{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:35:52Z","timestamp":1793198152886,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100016924","name":"National Cerebral and Cardiovascular Center","doi-asserted-by":"crossref","award":["22-4-5"],"award-info":[{"award-number":["22-4-5"]}],"id":[{"id":"10.13039\/100016924","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology of Japan","doi-asserted-by":"crossref","award":["20390489"],"award-info":[{"award-number":["20390489"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Decreases in masticatory function are believed to be related to the development of cardiovascular disease (CVD) through inappropriate nutritional intake. This study focused on maximum bite force (MBF), which is an objective, quantitative index of masticatory function, and its association with the development of CVD (stroke and coronary heart disease) was investigated. The subjects were 1547 participants of the Suita study with no history of CVD who underwent medical and dental health examinations between June 2008 and June 2013. In addition to undergoing a basic physical examination at baseline, their MBF was measured. They subsequently underwent follow-up surveys for the development of CVD (mean follow-up, 3.5\u00a0years). The association between baseline MBF and the development of CVD was investigated by multivariate adjustment using a Cox proportional hazards model. CVD developed in 32 subjects during follow-up. The trend test showed a significant association between baseline MBF and CVD in a model that combined men and women. When analysed by sex, the trend test found a significant association between baseline MBF and CVD in women. Low MBF, which is an objective and quantitative index of masticatory function, may be a risk factor for the development of CVD.<\/jats:p>","DOI":"10.1038\/s41598-021-87252-5","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T10:12:21Z","timestamp":1617790341000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["A lower maximum bite force is a risk factor for developing cardiovascular disease: the Suita study"],"prefix":"10.1038","volume":"11","author":[{"given":"Sakae","family":"Hashimoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Kosaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michikazu","family":"Nakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoyo","family":"Kida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuri","family":"Fushida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Kokubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Higashiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunori","family":"Ikebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Ono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"87252_CR1","unstructured":"Preventing chronic disease: a vital investment. World Health Organization 2005."},{"key":"87252_CR2","first-page":"197","volume":"59","author":"A Blaizot","year":"2009","unstructured":"Blaizot, A. et al. Periodontal diseases and cardiovascular events: meta-analysis of observational studies. Int. Dent. J. 59, 197\u2013209 (2009).","journal-title":"Int. Dent. J."},{"key":"87252_CR3","doi-asserted-by":"publisher","first-page":"2520","DOI":"10.1161\/CIR.0b013e31825719f3","volume":"125","author":"PB Lockhart","year":"2012","unstructured":"Lockhart, P. B. et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?. Circulation 125, 2520\u20132544 (2012).","journal-title":"Circulation"},{"key":"87252_CR4","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1902\/jop.2010.090680","volume":"81","author":"A Holmlund","year":"2010","unstructured":"Holmlund, A., Holm, G. & Lind, L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years. J. Periodontol. 81, 870\u2013876 (2010).","journal-title":"J. Periodontol."},{"key":"87252_CR5","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1177\/0022034515586352","volume":"94","author":"JM Liljestrand","year":"2015","unstructured":"Liljestrand, J. M. et al. Missing teeth predict incident cardiovascular events, diabetes, and death. J. Dent. Res. 94, 1055\u20131062 (2015).","journal-title":"J. Dent. Res."