Background: The objective of this study was to investigate the relationship between monthly tomato consumption (MTC) and serum lycopene (sLyco) levels, and a self-reported history of congestive heart failure (CHF) in individuals with periodontitis using data available in the Third National Health and Nutrition Examination Survey (NHANES III).
Methods: Adult participants in NHANES III were used in this study. Zero to thirty three percent of sites with a periodontal attachment loss (PAL) of >3 mm was considered a healthy periodontium, while greater than >33% of sites with PAL of >3 mm as periodontitis. The outcome variable was the self-reported history of CHF. MTC and sLyco levels were categorized into quartiles. Data was analyzed by Kruskal-Wallis, anova and multivariate analyses using SPSS(R). p<0.05 was used to reject the null hypothesis.
Results: Individuals with periodontitis showed a dose-response relationship between dietary MTC and self-reported CHF risk; moderate MTC (risk ratio (RR), 3.15; 95% confidence interval (CI), 1.03-9.67), low MTC (RR, 3.31; 95% CI, 1.33-8.24) (p<0.05) and very low MTC (RR, 5.10; 95% CI, 1.67-15.57) (p<0.01), adjusting for confounders of both diseases (periodontitis and CHF). The moderate sLyco level-healthy periodontium group showed a significant decrease in CHF risk (RR, 0.25; 95% CI, 0.07-0.84) (p<0.05), adjusting for confounders. Significant inverse dose-response relationships were seen between sLyco and C-reactive protein, and MTC and white blood cell count in periodontitis subjects, respectively (p<0.05). MTC was correlated with sLyco concentration (r=-0.018, p<0.05), adjusting for confounders abolished that significance.
Conclusions: A relationship exists between periodontitis and CHF risk, and high MTC appears to affect this relationship in a positive direction in periodontitis subjects.