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ADA urges more sugars, oral health research

April 29, 2015

By Craig Palmer

Before Congress: ADA President Maxine Feinberg April 29 urges NIDCR to investigate relationships between diet, nutrition and oral health. Photo by Fred Watkins
Washington – The Association urged the National Institute of Dental and Craniofacial Research in congressional testimony April 29 "to conduct more research on the effects of added sugars, sweeteners and artificial sweeteners on oral health" and Congress to appropriate funds to support the effort.

"Additionally, we are urging other federal research agencies to carve out a role for oral health when conducting any nutrition-related research," ADA president Maxine Feinberg told the House Appropriations Committee panel that has jurisdiction over the federal health research budget. The health and human services subcommittee invited ADA testimony on fiscal year 2016 appropriations and Dr. Feinberg was the Association witness at the hearing.

The Association requested a $425 million appropriation for the NIDCR, one of the National Institutes of Health, and urged the NIDCR to use "a portion of its resources" to investigate relationships between diet, nutrition and oral health.

Earlier this year, the 2015 Dietary Guidelines Advisory Committee reported there was a moderate degree of consistent evidence supporting a relationship between the amount of free sugars intake and the development of dental caries among children and adults.

"Mr. Chairman, considering how much money the federal government has already spent on nutrition research examining the relationship between dietary sugars and obesity — and associations with cardiovascular disease, type 2 diabetes and other health conditions — why is there still only a moderate degree of consistent evidence addressing the volume of added sugar(s) and artificial sweeteners consumed and the development of caries?" Dr. Feinberg said. "Surely we can do better than that."

NIDCR has funded a number of studies on sugar and sweeteners ranging from the impact of dietary interventions to trends in early childhood caries based on cariogenic beverage consumption. The Institute spent $9.3 million on nutrition-related research in fiscal year 2014.

"Many factors are involved in the development of caries, but there is a clear consensus that both the types of food consumed and the eating behaviors themselves are key components," the NIDCR said.

For many years, the ADA has pursued a "carrot" approach to encourage people to adopt healthier diets, Dr. Feinberg said.

"Mr. Chairman, we recognize and share the national concern about obesity," the ADA said in the written testimony. "We recognize the growing popularity of taxing sugar-sweetened beverages and pursuing other measures to tackle the epidemic of obesity," Dr. Feinberg said. "The ADA is primarily concerned with whether and how these policies would reduce the prevalence of dental caries. Compared to the available data on obesity, however, the available research on dental caries is lacking."

"We would like to see demonstration projects evaluating whether sugar-sweetened beverage taxes and other disincentive pricing strategies will lower dental caries rates over the life span, or whether consumers will simply switch to other foods that may further increase the risk for dental caries."

Dr. Feinberg also called for studies examining the synergistic effect of acids and sugars on dental caries and ways to leverage nutrition counseling in dental settings to improve oral health outcomes.

The Department of Health and Human Services and the Department of Agriculture are accepting comments on the 2015 Dietary Guidelines Advisory Committee's scientific report. Comments are due May 8.