Effect of childhood malnutrition on salivary flow and pH

While protein-energy malnutrition may have multiple effects on oral tissues and subsequent disease development, reports of the effect of malnutrition on the human salivary glands are sparse.

A retrospective cohort study of the effect of early childhood protein-energy malnutrition (EC-PEM) and adolescent nutritional status on salivary flow and pH was conducted with rural Haitian children, ages 11-19 years (n=1017). Malnutrition strata exposure cohorts were based on 1988-1996 weight-for-age records which covered the birth through 5-year-old period for all subjects. Then, data on current anthropometrical defined nutritional status categories, stimulated and unstimulated salivary flow rates, and salivary pH were collected for the same subjects of 11-19 years old during field examinations in the summer of 2005. Multivariate analysis of variance (MANOVA) was used for the analyses.

Stimulated and unstimulated salivary flow rates were reduced at statistically significant levels in subjects who had experienced severe malnutrition in their early childhood or who had continuing nutrition stress which resulted in delayed growth, as measured at ages 11-19 years. Salivary pH demonstrated little clinically meaningful variability between malnourished and nonmalnourished groups.

This study is the first to report of a continuing effect on diminished salivary gland function into adolescence as a result of early childhood malnutrition (EC-PEM) and suggests that exocrine glandular systems may be compromised for extended periods following EC-PEM, which may have important implications for the body's systemic antimicrobial defences.