{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:55:18Z","timestamp":1789181718179,"version":"build-2803163510"},"reference-count":200,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Periodontal diseases, including gingivitis and periodontitis, are chronic inflammatory conditions that compromise the supporting structures of the teeth, often leading to tooth loss and contributing to systemic comorbidities. Increasing evidence underscores the critical role of modifiable lifestyle factors, particularly diet and physical activity, in influencing periodontal health. This narrative review critically evaluates the current body of literature regarding the impact of dietary constituents and physical activity on the periodontium, with a focus on the molecular mechanisms, key biomarkers, and clinical implications. It aims to provide a deeper understanding of the complex interactions between nutrition, exercise, and periodontal health with potential implications for clinical management and preventive strategies.<\/jats:p>","DOI":"10.3390\/dj13050200","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T03:50:43Z","timestamp":1746071443000},"page":"200","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Influence of Diet and Physical Activity on Periodontal Health: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2760-8956","authenticated-orcid":false,"given":"Giuseppe","family":"Balice","sequence":"first","affiliation":[{"name":"Department of Innovative Technologies in Medicine and Dentistry, \u201cG. 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D\u2019Annunzio\u201d University, 66100 Chieti-Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Di Gregorio","sequence":"additional","affiliation":[{"name":"Department of Innovative Technologies in Medicine and Dentistry, \u201cG. D\u2019Annunzio\u201d University, 66100 Chieti-Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Femminella","sequence":"additional","affiliation":[{"name":"Department of Innovative Technologies in Medicine and Dentistry, \u201cG. 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J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/jcpe.12732","article-title":"Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action","volume":"44","author":"Tonetti","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1002\/JPER.21-0120","article-title":"Dysbiosis revisited: Understanding the role of the oral microbiome in the pathogenesis of gingivitis and periodontitis: A critical assessment","volume":"92","author":"Scannapieco","year":"2021","journal-title":"J. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/JPER.21-0211","article-title":"The 2018 classification of periodontal diseases: Its predictive value for tooth loss","volume":"93","author":"Stocker","year":"2022","journal-title":"J. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Bianchi, S., Mancini, L., Torge, D., Cristiano, L., Mattei, A., Varvara, G., Macchiarelli, G., Marchetti, E., and Bernardi, S. (2021). Bio-Morphological Reaction of Human Periodontal Ligament Fibroblasts to Different Types of Dentinal Derivates: In Vitro Study. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22168681"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Shi, X., Zhu, P., Du, M., Deng, K., Li, P., S\u00e1enz-Ravello, G., Xu, S., and Li, A. (2024). Dietary patterns and periodontitis: A systematic review. J. Periodontal Res.","DOI":"10.1111\/jre.13346"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cao, R., Qiu, P., Zhou, Y., Dong, B., Han, Y., and Fan, Z. (2023). The underlying relationship between exercise and the prevalence of periodontitis: A systematic review and meta-analysis. BMC Sports Sci. Med. Rehabil., 15.","DOI":"10.1186\/s13102-023-00759-4"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1203S","DOI":"10.1093\/ajcn\/54.6.1203s","article-title":"Molecular basis for the deficiency in humans of gulonolactone oxidase, a key enzyme for ascorbic acid biosynthesis","volume":"54","author":"Nishikimi","year":"1991","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/S0304-4165(99)00123-3","article-title":"Random nucleotide substitutions in primate nonfunctional gene for L-gulono-\u03b3-lactone oxidase, the missing enzyme in L-ascorbic acid biosynthesis","volume":"1472","author":"Ohta","year":"1999","journal-title":"Biochim. Biophys. Acta Gen. Subj."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1016\/0003-9861(88)90093-8","article-title":"Occurrence in humans and guinea pigs of the gene related to their missing enzyme l-gulono-\u03b3-lactone oxidase","volume":"267","author":"Nishikimi","year":"1988","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Murererehe, J., Uwitonze, A.M., Nikuze, P., Patel, J., and Razzaque, M.S. (2022). Beneficial Effects of Vitamin C in Maintaining Optimal Oral Health. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.805809"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Buzatu, R., Luca, M.M., and Bumbu, B.A. (2024). Does Vitamin C Supplementation Provide a Protective Effect in Periodontal Health? A Systematic Review and Meta-Analysis. