Influence of Vegetarian Diet on Calcium, Magnesium and Carbonate Level in Saliva

ORIGINAL PAPERS Dent. Med. Probl. 2007, 44, 2, 172 176 ISSN 1644 387X Copyright by Silesian Piasts University of Medicine in Wrocław and Polish Stomatological Association KATARZYNA HERMAN Influence of Vegetarian Diet on Calcium, Magnesium and Carbonate Level in Saliva Wpływ diety wegetariańskiej na stężenie wapnia, magnezu i węglanów w ślinie Department of Conservative Dentistry and Paedodontics, Silesian Piasts University of Medicine in Wrocław, Poland Abstract Background. Nowadays, a lot of people are interested in vegetarian diet. The possible influence of this diet on oral health is still unclear. Objectives. The aim of this study is to determine whether vegetarian diet may influence calcium, magnesium and carbonates level in saliva. Material and Methods. 92 healthy subjects, 64 women and 28 men were examined. They were divided into two groups: I vegetarian group and II control group. Group I consisted of 46 vegetarians, 32 women and 14 men. Group II consisted of age and sex matched omnivores. Unstimulated mixed saliva was collected. Values of its flow rate and levels of calcium, magnesium and carbonates were determined. Output of these components was also cal culated. Results. Average salivary flow rate was lower in group I but the difference was not statistically significant. Avera ge level of calcium was similar in both groups. Lower level and output of magnesium and carbonates were found in group I. The difference in concentration and output of magnesium was statistically significant and the differen ce in concentration and output of carbonates was close to statistical significance. Conclusions. Vegetarian diet reduces slightly unstimulated salivary flow rate and the level of carbonates but causes significant decrease in saliva magnesium concentration (Dent. Med. Probl. 2007, 44, 2, 172 176). Key words: vegetarian diet, saliva. Streszczenie Wprowadzenie. Obecnie obserwuje się powszechne zainteresowanie dietą wegetariańską. Ciągle nie jest wyja śniony wpływ tej diety na jamę ustną. Cel pracy. Określenie wpływu diety wegetariańskiej na stężenie wapnia, magnezu i węglanów w ślinie. Materiał i metody. Zbadano 92 zdrowe osoby, w tym 64 kobiety i 28 mężczyzn. Podzielono ich na 2 grupy: I grupa wegetarian i II grupa kontrolna. Grupa I składała się z wegetarian, w tym z 32 kobiet i 14 mężczyzn. Grupa II składała się ze sparowanych pod względem wieku i płci w odniesieniu do grupy I osób wszystkożernych. Zbierano niestymulowaną ślinę mieszaną. Określono szybkość wydzielania śliny oraz stężenia wapnia, magnezu i węglanów w ślinie. Wyliczono także szybkość wypływu tych składników śliny. Wyniki. Średnia szybkość wydzielania śliny była mniejsza w grupie I, lecz różnica ta nie była istotna statystycz nie. Średnie stężenie wapnia było podobne w obu grupach. W grupie I wykazano mniejsze stężenia i szybkość wy pływu magnezu i węglanów w ślinie. Różnice w stężeniu i szybkości wypływu magnezu były istotne statystycz nie, a różnice w stężeniu i szybkości wypływu węglanów były zbliżone do istotności statystycznej. Wnioski. Dieta wegetariańska nieznacznie zmniejsza szybkość wydzielania śliny niestymulowanej oraz stężenie wę glanów w ślinie, istotnie natomiast zmniejsza stężenie magnezu w ślinie (Dent. Med. Probl. 2007, 44, 2, 172 176). Słowa kluczowe: dieta wegetariańska, ślina. We have been experiencing food habit chan ges and interest in different diets recently. One of the most popular is a vegetarian diet which is based on eliminating consumption of meat. On the one hand, the influence of such diet on general health condition is well known and many resear

Influence of Vegetarian Diet on Calcium, Magnesium and Carbonate Level in Saliva 173 ches have been carried out on this subject. On the other hand, few papers have been devoted to its possible influence on oral health. One of the most important factor in maintaining homeostasis in oral cavity is saliva. Saliva consists mainly of wa ter but it contains a lot of organic and inorganic compounds as well. Calcium ions take a signifi cant part in remineralization process. Calcium su persaturated saliva is one of the factors preventing enamel demineralisation. Ionised calcium fraction is of particular significance [1]. Magnesium is al so an important component of