Letter to the Editor: Authors’ Response

• Nathan ; Elizabeth ^[2] ; Henry M ^[1] ; Raul ^[3]
  1. [1] Rhoda Goldman Institute on Aging

     Rhoda Goldman Institute on Aging

     Estados Unidos

     
  2. [2] Kaye Krall
  3. [3] Garcia

  Mostrar afiliaciones +
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 86, Nº. 4, 2015, págs. 489-490
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • We appreciate the thoughtful comments in the letter. The author correctly notes that there are many other antioxidants in the diet in addition to those found in coffee. We highlighted the caffeine literature mainly because of our primary research question regarding coffee consumption and because the nutrient database for the food frequency questionnaire (FFQ) at that time had values only for caffeine and not for the chlorogenic acids and other phenols that make up a large part of the antioxidant, antibacterial, and anti-inflammatory compounds in coffee. We agree that our findings suggest that a valuable next step would be to add information on these other antioxidants to our database and reevaluate our hypothesis.

    The letter notes that in the Cornell Medical Index (CMI), the participants responded to the question “Do you drink more than six cups of coffee/tea a day”? and that participants who consumed more than six cups of coffee/tea per day had fewer teeth with alveolar bone loss (ABL) ≥40%. We used the FFQ data to verify the analyses using the CMI. The FFQ data did separate out tea, caffeinated, and decaffeinated coffee. The only one of those beverages that we found to be associated with ABL was caffeinated coffee.

    We also used the FFQ data to classify participants into two groups, one of which is more than one cup per day. It is important to note that the findings in our study cannot be extrapolated to coffee intakes beyond those we observed in our cohort. As Bezerra et al.1 stated, the daily caffeine dose used in the animal studies was equivalent to 16 cups of coffee. In contrast, the maximum daily caffeine intake in our cohort was 1,000 mg, or the equivalent of 10 cups of coffee. We also performed and reported on a regression analysis in which caffeine was treated as a continuous variable and found that the number of teeth with ABL also decreased with increasing caffeine intake.

    In the Dental Longitudinal Study questionnaire the participants were asked about “any periodontal treatment in the past year (yes or no),” but no further elaboration regarding the type of periodontal therapy was given. Periodontal treatment, as assessed by this single question, was included a priori in the regression models along with several factors (such as smoking) that may directly affect an individual’s outcome of alveolar bone loss. The effect of periodontal treatment was small and not statistically significant at P <0.05; therefore, the results were not substantially changed if it was removed from the models or if it remained.

    The authors report no conflicts of interest related to this letter. The authors report no conflicts of interest related to this study.