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25168598"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/s13054-015-1131-2","article-title":"Ascorbate-dependent vasopressor synthesis: A rationale for vitamin C administration in severe sepsis and septic shock?","volume":"19","author":"Carr","year":"2015","journal-title":"Crit. Care"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ka\u017amierczak-Bara\u0144ska, J., Boguszewska, K., Adamus-Grabicka, A., and Karwowski, B.T. (2020). Two Faces of Vitamin C-Antioxidative and Pro-Oxidative Agent. Nutrients, 12.","DOI":"10.3390\/nu12051501"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Carr, A.C., and Maggini, S. (2017). Vitamin C and Immune Function. Nutrients, 9.","DOI":"10.3390\/nu9111211"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1189\/jlb.0903415","article-title":"Ascorbate-mediated enhancement of reactive oxygen species generation from polymorphonuclear leukocytes: Modulatory effect of nitric oxide","volume":"75","author":"Sharma","year":"2004","journal-title":"J. Leukoc. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1189\/jlb.0806541","article-title":"Ascorbate deficiency results in impaired neutrophil apoptosis and clearance and is associated with up-regulation of hypoxia-inducible factor 1\u03b1","volume":"81","author":"Vissers","year":"2007","journal-title":"J. Leukoc. Biol."},{"key":"ref_19","first-page":"837","article-title":"Oral scurvy and periodontal disease","volume":"63","author":"Touyz","year":"1997","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_20","first-page":"36","article-title":"Nutrition for oral health and oral manifestations of poor nutrition and unhealthy habits","volume":"65","author":"Pflipsen","year":"2017","journal-title":"Gen. Dent."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s12969-015-0020-1","article-title":"Childhood scurvy: An unusual cause of refusal to walk in a child","volume":"13","author":"Alqanatish","year":"2015","journal-title":"Pediatr. Rheumatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1542\/peds.108.3.e55","article-title":"An orange a day keeps the doctor away: Scurvy in the year 2000","volume":"108","author":"Weinstein","year":"2001","journal-title":"Pediatrics"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Trapani, S., Rubino, C., Indolfi, G., and Lionetti, P. (2022). A Narrative Review on Pediatric Scurvy: The Last Twenty Years. Nutrients, 14.","DOI":"10.3390\/nu14030684"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Tada, A., and Miura, H. (2019). The Relationship between Vitamin C and Periodontal Diseases: A Systematic Review. Int. J. Environ. Res. Public Health, 16.","DOI":"10.20944\/preprints201906.0007.v1"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ustianowski, \u0141., Ustianowska, K., Gurazda, K., Rusi\u0144ski, M., Ostrowski, P., and Pawlik, A. (2023). The Role of Vitamin C and Vitamin D in the Pathogenesis and Therapy of Periodontitis-Narrative Review. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24076774"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Munday, M.R., Rodricks, R., Fitzpatrick, M., Flood, V.M., and Gunton, J.E. (2020). A Pilot Study Examining Vitamin C Levels in Periodontal Patients. Nutrients, 12.","DOI":"10.3390\/nu12082255"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Li, W., Song, J., and Chen, Z. (2022). The association between dietary vitamin C intake and periodontitis: Result from the NHANES (2009-2014). BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02416-7"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1902\/jop.1986.57.8.472","article-title":"The effects of megadoses of ascorbic acid on PMN chemotaxis and experimental gingivitis","volume":"57","author":"Vogel","year":"1986","journal-title":"J. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/j.1600-0757.2008.00297.x","article-title":"Periodontal disease and nutrition: Separating the evidence from current fads","volume":"50","author":"Schifferle","year":"2009","journal-title":"Periodontology 2000"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1038\/35016151","article-title":"Antioxidant activity of fresh apples","volume":"405","author":"Eberhardt","year":"2000","journal-title":"Nature"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0003-9969(90)90049-G","article-title":"Assay of ascorbic acid in human crevicular fluid from clinically healthy gingival sites by high-performance liquid chromatography","volume":"35","author":"Meyle","year":"1990","journal-title":"Arch. Oral Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/j.1600-051X.1984.tb01319.x","article-title":"Relationship of ascorbic acid levels of blood and gingival tissue with response to periodontal therapy","volume":"11","author":"Woolfk","year":"1984","journal-title":"J. Clin. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"371","DOI":"10.15311\/selcukdentj.1115391","article-title":"Investigation of Effects of Local Vitamin C Application on Inflammatory Response and Periodontal Tissue Destruction in Rat Periodontitis Model","volume":"10","author":"Aytekin","year":"2023","journal-title":"Selcuk. Dent. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1902\/jop.2010.100173","article-title":"Assessment of total antioxidant capacity and the use of vitamin C in the treatment of non-smokers with chronic periodontitis","volume":"81","author":"Sulaiman","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2978741","DOI":"10.1155\/2016\/2978741","article-title":"Evaluation of the Anti-Inflammatory Effect of Locally Delivered Vitamin C in the Treatment of Persistent Gingival Inflammation: Clinical and Histopathological Study","volume":"2016","author":"Yussif","year":"2016","journal-title":"J. Nutr. Metab."