The Roles of Meal, Snack, and Daily Total Food and Beverage Exposures on Caries Experience in Young Children

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Abstract
Objectives: This study describes associations among caries experience and meal, snack and daily total exposures to beverages and foods in children. Methods: Subjects (n = 634) were members of the Iowa Fluoride Study. Beverage and food exposures were abstracted from 3-day diaries at 1, 2, 3, 4 and 5 years and calculated for 1–5 years. Eating events were defined as 30-minute intervals and categorized as meals or snacks based on time of consumption and nature of the foods. Beverage and food exposures were categorized by carbohydrate content. Dental examinations were conducted at 4.5–6.8 years; caries experience was dichotomized (any vs. none). Logistic regression models were developed to determine if caries experience differed for the fourth vs. first quartile of exposure after adjustment for age at dental exam and fluoride intake. Results: Higher snack (1, 2, 3, 4, 1–5 years) and daily total (2, 3, 4, 1–5 years) eating events increased caries risk (P < 0.05). Higher exposures to 100% juice at snacks (2 years) and soda pop at meals (2, 1–5 years), snacks (2, 3, 4, 1–5 years) and daily total (2, 3, 4, 1–5 years) increased caries risk (P < 0.05). Higher exposures to food sugars (3, 1–5 years) and starches (4, 5, 1–5 years) at meals decreased caries risk, while higher exposures to sugars (4, 1–5 years) at snacks increased caries risk (P < 0.05). Conclusions: Dietary methods used to investigate diet-caries relationships can influence the outcome. The cariogenicity of food, but not beverages, is associated with the timing of exposure.