Association between an anti-inflammatory low-carbohydrate diet and gingivitis in women with obesity

The Western diet contributes to the onset and progression of gingivitis. In contrast, an anti-inflammatory low-carbohydrate diet (AILCD) has been proposed as a dietary recommendation to improve gingival health. Although a few published studies have investigated the influence of an anti-inflammatory diet on gingivitis in individuals of normal weight, this study aimed to evaluate the association between an AILCD and gingivitis in women with obesity.

Twenty-three women with obesity and gingivitis participated in the 2-month study. Clinical parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing (BOP), were recorded at baseline, 1 month, and 2 months. Mouthwash samples were collected for real-time PCR detection of oral microbiota, including Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, and Fusobacterium nucleatum. Salivary inflammatory cytokines (IL-6, TNF-α, and IL-10) were measured using ELISA. Anthropometric parameters, including weight, body mass index (BMI), skeletal muscle mass (SMM), and percent body fat (PBF), were assessed using body composition analysis.

After 2 months, all clinical parameters were significantly reduced. The baseline PI was 1.14 ± 0.48 reduced to 0.54 ± 0.38, GI was 0.77 ± 0.32 reduced to 0.38 ± 0.17, PPD was 1.83 mm ± 0.22 mm reduced to 1.35 mm ± 0.30 mm, and BOP was reduced from 37% to 19%. Baseline weight, BMI, SMM, and PBF were significantly reduced by 3.8 kg, 1.3 kg/m², 0.5 kg, and 1.6%, respectively. However, no significant differences were observed in the periodontal pathogens and salivary inflammatory cytokines except for Tannerella forsythia, which showed a significant increase in its counts with a p value of 0.01.

The AILCD followed by participants in this study was associated with significant improvements in clinical and anthropometric parameters. However, Tannerella forsythia showed a significant increase in women with obesity.