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1902\/jop.2006.050140","article-title":"Local drug delivery in the treatment of periodontal diseases: Assessing the clinical significance of the results","volume":"77","author":"Greenstein","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sassi, F., Tamone, C., and D\u2019amelio, P. (2018). Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients, 10.","DOI":"10.3390\/nu10111656"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Garand, M., Toufiq, M., Singh, P., Huang, S.S.Y., Tomei, S., Mathew, R., Mattei, V., Al Wakeel, M., Sharif, E., and Al Khodor, S. (2021). Immunomodulatory Effects of Vitamin D Supplementation in a Deficient Population. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22095041"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7315797","DOI":"10.1155\/2018\/7315797","article-title":"Vitamin D Deficiency as It Relates to Oral Immunity and Chronic Periodontitis","volume":"2018","author":"Khammissa","year":"2018","journal-title":"Int. J. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Liang, F., Zhou, Y., Zhang, Z., Zhang, Z., and Shen, J. (2023). Association of vitamin D in individuals with periodontitis: An updated systematic review and meta-analysis. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03120-w"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1111\/jre.12531","article-title":"Vitamin D levels and risk for periodontal disease: A systematic review","volume":"53","author":"Pinto","year":"2018","journal-title":"J. Periodontal Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4727","DOI":"10.1007\/s00784-023-05100-4","article-title":"Associations between vitamin D levels and periodontal attachment loss","volume":"27","author":"Liu","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Machado, V., Lobo, S., Proen\u00e7a, L., Mendes, J.J., and Botelho, J. (2020). Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis. Nutrients, 12.","DOI":"10.3390\/nu12082177"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/jre.13083","article-title":"The role of vitamin D in periodontal health and disease","volume":"58","author":"Lu","year":"2023","journal-title":"J. Periodontal Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1210\/mend-4-4-623","article-title":"A unique point mutation in the human vitamin D receptor chromosomal gene confers hereditary resistance to 1,25-dihydroxyvitamin D3","volume":"4","author":"Sone","year":"1990","journal-title":"Mol. Endocrinol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1111\/odi.13097","article-title":"The influence of vitamin D supplementation on local and systemic inflammatory markers in periodontitis patients: A pilot study","volume":"25","author":"Meghil","year":"2019","journal-title":"Oral Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1902\/jop.1999.70.9.1032","article-title":"Association of a vitamin D receptor gene polymorphism with localized early-onset periodontal diseases","volume":"70","author":"Hennig","year":"1999","journal-title":"J. Periodontol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"324719","DOI":"10.1155\/2010\/324719","article-title":"Gene polymorphisms in chronic periodontitis","volume":"2010","author":"Laine","year":"2010","journal-title":"Int. J. Dent."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/j.1600-051X.2008.01233.x","article-title":"Vitamin D receptor polymorphism (-1056 Taq-I) interacts with smoking for the presence and progression of periodontitis","volume":"35","author":"Nibali","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1089\/gtmb.2019.0021","article-title":"Role of Vitamin D Receptor Gene Polymorphisms on the Susceptibility to Periodontitis: A Meta-Analysis of a Controversial Issue","volume":"23","author":"Wan","year":"2019","journal-title":"Genet. Test Mol. Biomark."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1080\/00016357.2019.1597160","article-title":"Associations between vitamin D receptor genetic variants and periodontitis: A meta-analysis","volume":"77","author":"Yu","year":"2019","journal-title":"Acta Odontol. Scand."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Y\u0131ld\u0131r\u0131m, Y.A., Ozturk, A., Do\u011fruel, F., Sara\u00e7o\u011flu, H., and Yaz\u0131c\u0131, C. (2024). Serum vitamin D concentration is inversely associated with matrix metalloproteinase-9 level in periodontal diseases. J. Periodontol.","DOI":"10.1002\/JPER.24-0106"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/jre.12445","article-title":"Vitamin D-binding protein expression in healthy tooth and periodontium: An experimental study both in monkeys in vivo and in humans in vitro","volume":"52","author":"Li","year":"2017","journal-title":"J. Periodontal Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"301","DOI":"10.4103\/ijdr.ijdr_646_21","article-title":"Evaluation of serum and gingival crevicular fluid levels of Vitamin D binding protein in subjects with clinically healthy periodontium and chronic periodontitis: A clinico bio-chemical study","volume":"33","author":"Chakravarthy","year":"2022","journal-title":"Indian J. Dent. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"674","DOI":"10.3181\/0711-MR-311","article-title":"The importance of the omega-6\/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases","volume":"233","author":"Simopoulos","year":"2008","journal-title":"Exp. Biol. