Dietary factors contributing to Māori dental health in Northland, New Zealand

Abstract

Background: Despite being preventable, dental diseases are the most prevalent non-communicable disease worldwide. Dietary factors can harm and protect dental health. Sugar consumption significantly increases dental caries risk, while acidic foods and beverages can contribute to tooth wear. Cheese and plain milk have protective qualities. In New Zealand, Northland is a region with poor dental health, particularly in children, but little is known about dietary intakes in this region, especially in the Māori population.

Objective: To investigate the relationship between parent/caregiver and child frequency of consuming foods and beverages that could harm and protect dental health among Māori families/households residing in Northland, New Zealand

Methods: A convenience sample of 31 Māori households (131 participants), living in high deprivation areas of Whangarei and Paihia, participated in this cross-sectional observational study. Children ages 5-14 years completed a qualitative food frequency questionnaire (FFQ), which assessed how often they usually consumed sugar-sweetened foods and beverages, citrus/acidic fruit, and cheese/plain milk per day over the past month. Parents/caregivers and older children (15+ years) completed a semi-quantitative FFQ, which assessed consumption frequency (and amount) of similar food and beverage items for the same food categories over the same time period. Consenting participants also provided a 3cm hair sample to quantify 13Carbon (ratio of 12C:13C), claimed to assess corn and cane sugars intake over the past three months. Each parent/caregiver was matched with a randomly selected child from their household for analysis (N=64, 32 dyads).

Results: Among 32 dyads, sugar-sweetened foods and beverages were consumed frequently by parents/caregivers and their children (medians 4.5 and 5.3 times a day, respectively). No statistically significant relationship between consumption frequency and hair 13Carbon was observed (rs= 0.29 [Adult QFFQ] and 0.06 [Child FFQ]). As a group, parents/caregivers and children had similar mean hair 13Carbon (18 adults: -19.94; 40 children: -20.05; p=0.204); the mean difference between 15 parent/caregiver-child dyads was insignificant (0.33 [95%CI: -0.21, -0.86], adjusted for 15N, sex, age). Between 32 parent/caregiver-child dyads, a significant association was found for sugar-sweetened beverages (rs= 0.49, p=0.004), but no other food category. On average, both groups consumed citrus/acidic fruit 0.7 times a day and cheese/plain milk 1.8-1.9 times a day.

Conclusions: This study offers insight into the food and beverage consumption patterns of 31 Māori families living in Northland, improving our understanding of dietary factors that may be influencing their dental health. Sugar intakes are the most pressing concern. More than half of the parents/caregivers and children in this sample need to reduce their sugary food and beverage consumption to meet recommended levels (<4 times a day), which indicates an urgent need for public health intervention. The next step for this research is to refine food frequency calculations, so diet and dental disease relationships can be explored.