saliva. Its role is not clear yet. It is known to play a part as a co factor of many enzymes taking part in metabolism of proteins, carbohydrates, fats, and nucleic acids. It is also essential for immunologic processes, in par ticular for humoral response. It has been shown that its level in saliva is lower than in blood [2, 3]. Some researches found some unclear dependence between high concentration of magnesium in sali va and susceptibility to caries [4 6]. Carbonates constitute the most important buffer system which controls ph of saliva. Their concentration is repor ted to be correlated with saliva flow rate [7]. The aim of this study is to determine if vege tarian diet can influence calcium, magnesium and carbonates level in saliva. Material and Methods 92 healthy subjects, 64 women and 28 men were examined. They were from 17 to 51 years old. They were divided into two groups: I vegetarian group and II control group. Group I consisted of 46 vegetarians, 32 women and 14 men. The dura tion of vegetarian diet was between 1 and 18 years (the mean duration was 9 years). Group II consi sted of age and sex matched omnivores. The mean age of subjects in both groups was 29 (Tab. 1). The individuals from group I were lactovege tarians. Their diet consisted of fruit, vegetables and dairy products. 76% of them were lactoovo vegetarians (their diet included eggs). Unstimulated mixed saliva (5 ml) was collec ted at least 2 hours after the meal. The samples were centrifuged at 4000 rpm. The flow rate (V) (ml/min) was calculated. Levels of calcium (Ca) (mg/ml), magnesium (Mg) (mg/ml) and carbona tes (meq/l 10 3 ) were determined and expressed also as 1 minute output. The data were analysed statistically using Stu dent s t test, U Mann Whitney test (when distribu tion deviated from normal) at confidence level Pearson and Spearman s correlation co efficients were also calculated. Results Average salivary flow rate in both groups was within the accepted range (0.33 0.55 ml/min) but lower in vegetarians. Average level of calcium was similar in both groups. Lower level and output of magnesium and car bonates were present in group I. The difference in concentration and output of magnesium was stati stically significant and the difference in concentra tion and output of carbonates was close to statisti cal significance (Tab. 2, Tab. 3). In vegetarian wo men, Mg output was significantly lower than in omnivorous women. Correlation analysis between examined parameters of saliva and the duration of vegetarian diet did not show any significant re sults. There was a significant negative correlation between the level of magnesium and age as well as a positive correlation between the concentration of Ca and Mg in vegetarians (Tab. 4). No such corre lations were present in group II in which a negati ve correlation between calcium and carbonates was observed. The negative correlation between magnesium and carbonate was close to statistical significance (Tab. 5). Discussion There are few papers devoted to the influence of vegetarian diet on the level of components of saliva and conclusions drawn are not always com patible. Linkosalo and Markkanen [8], Linkosalo et al. [9] observed that average salivary flow rate is lower in vegetarians and was not dependent on age. In contrast among controls, a fall in flow rate with age was shown. The data presented in this pa pier has not confirmed that. Another study showed a higher salivary flow rate in vegetarian [10]. But the statistically significant correlations were not shown in the above mentioned papers. Different results were shown by Johansson and Birkhed [11]. They carried a research on 29 subjects who turned to vegetarian diet for one year. The authors obse rved a significant increase of salivary flow rate in subjects and associated it with high consumption of tough food (fruit and vegetables) which could have a stimulating effect on saliva secretion. They suggested also a possible influence of different composition and nutritional value of consumed food. After returning to a mixed diet the salivary flow rate tended to decrease. Other researches con firm increased salivary flow rate in vegetarians [12]. Linkosalo et al. [9] did not observed significant difference in the level of calcium between vegeta rians and the control group which is compatible with my own research.