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1505S","DOI":"10.1093\/ajcn\/83.6.1505S","article-title":"n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases","volume":"83","author":"Calder","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/nri2294","article-title":"Resolving inflammation: Dual anti-inflammatory and pro-resolution lipid mediators","volume":"8","author":"Serhan","year":"2008","journal-title":"Nat. Rev. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.bbalip.2010.08.002","article-title":"Specialized pro-resolving lipid mediators in the inflammatory response: An update","volume":"1801","author":"Bannenberg","year":"2010","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/j.bbi.2011.07.229","article-title":"Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial","volume":"25","author":"Belury","year":"2011","journal-title":"Brain Behav. Immun."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1093\/jn\/136.5.1222","article-title":"Dietary (n-3) fatty acids reduce plasma F2-isoprostanes but not prostaglandin F2alpha in healthy humans","volume":"136","author":"Vessby","year":"2006","journal-title":"J. Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1161\/01.HYP.34.2.253","article-title":"Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans","volume":"34","author":"Mori","year":"1999","journal-title":"Hypertension"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1042\/BST0330423","article-title":"Polyunsaturated fatty acids and inflammation","volume":"33","author":"Calder","year":"2005","journal-title":"Biochem. Soc. Trans."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1002\/cre2.736","article-title":"Effects of Omega-3 as an adjuvant in the treatment of periodontal disease: A systematic review and meta-analysis","volume":"9","author":"Miroult","year":"2023","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s00784-016-1750-2","article-title":"Omega-3 fatty acids as an adjunct for periodontal therapy-a review","volume":"20","author":"Chee","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5051\/jpis.2014.44.1.25","article-title":"Omega 3 fatty acids as a host modulator in chronic periodontitis patients: A randomised, double-blind, palcebo-controlled, clinical trial","volume":"44","author":"Deore","year":"2014","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/jre.13056","article-title":"Changes in serum omega fatty acids on a Mediterranean diet intervention in patients with gingivitis: An exploratory study","volume":"57","author":"Bartha","year":"2022","journal-title":"J. Periodontal Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1111\/jcpe.13680","article-title":"The effect of omega-3 fatty acids on active periodontal therapy: A systematic review and meta-analysis","volume":"49","author":"Timmerman","year":"2022","journal-title":"J. Clin. Periodontol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0952-3278(02)00272-7","article-title":"Pilot study of dietary fatty acid supplementation in the treatment of adult periodontitis","volume":"68","author":"Rosenstein","year":"2003","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/prd.12233","article-title":"Effect of micronutrient malnutrition on periodontal disease and periodontal therapy","volume":"78","author":"Dommisch","year":"2018","journal-title":"Periodontology 2000"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"5679","DOI":"10.2147\/DDDT.S276904","article-title":"K. Intravenous Iron Isomaltoside 1000 Reduces Postoperative Anemia in Patients Undergoing Elective Urologic Surgery and Those with Urosepsis","volume":"14","author":"Goh","year":"2020","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_71","unstructured":"Institute of Medicine (US), and Panel on Micronutrients (2001). Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, The National Academies Press."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1017\/S1368980015001202","article-title":"Calcium, vitamin D, casein and whey protein intakes and periodontitis among Danish adults","volume":"19","author":"Adegboye","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1902\/jop.2000.71.7.1057","article-title":"Calcium and the risk for periodontal disease","volume":"71","author":"Nishida","year":"2000","journal-title":"J. Periodontol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Cao, H., Wang, M., Duan, M., Wang, S., and Zhang, H. (2025). Association of serum calcium level with periodontitis: A cross-sectional study from NHANES 2009-2014. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1520639"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1177\/154405910508401012","article-title":"Magnesium deficiency is associated with periodontal disease","volume":"84","author":"Meisel","year":"2005","journal-title":"J. Dent. Res."},{"key":"ref_76","first-page":"266","article-title":"Magnesium\/calcium ratio in serum predicts periodontitis and tooth loss in a 5-year follow-up","volume":"1","author":"Meisel","year":"2016","journal-title":"JDR Clin. Trans. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/0976-237X.205036","article-title":"Evaluation of Micronutrient (Zinc, Magnesium, and Copper) Levels in Serum and Glycemic Status after Nonsurgical Periodontal Therapy in Type 2 Diabetic Patients with Chronic Periodontitis","volume":"8","author":"Sundaram","year":"2017","journal-title":"Contemp. Clin. Dent."