Author: Jacob Watwood
A healthy diet is essential for maintaining good oral as well as overall health. A balanced diet that is rich in both micronutrients and macronutrients is required for the body and mind to function effectively.[i] An adequate supply of micronutrients is essential in managing a rapid immune response during inflammatory processes associated with periodontal disease, for example.[ii] Macronutrients, like carbohydrates, protein and fats are vital for tissue repair and healthy cell function.[iii]
Weight-loss is a vital part of preventing complications from excess weight, such as diabetes, kidney disease and cardiovascular disease, all of which are associated with poor oral health. However, sustainable methods that prioritise maintaining the intake of essential nutrients should be encouraged to ensure weight management is consistent, and that health is maintained throughout the process of reaching and remaining at a healthy weight. Diet or weight cycling, commonly known as yo-yo dieting, in combination with certain extreme dieting methods is associated with a net weight gain, and ultimately, has a deleterious effect on people’s oral, physical and mental health.[iv]
Unsustainable weight-loss
For many individuals, weight-loss is difficult and often unsustainable, leading to some seeking easy ways to shed pounds. More than one in five women have been on at least five diets that have not resulted in maintaining a healthy weight. 21% of British women say they have yo-yo dieted at least five times, and 11% have done it at least ten times. 6% of those surveyed have dieted and put the weight back on again more than 20 times.[v]
Although some popular diets may result in weight reduction, evidence suggests that 80–95% of dieters regain most of their lost weight within 5 years.iv This problem can result in a habit of cycling between different extreme diets in quick succession. In combination, fad diets and yo-yo dieting can have a detrimental effect on patients’ long-term oral as well as systemic health.i
Many popular diets encourage extreme approaches, such as entirely cutting out certain macronutrients or eating only one food for extended periods.[vi] While some of these extreme diets can be beneficial – at least for a limited time – some can have a direct impact on oral health. For example, diets that dictate a severely reduced carbohydrate intake can cause xerostomia, increasing the risk of caries, halitosis and periodontal disease. Many low carbohydrate, high protein diets prioritise extreme consumption of fats, increasing the risk of cardiovascular disease, which is strongly linked to periodontal disease. An overconsumption of meat and dairy can also be a risk factor for enamel erosion.i
Lifelong effects of yo-yo dieting
Weight cycling is thought to affect patients’ microbiome, potentially leading to gut dysbiosis. This imbalance results in the loss of beneficial microorganisms and alters the composition and function of gut microbiota.iv There is a reciprocal relationship between oral and gut microbiota, meaning that individuals with gut dysbiosis may be more susceptible to periodontitis and other related oral health issues.[vii]
Weight cycling is also associated with hyperinsulinemia and elevated basal insulin secretion, and some studies suggest that it is associated with poor cardiometabolic outcomes and increased risk of Type 2 diabetes. Inflammation and altered immune cell composition are known to remain in adipose tissue following weight loss.[viii]
Individuals who engage in weight cycling, commonly tend to have an increased percentage of body fat, making them more susceptible to the oral health challenges experienced by obese individuals.[ix] These include a higher prevalence of alveolar bone loss, caries, and tooth loss.[x]
Educating patients for optimal oral health
As well as educating patients on optimal oral hygiene, it is important to understand the importance of prioritising a healthy approach to nutrition. When patients are actively engaging in yo-yo dieting, encouraging enhanced hygiene can help them prevent complications that can result in a lifelong impact on their oral health.
Recommending products like FLEXI interdental brushes from TANDEX is a great way to provide optimal oral hygiene to patients every day. They come in 11 sizes to help patients keep all interdental spaces clean. Adding just a small amount of PREVENT Gel from TANDEX to FLEXI brushes ensures the benefits if 0.12% chlorhexidine and 900 ppm fluoride reach every interdental space.
A balanced diet, rich in whole foods can support healthy, sustainable weight management while also maintaining healthy oral mucosa and dental tissue.[xi] For patients that are caught in an endless diet cycle, encouraging them to choose more sustainable weight-loss methods can help them achieve better oral as well as physical health.
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[i] Sneha Kalpe, Anmol Mathur, Priyanka Kharat, How fad diets may jeopardize your oral well-being: The hidden consequences, Human Nutrition & Metabolism, Volume 33, 2023, 200214, ISSN 2666-1497, https://doi.org/10.1016/j.hnm.2023.200214.
[ii] Willershausen B, Ross A, Försch M, Willershausen I, Mohaupt P, Callaway A. The influence of micronutrients on oral and general health. Eur J Med Res. 2011 Nov 10;16(11):514-8. doi: 10.1186/2047-783x-16-11-514. PMID: 22027646; PMCID: PMC3351810.
[iii] Shailesh M. Gondivkar, Amol R. Gadbail, Rima S. Gondivkar, Sachin C. Sarode, Gargi S. Sarode, Shankargouda Patil, Kamran H. Awan, Nutrition and oral health,Disease-a-Month, Volume 65, Issue 6,
2019, Pages 147-154, ISSN 0011-5029, https://doi.org/10.1016/j.disamonth.2018.09.009.
[iv] Phuong-Nguyen K, O’Hely M, Kowalski GM, McGee SL, Aston-Mourney K, Connor T, Mahmood MQ, Rivera LR. The Impact of Yo-yo Dieting and Resistant Starch on Weight Loss and Gut Microbiome in C57Bl/6 Mice. Nutrients. 2024 Sep 17;16(18):3138. doi: 10.3390/nu16183138. PMID: 39339738; PMCID: PMC11435396.
[v] https://ygo-assets-websites-editorial-emea.yougov.net/documents/yg-archives-yougov-slimmingworld-yoyodieting-230511_e4PVakM.pdf
[vi] https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/weight/diets/extreme-diets
[vii] Di Stefano M, Santonocito S, Polizzi A, Mauceri R, Troiano G, Lo Giudice A, Romano A, Mascitti M, Isola G. A Reciprocal Link between Oral, Gut Microbiota during Periodontitis: The Potential Role of Probiotics in Reducing Dysbiosis-Induced Inflammation. International Journal of Molecular Sciences. 2023; 24(2):1084. https://doi.org/10.3390/ijms24021084
[viii] Thillainadesan, S., Lambert, A., Cooke, K.C. et al. The metabolic consequences of ‘yo-yo’ dieting are markedly influenced by genetic diversity. Int J Obes 48, 1170–1179 (2024). https://doi.org/10.1038/s41366-024-01542-2
[ix] Bosy-Westphal A, Kahlhöfer J, Lagerpusch M, Skurk T, Müller MJ. Deep body composition phenotyping during weight cycling: relevance to metabolic efficiency and metabolic risk. Obes Rev. 2015 Feb;16 Suppl 1:36-44. doi: 10.1111/obr.12254. PMID: 25614202.
[x] Arslan ZB. Evaluation of the Relationship Between Oral Health and Body Mass Index. Eurasian J Med. 2023 Oct;55(3):259-262. doi: 10.5152/eurasianjmed.2023.23272. PMID: 37909201; PMCID: PMC10724796.
[xi] Najeeb S, Zafar MS, Khurshid Z, Zohaib S, Almas K. The Role of Nutrition in Periodontal Health: An Update. Nutrients. 2016 Aug 30;8(9):530. doi: 10.3390/nu8090530. PMID: 27589794; PMCID: PMC5037517.
