LAUSR

AIM To investigate pathways between unhealthy and healthy dietary patterns with periodontitis in adolescents (18-19 years). METHODS This population-based study (n=2,515) modeled direct and mediated pathways (via biofilm and obesity) from patterns of Healthy Diet (fruits, fiber, vegetables, and dairy) and Unhealthy Diet (sugars, snacks, salty/fast foods) with Initial Periodontitis (bleeding on probing (BoP), probing depth (PD) ≥ 4mm, clinical attachment loss (CAL) ≥ 4mm), Moderate Periodontitis (BoP, PD ≥ 5 mm and CAL ≥ 5 mm) and EFP-AAP Periodontitis definition at, adjusting for sex, socioeconomic status, smoking, and alcohol, through structural equation modeling (alpha=5%). RESULTS Higher values of Healthy Diet were associated with lower values ​​of Initial [Standardized Coefficient (SC) = -0.160; p< 0.001], Moderate Periodontitis (SC = -0.202; p<0.001), and EFP-AAP periodontitis (p<0.05). A higher value of Unhealthy Diet was associated with higher values ​​of Initial (SC = 0.134; p=0.005) and Moderate Periodontitis (SC = 0.180; p<0.001). Biofilm mediated the association between higher values of Unhealthy Diet and all periodontal outcomes (p<0.05). CONCLUSION Our findings suggest healthy and unhealthy dietary patterns may contribute to reduced or increased extent and severity of periodontitis by local and systemic mechanisms, preceding the effect of other established causes, like smoking and obesity, in younger.