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1902\/jop.2010.100211","article-title":"Relationship Between Decrease of Erythrocyte Count and Progression of Periodontal Disease in a Rural Japanese Population","volume":"82","author":"Yamamoto","year":"2011","journal-title":"J. Periodontol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"\u0141obacz, M., Mertowska, P., Mertowski, S., Kozi\u0144ska, A., Kwa\u015bniewski, W., Kos, M., Grywalska, E., and Rahnama-Hezavah, M. (2024). The Bloody Crossroads: Interactions between Periodontitis and Hematologic Diseases. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25116115"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/0972-124X.51887","article-title":"Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional study","volume":"13","author":"Agarwal","year":"2009","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5051\/jpis.2014.44.2.57","article-title":"Impact of iron deficiency anemia on chronic periodontitis and superoxide dismutase activity: A cross-sectional study","volume":"44","author":"Chakraborty","year":"2014","journal-title":"J. Periodontal Implant. Sci."},{"key":"ref_82","first-page":"70","article-title":"High Level of Serum Calcium and Iron Influences the Risk of Type 2 Diabetes Mellitus with Periodontitis","volume":"4","author":"Pushparani","year":"2014","journal-title":"J. Asian Sci. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"468","DOI":"10.4103\/0970-9290.118400","article-title":"Evaluation of micronutrient (zinc, copper and iron) levels in periodontitis patients with and without diabetes mellitus type 2: A biochemical study","volume":"24","author":"Thomas","year":"2013","journal-title":"Indian J. Dent. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1902\/jop.2009.090209","article-title":"Relationship between iron-deficiency anemia and periodontal status in female patients","volume":"80","author":"Enhos","year":"2009","journal-title":"J. Periodontol."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Lin, P.H., Sermersheim, M., Li, H., Lee, P.H.U., Steinberg, S.M., and Ma, J. (2017). Zinc in Wound Healing Modulation. Nutrients, 10.","DOI":"10.3390\/nu10010016"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1093\/jn\/130.9.2251","article-title":"Prenatal iron supplements impair zinc absorption in pregnant Peruvian women","volume":"130","author":"Zavaleta","year":"2000","journal-title":"J. Nutr."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s10534-012-9524-z","article-title":"Acute inhibition of iron bioavailability by zinc: Studies in humans","volume":"25","author":"Olivares","year":"2012","journal-title":"Biometals"},{"key":"ref_88","unstructured":"Gr\u00f6ber, U. (2009). Micronutrients: Metabolic Tuning-Prevention-Therapy, MedPharm Scientific Publisher. Available online: https:\/\/search.worldcat.org\/title\/276777395."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"8199","DOI":"10.3390\/nu7095388","article-title":"Magnesium in Prevention and Therapy","volume":"7","author":"Schmidt","year":"2015","journal-title":"Nutrients"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2592","DOI":"10.1111\/odi.14650","article-title":"Serum zinc and periodontitis in non-diabetic smoking and non-smoking adults: NHANES 2011\u20132014","volume":"30","author":"Zhou","year":"2024","journal-title":"Oral Dis."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Jeong, J., Kim, H.S., Lee, D., Kim, K., and Kim, Y.H. (2022). Association between Four Dietary Patterns and the Risk of Periodontal Diseases: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14204362"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s13668-023-00458-z","article-title":"Dietary Intake and Systemic Inflammation: Can We Use Food as Medicine?","volume":"12","author":"Graff","year":"2023","journal-title":"Curr. Nutr. Rep."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"218","DOI":"10.3945\/ajcn.113.079533","article-title":"Glycemic index, glycemic load, and risk of type 2 diabetes: Results from 3 large US cohorts and an updated meta-analysis","volume":"100","author":"Bhupathiraju","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.2337\/dc08-1239","article-title":"International tables of glycemic index and glycemic load values: 2008","volume":"31","author":"Atkinson","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1017\/S095442241600007X","article-title":"Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective","volume":"29","author":"Hosseini","year":"2016","journal-title":"Nutr. Res. Rev."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1093\/ajcn\/80.4.1029","article-title":"Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction","volume":"80","author":"Schulze","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1038\/ni.2001","article-title":"The immune system in atherosclerosis","volume":"12","author":"Hansson","year":"2011","journal-title":"Nat. Immunol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1038\/ni.2639","article-title":"CD36 coordinates NLRP3 inflammasome activation by facilitating intracellular nucleation of soluble ligands into particulate ligands in sterile inflammation","volume":"14","author":"Sheedy","year":"2013","journal-title":"Nat. Immunol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/j.cmet.2018.03.014","article-title":"Evidence that TLR4 Is Not a Receptor for Saturated Fatty Acids but Mediates Lipid-Induced Inflammation by Reprogramming Macrophage Metabolism","volume":"27","author":"Lancaster","year":"2018","journal-title":"Cell Metab."