174 K. HERMAN Table. 1. Number of examined subjects Tabela 1. Liczba badanych osób Sex Group I Group II (Płeć) (Grupa I) (Grupa I) number of subjects mean age years mean duration number of subjects mean age years (liczba osób) (średni wiek of vegetarian diet (liczba osób) (średni wiek n (%) lata) (średni czas n (%) lata) trwania diety wegetariańskiej) Women 32 (69.6) 28 9 32 (69.6) 28 (Kobiety) Men 14 (30.4) 34 10 14 (30.4) 34 (Mężczyźni) Total 46 (100) 30 9 46 (100) 30 (Razem) Table 2. Mean levels of salivary flow rate, Ca, Mg and carbonate concentrations Tabela 2. Średnie wydzielanie śliny oraz stężenia wapnia, magnezu i węglanów w ślinie Group I (n = 46) Group II (n = 46) women men total women men total (kobiety) (mężczyźni) (razem) (kobiety) (mężczyźni) (razem) x ± SD x ± SD x ± SD x ± SD x ± SD x ± SD V (ml/min) 0.32 ± 0.20 0.44 ± 0.31 0.35 ± 0.24 0.43 ± 0.36 0.46 ± 0.25 0.43 ± 0.33 Ca (mg/ml) 0.0622 ± 0.0968 ± 0.0727 ± 0.0764 ± 0.0558 ± 0.0702 ± 0.0336 0.0554 0.0444 0.0507 0.0262 0.0457 Mg (mg/ml) 0.0062 ± 0.0066 ± 0.0063 ± 0.0084 ± 0.0090 ± 0.0086 ± 0.0046 0.0034 0.0043 0.0044 0.0044 0.0044 Carbonate 22.91 ± 3.47 23.28 ± 3.15 23.18 ± 3.40 24.30 ± 2.98 24.22 ± 1.98 24.27 ± 2.71 meq/ml 10 3 Close to stastistical significance. Zbliżone do istotności statystycznej. Table 3. Mean output of Ca, Mg and carbonate Tabela 3. Średnia szybkość wypływu Ca, Mg i węglanów Group I (n = 46) Group II (n = 46) women men total women men total (kobiety) (mężczyźni) (razem) (kobiety) (mężczyźni) (razem) x ± SD x ± SD x ± SD x ± SD x ± SD x ± SD Ca 0.0196 ± 0.0413 ± 0.0257 ± 0.0357 ± 0.0260 ± 0.0330 ± (mg/min) 0.0182 0.0365 0.0261 0.0502 0.0192 0.0438 Mg 0.0017 ± 0.0032 ± 0.0022 ± 0.0034 ± 0.0046 ± 0.0038 ± (mg/min) 0.0016 0.0035 0.0024 0.0039 0.0041 0.0040 Carbonate 7.29 ± 4.85 11.07 ± 8.69 8.34 ± 6.29 10.56 ± 9.42 11.30 ± 6.91 10.77 ± 8.72 meq/ml 10 3 Close to stastistical significance. Zbliżone do istotności statystycznej.

