Founders' and Benefactors' lecture 2001. Preventing the preventable--the enigma of dental caries.
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Adolescent↗
Biomedical subjects
A Rugg-Gunn
Publications and source records attributed to A Rugg-Gunn.
Combination of low parental educational attainment and high parental income related to high caries experience in pre-school children in Abu Dhabi.
Children aged 2, 4 and 5 years were examined for dental caries using WHO criteria, in the Emirate of Abu Dhabi, UAE, in 1996. The children were from the three administrative regions of Abu Dhabi, Al Ain and Western Region. Sampling of health centres and kindergartens was stratified by urban or rural location. Parents completed a questionnaire, and children were classified into high, middle or low groups on the basis of their parents' education and income. All 20 kindergartens and 22 health centres sampled agreed to participate. The participation rate of sampled children was high and complete data were available for 640 children--217 aged 2 years, 204 aged 4 years, and 219 aged 5 years. Similar numbers of boys and girls were included. The prevalence of dental caries was very high--36% to 47% at age 2 years, 71% to 86% at age 4 years and 82% to 94% at age 5 years. The mean dmft at age 5 years was 8.4 in Abu Dhabi, 8.6 in Al Ain and 5.7 in Western Region. Few teeth had been filled. Apart from age, the parents' education and income were found to be statistically significantly related to caries experience (P<0.05), while gender, ethnicity (UAE or non-UAE), region, and urban or rural living, were not related to dental caries experience (P>0.3). While high parental educational attainment was related to lower caries experience, conversely, high parental income was related to higher caries experience. Caries experience was higher than that recorded approximately 6 years previously and is a cause of concern.
Age Factors↗
Nutrition labelling of sugar-containing foods in 1996 compared with 1989.
OBJECTIVE: To record the prevalence of nutrition labelling of foodstuffs with respect to sugar content in selected supermarkets in the UK in 1996 and to compare the prevalence with results reported for 1989. RESEARCH DESIGN: Examination of the labelling of foodstuffs to see whether the labelling of the nutrition content conformed to Government guidelines. Foodstuffs were grouped into 12 types of sugar-containing foods. RESEARCH SETTING: Three large food supermarkets in Newcastle upon Tyne. MAIN OUTCOME MEASURES: Conformity with government guidelines on nutrition labelling of foodstuffs. RESULTS: Most labelling conformed to guidelines. Prevalence had increased considerably between 1989 and 1996. Foods with high sugars content, particularly confectionery, were the least likely to be labelled for sugars content. CONCLUSIONS: Although substantial progress in nutrition labelling for sugars content has occurred, voluntary compliance appears to allow inadequate labelling of high sugar foods.
Beverages↗
Low fat caries.
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Cardiovascular Diseases↗
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 (mutants 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.
Child↗
Dietary sources of calcium and the contribution of flour fortification to total calcium intake in the diets of Northumbrian adolescents.
Increased Ca intake by adolescents is desirable. In order to achieve this, information on the current dietary sources of Ca by this age group is essential to enable change to build on existing habits. This paper addresses two issues: first, the dietary sources of Ca for adolescents are reported and, second, the importance of fortification of flour with Ca to present-day Ca intakes was determined. In 1990 the diets of 379 children aged 12 years were assessed using the 3 d dietary diary and interview method. Computerized food tables were used to calculate the contributions of different food groups to total Ca intake. The Ca content of each food was subdivided into naturally occurring Ca and Ca from fortification, and data were analysed to give the daily intake of each. The four most important sources of Ca were milk (25%), beverages (12%), puddings (10%) and bread (9%). Fortification of flour accounted for 13% of total Ca intake. When the contribution of fortification was removed, the proportion of subjects with intakes of Ca below the lower reference nutrient intake (Department of Health, 1991) increased more than fourfold, to 10% of girls and 12% of boys. Milk is contributing less to Ca intake than in the past and increased consumption should be encouraged. Ca fortification of flour remains an important source of Ca. Therefore, unless dietary habits are modified to ensure adequate Ca from other sources, increased consumption of unfortified products from outside the UK will lead to a further reduction in Ca intake.
Adolescent↗
Andrew Rugg-Gunn takes on the BDJ. Interview by Kate O'Malley.
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Humans↗
Nutritional intake, height and weight of 11-12-year-old Northumbrian children in 1990 compared with information obtained in 1980.
There is little age-specific information on changes in dietary intake over time in this country, yet this is valuable in assessing the effectiveness of health education programmes particularly in vulnerable groups such as adolescents. In 1990, 379 children aged 12 years completed two 3 d dietary records. They were interviewed by one dietitian on the day after completion of each diary to verify and enlarge on the information provided and, with the aid of food models, obtain a quantitative record of food intake. Nutrient intake was calculated using computerized food tables. These children attended the same seven Middle schools in Northumberland as 405 children of the same age who recorded their diet using the same method, 10 years previously. Heights and weights were also recorded in both studies in the same manner. Comparing the nutrient intakes in 1990 with 1980, energy intake fell in the boys (to 8.6 MJ) but not in the girls (8.3 MJ). The contribution of fat to energy intake was unchanged at about 40% (about 90 g/d). Likewise, intake of sugars was unchanged at about 22% of energy (about 118 g/d). Calcium intake remained the same in the girls (763 mg/d in 1990) but fell in the boys (786 mg/d in 1990). Iron, vitamin C and unavailable carbohydrate intakes increased in both sexes, and the nutrient density of the diet improved in all sex and social-class groups. However, a social trend evident in 1980 still existed in 1990 with low social groups having the poorest-quality diet. It is concluded that there is little evidence of substantial progress towards improving the diet of adolescents in this country.
Body Height↗
The current status of nutrition labelling in the United Kingdom.
During the past 10 years there has been considerable discussion about nutrition labelling of foodstuffs. In the United Kingdom, the Ministry of Agriculture, Fisheries and Food has published several proposals for guidelines and regulations. The European Community has more recently considered this subject and has issued their proposals for draft directives. There is now considerable agreement between the UK guidelines on nutrition labelling published in 1987 and EC proposals which are under discussion. Compulsory nutrition labelling is unlikely in the immediate future, except when a nutrition claim is made, when labelling is to be compulsory and must conform to one of several specified formats. In contrast, many consumer groups believe that nutrition labelling should be compulsory for all packaged foods. The Ministry of Agriculture, Fisheries and Food intends to control nutrition claims, such as claims of 'high' or 'low' levels of various nutrients, and definitions of these nutrient levels have been proposed for discussion. Whether to label foods according to 'total' or 'added' sugars content, or both, is also under discussion.
Consumer Organizations↗
A survey of nutrition labelling of sugar-containing foods in the north of England in 1989.
A survey of the nutrition labelling of 880 varieties of foods on sale in three stores in Newcastle upon Tyne was undertaken in May-July 1989. The foods were chosen for investigation because they contained sugars, and they were categorised into 12 types of food. Some nutritional information was given for most foods but it seldom conformed to the format suggested by the Ministry of Agriculture, Fisheries and Food. The sugars content of the foods was seldom given. Even when nutritional claims were made (e.g. 'low sugar', 'high fibre'), nutritional information was often incomplete. The three stores differed in the extent to which their own-brand products were labelled for nutrient content. Tesco products were comprehensibly labelled, while own-brand products for sale in the other two stores were not, although both stores stated their intention to introduce comprehensive nutrition labelling. Two of the three stores had, or intended to have, obligatory sugar labelling. Despite this, there were many examples of nutrition labelling which was misleading. It is concluded that nutrition labelling should be compulsory and should conform to a format which specifies sugars content.
Dietary Carbohydrates↗