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1172\/JCI94601","article-title":"l-Carnitine in omnivorous diets induces an atherogenic gut microbial pathway in humans","volume":"129","author":"Koeth","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Sansores-Espa\u00f1a, L.D., Melgar-Rodr\u00edguez, S., Olivares-Sagredo, K., Cafferata, E.A., Mart\u00ednez-Aguilar, V.M., Vernal, R., Paula-Lima, A.C., and D\u00edaz-Z\u00fa\u00f1iga, J. (2021). Oral-Gut-Brain Axis in Experimental Models of Periodontitis: Associating Gut Dysbiosis with Neurodegenerative Diseases. Front. Aging, 2.","DOI":"10.3389\/fragi.2021.781582"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1402S","DOI":"10.1093\/ajcn\/61.6.1402S","article-title":"Mediterranean diet pyramid: A cultural model for healthy eating","volume":"61","author":"Willett","year":"1995","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/ejcn.2017.58","article-title":"Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials","volume":"72","author":"Dinu","year":"2018","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/jcpe.13576","article-title":"Effect of the Mediterranean diet on gingivitis: A randomized controlled trial","volume":"49","author":"Bartha","year":"2022","journal-title":"J. Clin. Periodontol."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Laiola, M., De Filippis, F., Vitaglione, P., and Ercolini, D. (2020). A Mediterranean Diet Intervention Reduces the Levels of Salivary Periodontopathogenic Bacteria in Overweight and Obese Subjects. Appl. Environ. Microbiol., 86.","DOI":"10.1128\/AEM.00777-20"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/jcpe.13094","article-title":"The influence of an anti-inflammatory diet on gingivitis. A randomized controlled trial","volume":"46","author":"Woelber","year":"2019","journal-title":"J. Clin. Periodontol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1002\/JPER.21-0643","article-title":"Adherence to Mediterranean diet, physical activity level, and severity of periodontitis: Results from a university-based cross-sectional study","volume":"93","author":"Marruganti","year":"2022","journal-title":"J. Periodontol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/jcpe.13766","article-title":"Leisure-time and occupational physical activity demonstrate divergent associations with periodontitis: A population-based study","volume":"50","author":"Marruganti","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/jre.12833","article-title":"Association between periodontitis and the Mediterranean diet in young Moroccan individuals","volume":"56","author":"Iwasaki","year":"2021","journal-title":"J. Periodontal Res."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e35633","DOI":"10.1016\/j.heliyon.2024.e35633","article-title":"The Mediterranean diet and periodontitis: A systematic review and meta-analysis","volume":"10","author":"Aalizadeh","year":"2024","journal-title":"Heliyon"},{"key":"ref_111","unstructured":"(2025, March 11). Plant-Based Diets and Their Impact on Health, Sustainability and the Environment: A Review of the Evidence: WHO European Office for the Prevention and Control of Noncommunicable Diseases. Available online: https:\/\/iris.who.int\/handle\/10665\/349086."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.appet.2011.09.019","article-title":"Vegetarianism. A blossoming field of study","volume":"58","author":"Ruby","year":"2012","journal-title":"Appetite"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.1007\/s00394-023-03191-z","article-title":"The association between diet quality, plant-based diets, systemic inflammation, and mortality risk: Findings from NHANES","volume":"62","author":"Wang","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1038\/s41432-023-00853-z","article-title":"Influence of the vegan, vegetarian and omnivore diet on the oral health status in adults: A systematic review and meta-analysis","volume":"24","author":"Azzola","year":"2023","journal-title":"Evid. Based Dent."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/jcpe.13785","article-title":"Association between the quality of plant-based diets and periodontitis in the U.S. general population","volume":"50","author":"Li","year":"2023","journal-title":"J. Clin. Periodontol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.jacc.2017.05.047","article-title":"Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults","volume":"70","author":"Satija","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Satija, A., Bhupathiraju, S.N., Rimm, E.B., Spiegelman, D., Chiuve, S.E., Borgi, L., Willett, W.C., Manson, J.E., Sun, Q., and Hu, F.B. (2016). Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002039"},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Woelber, J.P., Reichenb\u00e4cher, K., Gro\u00df, T., Vach, K., Ratka-Kr\u00fcger, P., and Bartha, V. (2023). Dietary and Nutraceutical Interventions as an Adjunct to Non-Surgical Periodontal Therapy\u2014A Systematic Review. Nutrients, 15.","DOI":"10.3390\/nu15061538"},{"key":"ref_119","unstructured":"Masood, W., Annamaraju, P., Suheb, M.Z.K., and Uppaluri, K.R. (2025, March 11). Ketogenic Diet, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499830\/."