},{"key":"87252_CR6","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s00784-011-0625-9","volume":"16","author":"I Polzer","year":"2012","unstructured":"Polzer, I. et al. The association of tooth loss with all-cause and circulatory mortality. Is there a benefit of replaced teeth? A systematic review and meta-analysis. Clin. Oral. Invest. 16, 333\u201351 (2012).","journal-title":"Clin. Oral. Invest."},{"key":"87252_CR7","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1097\/HJR.0b013e3282f14a6d","volume":"15","author":"T Ansai","year":"2008","unstructured":"Ansai, T. et al. Association of chewing ability with cardiovascular disease mortality in the 80-year-old Japanese population. Eur. J. Cardiovasc. Prev. Rehabil. 15, 104\u2013106 (2008).","journal-title":"Eur. J. Cardiovasc. Prev. Rehabil."},{"key":"87252_CR8","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1177\/0022034511414423","volume":"90","author":"J Aida","year":"2011","unstructured":"Aida, J. et al. Oral health and cancer, cardiovascular, and respiratory mortality of Japanese. J. Dent. Res. 90, 1129\u20131135 (2011).","journal-title":"J. Dent. Res."},{"key":"87252_CR9","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.jdent.2004.09.002","volume":"33","author":"K Ikebe","year":"2005","unstructured":"Ikebe, K. et al. Association of bite force with ageing and occlusal support in older adults. J. Dent. 33, 131\u2013137 (2005).","journal-title":"J. Dent."},{"key":"87252_CR10","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1111\/joor.12214","volume":"41","author":"T Okada","year":"2014","unstructured":"Okada, T. et al. Association of periodontal status with occlusal force and food acceptability in 70-year-old adults: from SONIC Study. J. Oral. Rehabil. 41, 912\u2013919 (2014).","journal-title":"J. Oral. Rehabil."},{"key":"87252_CR11","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/j.1532-5415.2011.03780.x","volume":"60","author":"T Iinuma","year":"2012","unstructured":"Iinuma, T. et al. Maximum occlusal force and physical performance in the oldest old: the Tokyo oldest old survey on total health. J. Am. Geriatr. Soc. 60, 68\u201376 (2012).","journal-title":"J. Am. Geriatr. Soc."},{"key":"87252_CR12","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1111\/joor.12371","volume":"43","author":"T Kosaka","year":"2016","unstructured":"Kosaka, T. et al. A multifactorial model of masticatory performance: the Suita study. J. Oral. Rehabil. 43, 340\u2013347 (2016).","journal-title":"J. Oral. Rehabil."},{"key":"87252_CR13","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.jdent.2014.02.015","volume":"42","author":"C Inomata","year":"2014","unstructured":"Inomata, C. et al. Significance of occlusal force for dietary fibre and vitamin intakes in independently living 70-year-old Japanese: from SONIC Study. J. Dent. 42, 556\u2013564 (2014).","journal-title":"J. Dent."},{"key":"87252_CR14","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1161\/HYPERTENSIONAHA.108.118273","volume":"52","author":"Y Kokubo","year":"2008","unstructured":"Kokubo, Y. et al. Impact of high-normal blood pressure on the risk of cardiovascular disease in a Japanese urban cohort: the Suita study. Hypertension 52, 652\u2013659 (2008).","journal-title":"Hypertension"},{"key":"87252_CR15","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.1038\/s41440-019-0284-9","volume":"42","author":"S Umemura","year":"2019","unstructured":"Umemura, S. et al. The Japanese society of hypertension guidelines for the management of hypertension (JSH2019). Hypertens. Res. 42, 1235\u20131481 (2019).","journal-title":"Hypertens. Res."},{"key":"87252_CR16","first-page":"1985","volume":"47","author":"R Little","year":"2001","unstructured":"Little, R. et al. The national glycohemoglobin standardization program: a five-year progress report. Clin. Chem. 47, 1985\u20131992 (2001).","journal-title":"Clin. Chem."},{"key":"87252_CR17","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s13340-010-0006-7","volume":"1","author":"Y Seino","year":"2010","unstructured":"Seino, Y. et al. Report of the committee on the classification and diagnostic criteria of diabetes mellitus. Diabetol. Int. 1, 2\u201320 (2010).","journal-title":"Diabetol. Int."