Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III) Nelson Wood, Roger B. Johnson, and Charles F. Streckfus Department of Periodontics, University of Mississippi School of Dentistry, Jackson, MS, USA Wood N, Johnson RB, Streckfus CF: Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol 2003; 30: 321–327. r Blackwell Munksgaard, 2003. Abstract Objectives: The objective of this study was to investigate the association of body composition (obesity) and periodontal disease using simple, inexpensive nutritional assessment techniques available in the Third National Health and Nutrition Examination Survey (NHANES III). Material and Methods: Caucasian subjects, aged 18 years and above, participating in NHANES III, were used for this study. Weight, height, waist circumference, hip circumference, skinfold thickness (S), and bioelectrical impedance analysis measurements were performed and used in the calculation of body mass index (BMI), waist-to-hip ratio (WHR) (visceral fat), log sum of S (subcutaneous fat), and fat-free mass (FFM). Data were analyzed using SPSS s . One-way, factorial ANOVA, multivariate analyses, and regression curve analyses were performed. po0.05 was used to reject the null hypothesis. Results: Adjusting for age, gender, history of diabetes, current smoking, and socioeconomic status, statistically significant correlations were found between periodontitis and WHR, BMI, FFM, and in some instances S. Conclusion: This study, indicating significant correlations between body composition and periodontal disease (with WHR being the most significant, followed by BMI, FFM, and S), showed similarities to those observed in other obesity-related health problems. This strengthened arguments that periodontal disease and certain obesity- related systemic illnesses are related, with abnormal fat metabolism possibly being an important factor. Key words: periodontitis; body composition; waist-to-hip ratio; body mass index; free-fat mass; skinfold thickness Accepted for publication 4 April 2002 Obesity, the most common nutritional disorder in America (Kopelman 2000), is a significant risk factor for numerous adult diseases, and may be a factor in the incidence of periodontitis. Body mass index (BMI) (Elter et al. 2000, Grossi & Ho 2000, Wood & Johnson 2001), waist-to-hip circumference ratio (WHR), body fat, and maximum oxygen consumption (Saito et al. 1998, 2000, 2001) may be factors in the incidence of this disease. Conditions associated with obesity, e.g. ‘‘the metabolic syndrome’’, a clustering of dyslipidemia and insulin resistance (Vanhala et al. 1997) may exacerbate periodontitis (Grossi & Ho 2000). Long-term interest in the role of nutrition and periodontal disease (Rus- sell et al. 1961, Russell 1963, Oles 1966, Alfano 1976, Muroff et al. 1979, Carlos & Wolfe 1989) questions the role of nutrients in periodontal disease pathogenesis (Carlos & Wolfe 1989). J Clin Periodontol 2003; 30: 321–327 Copyright r Blackwell Munksgaard 2003 Printed in Denmark. All rights reserved