},{"key":"ref_120","first-page":"e10796","article-title":"Effects of the Ketogenic Diet on Glycemic Control in Diabetic Patients: Meta-Analysis of Clinical Trials","volume":"12","author":"Alarim","year":"2020","journal-title":"Cureus"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/jispcd.JISPCD_365_20","article-title":"Influence of a Low-Carbohydrate and Rich in Omega-3 Fatty Acids, Ascorbic Acid, Antioxidants, and Fiber Diet on Clinical Outcomes in Patients with Chronic Gingivitis: A Randomized Controlled Trial","volume":"11","author":"Rajaram","year":"2021","journal-title":"J. Int. Soc. Prev. Community Dent."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Woelber, J.P., Tennert, C., Ernst, S.F., Vach, K., Ratka-Kr\u00fcger, P., Bertz, H., and Urbain, P. (2021). Effects of a Non-Energy-Restricted Ketogenic Diet on Clinical Oral Parameters. An Exploratory Pilot Trial. Nutrients, 13.","DOI":"10.3390\/nu13124229"},{"key":"ref_123","first-page":"104","article-title":"Association of serum LDL cholesterol level with periodontitis among patients visiting a tertiary-care hospital","volume":"51","author":"Sharma","year":"2011","journal-title":"JNMA J. Nepal Med. Assoc."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1111\/j.1600-051X.2008.01331.x","article-title":"Association between serum lipid levels and periodontal infection","volume":"35","author":"Saxlin","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1601-5037.2008.00318.x","article-title":"A study to evaluate the relationship between periodontitis, cardiovascular disease and serum lipid levels","volume":"7","author":"Sridhar","year":"2009","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Al Taher, H., Salah, A., Rammal, C., and Varma, S.R. (2024). Role of ketogenic diet and its effect on the periodontium. A scoping review. Front. Oral Health, 5.","DOI":"10.3389\/froh.2024.1364578"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1475-2840-8-35","article-title":"Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study","volume":"8","author":"Granfeldt","year":"2009","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Jamka, M., Kulczy\u0144ski, B., Juru\u0107, A., Gramza-micha\u0142owska, A., Stokes, C.S., and Walkowiak, J. (2020). The Effect of the Paleolithic Diet vs. Healthy Diets on Glucose and Insulin Homeostasis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020296"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1902\/jop.2009.080376","article-title":"The impact of the stone age diet on gingival conditions in the absence of oral hygiene","volume":"80","author":"Baumgartner","year":"2009","journal-title":"J. Periodontol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1093\/ibd\/izac241","article-title":"The Oral-Gut Axis: Periodontal Diseases and Gastrointestinal Disorders","volume":"29","author":"Lam","year":"2023","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.1007\/s10620-020-06612-9","article-title":"Oral Health and the Altered Colonic Mucosa-Associated Gut Microbiota","volume":"66","author":"Xu","year":"2021","journal-title":"Dig. Dis. Sci."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1177\/0022034520924633","article-title":"The Bacterial Connection between the Oral Cavity and the Gut Diseases","volume":"99","author":"Kitamoto","year":"2020","journal-title":"J. Dent. Res."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41368-022-00183-3","article-title":"Periodontitis may induce gut microbiota dysbiosis via salivary microbiota","volume":"14","author":"Bao","year":"2022","journal-title":"Int. J. Oral Sci."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/omi.12359","article-title":"Porphyromonas gingivalis indirectly elicits intestinal inflammation by altering the gut microbiota and disrupting epithelial barrier function through IL9-producing CD4+ T cells","volume":"37","author":"Sohn","year":"2022","journal-title":"Mol. Oral Microbiol."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Di Stefano, M., Polizzi, A., Santonocito, S., Romano, A., Lombardi, T., and Isola, G. (2022). Impact of Oral Microbiome in Periodontal Health and Periodontitis: A Critical Review on Prevention and Treatment. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23095142"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"2126272","DOI":"10.1080\/19490976.2022.2126272","article-title":"Periodontitis-related salivary microbiota aggravates Alzheimer\u2019s disease via gut-brain axis crosstalk","volume":"14","author":"Lu","year":"2022","journal-title":"Gut Microbes"},{"key":"ref_137","doi-asserted-by":"crossref","unstructured":"Kamer, A.R., Pushalkar, S., Hamidi, B., Janal, M.N., Tang, V., Annam, K.R.C., Palomo, L., Gulivindala, D., Glodzik, L., and Saxena, D. (2024). Periodontal Inflammation and Dysbiosis Relate to Microbial Changes in the Gut. Microorganisms, 12.","DOI":"10.3390\/microorganisms12061225"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1177\/00220345231222800","article-title":"Effect of Periodontitis and Periodontal Therapy on Oral and Gut Microbiota","volume":"103","author":"Baima","year":"2024","journal-title":"J. Dent. Res."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s12967-017-1175-y","article-title":"Influence of diet on the gut microbiome and implications for human health","volume":"15","author":"Singh","year":"2017","journal-title":"J. Transl. Med."