The Michigan study: the relationship between sugars intake and dental caries over three years
Burt, B.A.; Szpunar, S.M.
International Dental Journal 44(3): 230-240
1994
ISSN/ISBN: 0020-6539 PMID: 7960162 Document Number: 428476
National policies to decrease sugars consumption by about half have been suggested in order to decrease the incidence of dental caries - an approach which assumes that caries experience is directly related to sugars intake. Consideration of data from the Michigan diet study suggests that such policies are inadvisable. The Michigan study collected detailed information on diet and caries incidence over a 3-year period (1982-1985) on 499 children aged 10-15 years at baseline. Results showed that caries incidence was poorly related to sugars intake, whether measured as total daily amount, between-meal intake, sugars as a proportion of total energy, or frequency of consumption. The average daily intake of sugars from all sources was 156 g for boys and 127 g for girls. Mean caries incidence was 2.9 DMFS over the 3 years. When children were divided into quartiles by amounts of sugars consumed, those in the highest quartile, compared with the lowest, had a relative risk of 1.22 of developing caries. This relative risk rose to 1.80 for proximal lesions. The risks were similar when consumption was restricted to between-meal sugars. If consumption of sugars were halved in this population, fat consumption would be likely to rise from the present 38% of total energy to ~47%. National policies to restrict sugars consumption might therefore be not only expensive and ineffective, but could damage public health by inadvertently leading to higher consumption of fats.