Influence of Vegetarian Diet on Calcium, Magnesium and Carbonate Level in Saliva 175 Table 4. Values of correlation coefficient in group I Tabela 4. Wartości współczynników korelacji w grupie I V V Ca Mg Carbonate Ca 0.010 Mg 0.117 0.283 Carbonate 0.004 0.014 0.084 Age 0.051 0.048 * 0.172 (Wiek) 0.302 Duration 0.229 0.146 0.163 0.218 of diet (Czas trwa nia diety) * p < 0,05. Close to stastistical significance. Zbliżone do istotności statystycznej. I was not able to compare the results of my re search on the influence of vegetarian diet on the Table 5. Values of correlation coefficient in group II Tabela 5. Wartości współczynników korelacji w grupie II V Ca 0.315 V Ca Mg Carbonate Mg 0.122 0,099 Carbonate 0.106 * 0.318 0.26 Age (Wiek) 0.143 0.076 0.161 0.164 * p < 0,05. Close to stastistical significance. Zbliżone do istotności statystycznej. level of magnesium in saliva with other papers. Some research showed no differences in plasma Mg level between vegetarians and nonvegetarians [13 15]. Since the level of magnesium in saliva was found to be significantly lower in vegetarians, it is appropriate to carry out further research to explain it. References [1] LAGERLÖF F., OLIVERBY A.: Caries protective factors in saliva. Adv. Dent. Res. 1994, 8, 229 238. [2] MANDEL I. D.: Relation of saliva and plaque to caries. J. Dent. Res. 1974, 43, Suppl. 2, 246 266. [3] MÄKKINEN K.K.: Studies on oral enzymes. II. Fraction and characterization of aminopeptidases in human dental plaque. Acta Odont. Scand. 1966, 24, 605 608. [4] CIEŚLAK M., JĘDRZEJEWSKA T., ZGIRSKI A.: Badanie zawartości magnezu, żelaza i miedzi w ślinie ludzi zdrowych. Czas. Stomat. 1990, 43, 202 204. [5] KACZMAREK U.: Poziom fluoru w wodzie pitnej a zachowanie się niektórych składników śliny i występowanie próchnicy. Czas. Stomat. 1979, 32, 7, 657 633. [6] SOŁTAN E.: Aktywność leucyloaminopeptydazy śliny w niektórych schorzeniach jamy ustnej. Praca doktorska, AM Wrocław 1997. [7] WASZKIEL D., CHOROMAŃSKA M., MARCZUK KOLADA G.: Ocena wybranych właściwości fizykochemicznych śli ny u osób z nadżerkami szkliwa. Czas. Stomat. 2002, 55, 775 782. [8] LINKOSALO E., MARKKANEN H.: Dental erosions in relation to lactovegetarian diet. Scand. J. Dent. 1985, 93, 436 441. [9] LINKOSALO E., OHTONEN S., MARKKANEN H.: Caries, periodontal status and some salivary factors in lactovegeta rians. Scand. J. Dent. 1985b, 93, 4, 304 308. [10] LINKOSALO E., MARKKANEN H., SYRJANEN S.: Effects of a lacto ovo vegetarian diet on the free amino acid com position of wax stimulated whole human saliva. J. Nutr. 1985, 115, 588 592. [11] JOHANSSON G., BIRKHED D.: Effect of a long term change from a mixed to a lactovegetarian diet on human saliva. Archs. Oral Biol. 1994, 39, 4, 283 288. [12] JOHANSSON G., RAVALD N.: Comparison of some salivary variables between vegetarians and omnivores. Eur. J. Oral Sci. 1995,103, 95 98. [13] HUNT J.R., MATTHYS L.A., JOHNSON L.K.: Zinc absorption, mineral balance and blood lipids in women consuming controlled lactoovovegetarian and omnivorous diet. Am. J. Clin. Nutr. 1998, 67, 3, 421 430. [14] KADRABOVA J., MADARIC A., GINTER E.: Selenium status, plasma zinc, cooper and magnesium in vegetarians. Biol. Trace Elem. Res. 1995, 50, 1, 13 24. [15] LEVIN N., RATTAN J., GILAT T.: Mineral intake and blood levels in vegetarians. Isr. J. Med. Sci. 1986, 22, 2, 105 108.

176 K. HERMAN Address for correspondence: Katarzyna Herman Department of Conservative Dentistry and Paedodontics Silesian Piast University of Medicine Krakowska 26 50 425 Wrocław Tel.: +48 71 784 03 62 E mail: ksherman@wp.pl Received: 1.02.2007 Revised: 5.06.2007 Accepted: 5.06.2007 Praca wpłynęła do Redakcji: 1.02.2007 r. Po recenzji: 5.06.2007 r. Zaakceptowano do druku: 5.06.2007 r.