A new nationally representative study suggests that insufficient dietary lycopene—an antioxidant found in tomatoes and other red fruits—may increase the risk of severe periodontitis among older U.S. adults, with differences observed by race and sex.
Researchers analyzed data from 1,227 adults aged 65 to 79 who participated in the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2014. Dietary intake was measured using two-day recall interviews, with at least 8,000 µg of lycopene per day considered sufficient. Periodontitis severity was determined through standardized oral exams.
The study found that nearly half of participants (48.7%) had some form of periodontitis, and 77.9% reported insufficient lycopene intake. Severe periodontitis was less common among those with adequate lycopene intake (2.4% vs. 6.5%). After adjusting for age, sex, race, smoking, education, and other factors, sufficient lycopene intake was linked to a significantly lower likelihood of severe disease.
Racial and sex disparities were evident. Non-Hispanic Black adults were nearly three times more likely to have severe periodontitis compared with non-Hispanic White adults. Women had a lower risk of severe disease than men, particularly among non-Hispanic White participants. Stratified analyses showed that adequate lycopene intake was associated with reduced risk primarily in non-Hispanic White adults, but not in non-Hispanic Black adults.
Smoking remained a major risk factor, with current smokers showing markedly higher rates of severe periodontitis than former or never-smokers.
Lead author Katherine Kwong, from Connecticut College’s Department of Human Development, noted that behavioral, biological, and social factors may contribute to these disparities.
The study has limitations, including its cross-sectional design, which prevents establishing cause and effect. NHANES also does not capture dental insurance coverage or routine preventive care, and lycopene intake was measured from total diet without distinguishing between foods and supplements. The relatively small number of participants with severe periodontitis may have affected some subgroup analyses.
Despite these limitations, the findings suggest that dietary lycopene could be an important, modifiable factor for improving periodontal care in older adults, especially non-Hispanic White individuals. The researchers call for race- and sex-specific dietary approaches and recommend longitudinal studies and randomized trials to confirm whether increasing lycopene intake can prevent or slow periodontitis.