Fruit and vegetable consumption frequency and tooth-loss transitions across baseline dentition strata in older...

Fruit and vegetable consumption is linked to oral health in later life, but whether consumption frequency is associated with subsequent tooth-loss transitions across baseline dentition stages remains unclear. We examined these associations in older Chinese adults.

We used Chinese Longitudinal Healthy Longevity Survey data from 2008, 2011, 2014, and 2018. Participants aged ≥65 years were grouped by baseline dentition; the outcome was incident edentulism in the 1-19-teeth stratum and transition to fewer than 20 teeth in the 20-24 and 25-32-teeth strata. Models mutually adjusted fruit and vegetable consumption frequency. Target-population interpretation prioritised a full baseline-eligible cohort competing-outcome analysis treating death as a competing outcome; additional analyses addressed alternative exposure definitions, differential inclusion, and competing survival.

In the full baseline-eligible cohort competing-outcome analysis among participants with 1-19 baseline teeth, more frequent vegetable consumption showed an attenuated inverse association with incident edentulism after accounting for death as a competing outcome (HR 0.88, 95% CI 0.73-1.04). In the observed-outcome sample with follow-up tooth counts, the corresponding vegetable estimate was stronger (HR 0.83, 95% CI 0.69-0.99), whereas fruit consumption was not associated with incident edentulism (HR 0.97, 95% CI 0.86-1.09). Associations in the 20-24 and 25-32 baseline-teeth strata were weaker and less consistent.

Among older Chinese adults with 1-19 baseline natural teeth, higher vegetable consumption frequency showed only a weak inverse association with incident edentulism when the full baseline-eligible cohort and competing death were considered, whereas fruit consumption remained near null. The stronger estimate from the observed-outcome sample may overstate the association in the target population and should not be interpreted as evidence of an independent protective effect.