Relationship Between Nutritional Status, Physical Activity and Periodontal Status

Based on the clinical and radiographic evaluation, the participants were distributed into the healthy, Stage I-II, and Stage III-IV periodontitis groups. Periodontitis patients were defined as patients presenting gingival inflammation with clinical attachment loss/bone loss, according to the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions. After concluding a diagnosis for periodontitis, a stage was assigned based on the degree of clinical attachmentloss (CAL) and radiographic bone loss (RBL) (1-2 mm or 3-4 mm CAL for Stage I or II and ≥ 5 mm for Stage III-IV). Healthy subjects were defined as: no sites with interdental attachment loss, PD = 1-3 mm and BOP < 10% (Madruga et al. BMC Oral Health 2023;23:335). The higher the stage, the more severe the periodontitis.

Physical activity level of participants was determined by means of the International physical activity questionnaire short form (IPAQ-SF), consisting of 7 questions (J Sports Med Phys Fitness 2016;56(10):1139-1146).Total Metabolic Equivalent of Task (MET) minutes per week will be calculated based on the scoring protocol. The higher the value, the more active. Participants completed the questionnaire on-site.

Body weight was assessed using a digital weight scale (Insmart; Hanoi, Vietnam; FG260) with a precision of 50 g and expressed in kg.

The estimated % body fat mass (%FM) value measured by means of a manual Bioelectrical Impedance Analysis (BIA) bipolar analyzer (Omron Corporation; Kyoto, Japan; BF306) will be used to compare the results of body composition obtained by anthropometry and by BIA as previously described (Lizana Arze et al., Int. J. Morphol 2011;29(4)_1364-1369). Briefly, manual bioimpedance devices work through the emission of low electrical currents (5KHz, 500mA). Body fluids and electrolytes are responsible for conductance, and cell membranes produce capacitance. Because adipose tissue is less hydrated than lean body tissue, more adipose tissue results in a smaller conducting volume or path for current and larger impedance to current passage.

Waist circumference (WC) in cm was measured midway between the lower margin of the last rib and the anterior and superior iliac spine. Consequently, the waist-height ratio (WHtR) will be calculated as WC(cm)/height(cm).

Hip circumference (HC) in cm was measured around the pelvis at the point of maximum protusion of the buttcocks and the waist-hip ratio (WHR) will then be calculated according to the formula WC(cm)/HC(cm).

Height was measured in cm with a portable stadiometer (Seca Corp.; Berlin, Germany; CE 0123) with a 0.1cm precision.

Body mass index (BMI) will be calculated as (Wt (kg))/(Ht (m^2)), as an index of general adiposity and cardiometabolic risk factor (high for individuals with overweight and obesity). BMI will be categorized as obese (≥ 30 kg/m²), overweight (25-29.9 kg/m²), or normal weight (< 25 kg/m²).

Increased risks of cardiometabolic morbidity will be defined as waist circumference (WC) ≥ 102 cm for men and ≥ 88 cm for women. Central obesity will be defined using a waist height ratio (WHtR = WC (cm)/height (cm)) cut-off point for high cardiovascular risk of > 0.50 for individuals <50 years and >0.6 for those >50 years, and waist-hip ratio (WHR = WC (cm)/HC(cm)) cut-offs of ≥ 1.00 for men and ≥ 0.85 for women. For % body fat mass (%FM), obesity will be defined as > 25% for men and > 35% for women, while overweight will be 20-25% and 30-35%, respectively.

Other indices will be subject to calculation as better indices of cardiovascular risk, and abdominal and gluteofemoral adiposity. The higher the values, the greater the adiposity and risk factor. Conicity index (CONI) calculated as (WC (m))/(0.109√((Wt (kg))/(Ht (m)))), body shape index (ABSI) calculated as (1000×(WC(m)×Wt(kg) )_^(-2/3)-(Ht(m)^(5/6) )); abdominal volume index (AVI) calculated as ((2×((WC(cm) )^2+(0.7×(WC(cm)-HC(cm) )^2))/1000; body roundness index (BRI) calculated as 364.2-365.5×√(1 - [WC/2π]2/[0.5×Ht2]); estimated Total Body Fat (eTBF) calculated as 100 * (-Z + A - B)/C, where A = (4.15*WC*39.3701), B = (0.082*Wt*2.20462), C = (Wt*2.20462), Z = 98.42 (men), Z = 76.76 (women); relative fat mass (RFM) calculated as 64 - (20*Ht/WC) + (12*S), where S = 0 (men), S = 1 (women); Hip Index (HI) calculated as HC * Wt -0.482*Ht0.310; Weight-adjusted Waist Index (WWI) calculated as (WC (m)×100)/(√Wt(kg)).

Male/female. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Age in years. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Manual/electric. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Number of times. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Name of the pathology. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Medications being used. Correlations between periodontal status, physical activity and anthropometric measurements will be analyzed.

Yes/No