Added Sugar Intake Associated With Dental Outcomes Among Mexican Immigrants

Objectives: To explore the association between dental outcomes and added sugar intake, using a questionnaire culturally tailored to urban Mexican adults.
Methods: We used data from the TalaSurvey Study (an egocentric exploration of community networks): data included acculturation and socio-demographic items, CDC/NIDCR DRC items about dental experiences and self-care practices, and the Added Sugar Intake Estimate (ASIE). ASIE is a semi-quantitative food frequency questionnaire adapted from the National Cancer Institute Diet History Questionnaire II into 21 food categories for desserts, candy, spreads, pastries, juices, fruit-flavored drinks, sugared beverages, and dairy drinks. ASIE included size and number of portions, intake frequency, and intake within 1 h of bedtime. Sugar content was converted to daily ASIE and analyzed with ANOVA/linear regression, and multiple linear regression.
Results: Data from 326 respondents were analyzed (age 36.2±12.1 years; 63% female; 80% 1^st generation immigrants; income US$30k±$13k). Acculturation scores were low. Mean total ASIE was 99.6±94.6 grams/day (food/snacks: 36.5±44.4; beverages: 63.1±68.2). Factors associated with higher total ASIE were having toothache/receiving antibiotics in past 12 months, eating or drinking within 1 h of bedtime, lower psychological acculturation, and lower likelihood of flossing daily. For higher food/snack ASIE, eating/drinking within 1 h of bedtime, younger age, and better flossing patterns were significant. For higher drink ASIE, male gender, having toothache, eating/drinking within 1 h of bedtime, lower psychological acculturation, lower likelihood of flossing daily, and not avoiding foods because of mouth problems were significant.
Conclusions: Past research indicate dietary quality among Mexican immigrants deteriorates with greater acculturation or longer time in the USA. Culturally-specific tools are necessary to sharply focus the impact of dietary changes on dentally important outcomes. Initial ASIE assessments support more extensive testing in future research; they point to the need to promote dietary improvement and better delineate the roles of oral self-care practices.