},{"key":"87252_CR18","doi-asserted-by":"crossref","unstructured":"Hidaka O, Iwasaki M, Saito M, et al. T. Influence of clenching intensity on bite force balance, occlusal contact area, and average bite pressure. J Dent Res 1999; 78: 1336\u201344.","DOI":"10.1177\/00220345990780070801"},{"key":"87252_CR19","first-page":"386","volume":"10","author":"T Suzuki","year":"1997","unstructured":"Suzuki, T. et al. Evaluation of complete denture occlusal contacts using pressure-sensitive sheets. Int. J. Prosthodont. 10, 386\u2013391 (1997).","journal-title":"Int. J. Prosthodont."},{"key":"87252_CR20","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1111\/j.1365-2842.1996.tb00891.x","volume":"23","author":"Y Matsui","year":"1996","unstructured":"Matsui, Y. et al. A computerized method for evaluating balance of occlusal load. J. Oral. Rehabil. 23, 530\u2013535 (1996).","journal-title":"J. Oral. Rehabil."},{"key":"87252_CR21","doi-asserted-by":"publisher","first-page":"846","DOI":"10.5551\/jat.GL2017","volume":"25","author":"M Kinoshita","year":"2018","unstructured":"Kinoshita, M. et al. Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017. J. Atheroscler. Thromb. 25, 846\u2013984 (2018).","journal-title":"J. Atheroscler. Thromb."},{"key":"87252_CR22","first-page":"281","volume":"32","author":"J Ainamo","year":"1982","unstructured":"Ainamo, J. et al. Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int. Dent. J. 32, 281\u2013291 (1982).","journal-title":"Int. Dent. J."},{"key":"87252_CR23","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.1177\/00220345990780070801","volume":"78","author":"O Hidaka","year":"1999","unstructured":"Hidaka, O. et al. Influence of clenching intensity on bite force balance, occlusal contact area, and average bite pressure. J. Dent. Res. 78, 1336\u20131344 (1999).","journal-title":"J. Dent. Res."},{"key":"87252_CR24","first-page":"I13","volume":"12","author":"AE Walker","year":"1981","unstructured":"Walker, A. E., Robins, M. & Weinfeld, F. D. The national survey of stroke Clinical findings. Stroke 12, I13\u2013I44 (1981).","journal-title":"Stroke"},{"key":"87252_CR25","unstructured":"Document for meeting of MONICA Principal Investigators. In: WHO, editors. MONICA Project: Event Registration Data Component, MONICA Manual, Version 1.1. World Health Organization 1986;S-4:9\u201311."},{"key":"87252_CR26","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1177\/154411130201300306","volume":"13","author":"CS Ritchie","year":"2002","unstructured":"Ritchie, C. S. et al. Nutrition as a mediator in the relation between oral and systemic disease: associations between specific measures of adult oral health and nutrition outcomes. Crit. Rev. Oral. Biol. Med. 13, 291\u2013300 (2002).","journal-title":"Crit. Rev. Oral. Biol. Med."},{"key":"87252_CR27","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1111\/j.1600-0528.2009.00512.x","volume":"38","author":"K Wakai","year":"2010","unstructured":"Wakai, K. et al. Tooth loss and intakes of nutrients and foods: a nationwide survey of Japanese dentists. Commun. Dent Oral Epidemiol. 38, 43\u201349 (2010).","journal-title":"Commun. Dent Oral Epidemiol."},{"key":"87252_CR28","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1093\/ajcn\/78.3.383","volume":"78","author":"LM Steffen","year":"2003","unstructured":"Steffen, L. M. et al. Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC)Study. Am. J. Clin. Nutr. 78, 383\u2013390 (2003).","journal-title":"Am. J. Clin. Nutr."},{"key":"87252_CR29","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1038\/ejcn.2014.276","volume":"69","author":"N Okuda","year":"2015","unstructured":"Okuda, N. et al. Fruit and vegetable intake and mortality from cardiovascular disease in Japan: a 24-year follow-up of the NIPPON DATA80 Study. Eur. J. Clin. Nutr. 69, 482\u2013488 (2015).","journal-title":"Eur. J. Clin. Nutr."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-87252-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-87252-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-87252-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T06:21:54Z","timestamp":1670048514000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-87252-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,7]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["87252"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-87252-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,7]]},"assertion":[{"value":"8 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7671"}}