than in the lowest quartile. For every subsequent quartile in the same pattern, there was a 1.98% higher (95% CI: 0.15, 3.85) DMFT score. However, analysis using the two strongest loading food groups from any of the PCs did not identify any predictors of caries experience. Conclusions: Dietary patterns were associated with the prevalence of dental caries experience, with differing findings by age. Although effect sizes were small, the population impact may be substantial. While food groups high in sugar were associated with caries prevalence and severity, associations were more apparent in the context of overall diet. Prospective studies are needed to confirm whether particular dietary patterns are causally related to the development of dental caries. [ABSTRACT FROM AUTHOR]

Abstract Background Sugar-sweetened beverages (SSB) are considered a risk factor for obesity. Objective The objective of the current study was to investigate associations between the predictors of beverage and energy intakes and mean adequacy ratios (MARs), and the outcome of body mass index (BMI) z scores, in a birth cohort using longitudinal models. Design This was a longitudinal analysis of secondary data. Participants/setting Participants in the Iowa Fluoride and Iowa Bone Development Studies with two beverage intake questionnaires completed between ages 2 and 4.7 years or 5 and 8.5 years or one questionnaire between ages 9 and 10.5, 11 and 12.5, 13 and 14.5, or 15 and 17 years (n=720); two food and beverage diaries completed between ages 2 and 4.7 years or 5 and 8.5 years or completion of the Block's Kids' Food Frequency Questionnaires at age 11, 13, 15, or 17 years (n=623); and anthropometric measures at the corresponding age 5-, 9-, 11-, 13-, 15-, or 17-year examination(s). Predictors Mean daily 100% juice, milk, SSB, water/sugar-free beverage, and energy intakes and MARs averaged over ages 2 to 4.7, 5 to 8.5, 9 to 10.5, 11 to 12.5, 13 to 14.5, or 15 to 17 years were predictors. Outcome BMI z score was the outcome. Statistical analyses Linear mixed models were fit for each beverage, energy, and MAR variable, with the beverage, energy, or MAR variable as the predictor and BMI z score as the outcome. Beverage models were adjusted for energy and MAR and baseline socioeconomic status. Results SSB intake adjusted for energy intake, MAR, and baseline socioeconomic status was associated with BMI z score; each additional 8 oz SSB consumed/day throughout childhood and adolescence increased the BMI z score an average 0.050 units (95% CI 0.022 to 0.079; P =0.001). Adjusted water/sugar-free beverage intake (0.026 units; 95% CI 0.006 to 0.046; P =0.013) was modestly associated with BMI z score, while 100% juice (–0.001 units; 95% CI –0.059 to 0.057; P =0.97) and milk (0.022 units; 95% CI –0.007 to 0.052; P =0.13) intakes were not associated with BMI z scores. Conclusions Higher SSB intakes were associated with increased BMI z scores throughout childhood and adolescence in Iowa Fluoride Study participants. Public health initiatives targeting SSB consumption during childhood and adolescence remain relevant. [ABSTRACT FROM AUTHOR]

Background and Overview. Dental erosion occurs after exposure to intrinsic or extrinsic acids. Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. Extrinsic dietary acids from foods or beverages also can cause erosion, particularly when exposure is prolonged by holding or swishing behaviors. Conclusions. Clinicians should screen patients exhibiting dental erosion for anorexia nervosa, bulimia nervosa, rumination syndrome, and gastroesophageal reflux disease. Clinicians should screen patients without a medical explanation for their erosion for exposure to acidic foods and beverages, particularly for habits that prolong exposure. Practical Implications. Identification of intrinsic and extrinsic acid exposures and recommendations to minimize exposures are important to prevent erosion and maintain oral health. [ABSTRACT FROM AUTHOR]

Objectives: The Akaike Information Criterion (AIC) is a well-known tool for variable selection in multivariable modeling as well as a tool to help identify the optimal representation of explanatory variables. However, it has been discussed infrequently in the dental literature. The purpose of this paper is to demonstrate the use of AIC in determining the optimal representation of dietary variables in a longitudinal dental study.Methods: The Iowa Fluoride Study enrolled children at birth and dental examinations were conducted at ages 5, 9, 13, and 17. Decayed or filled surfaces (DFS) trend clusters were created based on age 13 DFS counts and age 13-17 DFS increments. Dietary intake data (water, milk, 100 percent-juice, and sugar sweetened beverages) were collected semiannually using a food frequency questionnaire. Multinomial logistic regression models were fit to predict DFS cluster membership (n=344). Multiple approaches could be used to represent the dietary data including averaging across all collected surveys or over different shorter time periods to capture age-specific trends or using the individual time points of dietary data.Results: AIC helped identify the optimal representation. Averaging data for all four dietary variables for the whole period from age 9.0 to 17.0 provided a better representation in the multivariable full model (AIC=745.0) compared to other methods assessed in full models (AICs=750.6 for age 9 and 9-13 increment dietary measurements and AIC=762.3 for age 9, 13, and 17 individual measurements). The results illustrate that AIC can help researchers identify the optimal way to summarize information for inclusion in a statistical model.Conclusions: The method presented here can be used by researchers performing statistical modeling in dental research. This method provides an alternative approach for assessing the propriety of variable representation to significance-based procedures, which could potentially lead to improved research in the dental community. [ABSTRACT FROM AUTHOR]

Objectives Early childhood caries ( ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. Methods Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). Results Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant ( P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. Conclusions By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population. [ABSTRACT FROM AUTHOR]

Objectives: This study describes associations among caries experience and meat, snack and daily total exposures to beverages and foods in children. Methods: Subjects (n = 634) were members of the Iowa Fluoride Study. Beverage and food exposures were abstracted from 3-day diaries at 1, 2, 3, 4 and 5 years and calculated for 1–5 years. Eating events were defined as 30-minute intervals and categorized as meals or snacks based on time of consumption and nature of the foods. Beverage and food exposures were categorized by carbohydrate content. Dental examinations were conducted at 4.5–6.8 years; caries experience was dichotomized (any vs. none). Logistic regression models were developed to determine if caries experience differed for the fourth vs. first quartile of exposure after adjustment for age at dental exam and fluoride intake. Results: Higher snack (1, 2, 3, 4, 1–5 years) and daily total (2, 3, 4, 1–5 years) eating events increased caries risk (P < 0.05). Higher exposures to 100% juice at snacks (2 years) and soda pop at meals (2, 1–5 years), snacks (2, 3, 4, 1–5 years) and daily total (2, 3, 4, 1–5 years) increased caries risk (P < 0.05). Higher exposures to food sugars (3, 1–5 years) and starches (4, 5, 7–5 years) at meals decreased caries risk, with higher exposures to sugars (4, 1–5 years) at snacks increased caries risk (P < 0.05). Conclusions: Dietary methods used to investigate diet-caries relationships can influence the outcome. The cariogenicity of food, but not beverages, is associated with the timing of exposure. [ABSTRACT FROM AUTHOR]