},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Beam, A., Clinger, E., and Hao, L. (2021). Effect of Diet and Dietary Components on the Composition of the Gut Microbiota. Nutrients, 13.","DOI":"10.3390\/nu13082795"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Barber, T.M., Kabisch, S., Pfeiffer, A.F.H., and Weickert, M.O. (2023). The Effects of the Mediterranean Diet on Health and Gut Microbiota. Nutrients, 15.","DOI":"10.3390\/nu15092150"},{"key":"ref_142","doi-asserted-by":"crossref","unstructured":"Merra, G., Noce, A., Marrone, G., Cintoni, M., Tarsitano, M.G., Capacci, A., and De Lorenzo, A. (2021). Influence of Mediterranean Diet on Human Gut Microbiota. Nutrients, 13.","DOI":"10.3390\/nu13010007"},{"key":"ref_143","doi-asserted-by":"crossref","unstructured":"Leeuwendaal, N.K., Stanton, C., O\u2019toole, P.W., and Beresford, T.P. (2022). Fermented Foods, Health and the Gut Microbiome. Nutrients, 14.","DOI":"10.3390\/nu14071527"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"7780","DOI":"10.3168\/jds.2017-12961","article-title":"Effect of fermented milk containing Lactobacillus rhamnosus SD11 on oral microbiota of healthy volunteers: A randomized clinical trial","volume":"100","author":"Rungsri","year":"2017","journal-title":"J. Dairy Sci."},{"key":"ref_145","doi-asserted-by":"crossref","unstructured":"Lim, J.-M., Letchumanan, V., Tan, L.T.-H., Hong, K.-W., Wong, S.-H., Ab Mutalib, N.-S., Lee, L.-H., and Law, J.W.-F. (2022). Ketogenic Diet: A Dietary Intervention via Gut Microbiome Modulation for the Treatment of Neurological and Nutritional Disorders (a Narrative Review). Nutrients, 14.","DOI":"10.3390\/nu14173566"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s13229-016-0099-3","article-title":"Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder","volume":"7","author":"Newell","year":"2016","journal-title":"Mol. Autism"},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1038\/ejcn.2009.139","article-title":"Body fat distribution and noncommunicable diseases in populations: Overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist-Hip Ratio","volume":"64","author":"Nishida","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"e381","DOI":"10.1111\/j.1467-789X.2010.00808.x","article-title":"Association between overweight\/obesity and periodontitis in adults. A systematic review","volume":"12","author":"Suvan","year":"2011","journal-title":"Obes. Rev."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"191","DOI":"10.4103\/jisp.jisp_512_19","article-title":"Biomarkers in biological fluids in adults with periodontitis and\/or obesity: A meta-analysis","volume":"24","author":"Brum","year":"2020","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.jaci.2005.02.023","article-title":"Adipose tissue, adipokines, and inflammation","volume":"115","author":"Fantuzzi","year":"2005","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/S1473-3099(06)70523-0","article-title":"Obesity and infection","volume":"6","author":"Falagas","year":"2006","journal-title":"Lancet Infect. Dis."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1902\/jop.2017.170355","article-title":"Obesity and periodontitis: An experimental study to evaluate periodontal and systemic effects of comorbidity","volume":"89","author":"Virto","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1111\/obr.12668","article-title":"Is overweight\/obesity a risk factor for periodontitis in young adults and adolescents?: A systematic review","volume":"19","author":"Khan","year":"2018","journal-title":"Obes. Rev."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s40496-021-00296-4","article-title":"The Link Between Periodontal Inflammation and Obesity","volume":"8","author":"Iwashita","year":"2021","journal-title":"Curr. Oral Health Rep."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"4281","DOI":"10.1007\/s00784-021-03961-1","article-title":"Association between clinical measures of gingival inflammation and obesity in adults: Systematic review and meta-analyses","volume":"25","author":"Pola","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1111\/j.1600-051X.2007.01075.x","article-title":"Obesity and periodontitis in 60-70-year-old men","volume":"34","author":"Linden","year":"2007","journal-title":"J. Clin. Periodontol."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/j.1600-051X.2008.01203.x","article-title":"Association between body weight and periodontal infection","volume":"35","author":"Reunanen","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1902\/jop.2009.080559","article-title":"The relationship between body mass index and periodontitis in the Copenhagen City Heart Study","volume":"80","author":"Kongstad","year":"2009","journal-title":"J. Periodontol."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/prd.12457","article-title":"Inflammation as a link between periodontal disease and obesity","volume":"90","author":"Pamuk","year":"2022","journal-title":"Periodontology 2000"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1177\/154405910708600503","article-title":"Obesity, inflammation, and periodontal disease","volume":"86","author":"Pischon","year":"2007","journal-title":"J. Dent. Res."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.archoralbio.2011.01.008","article-title":"Effects of exercise training on gingival oxidative stress in obese rats","volume":"56","author":"Azuma","year":"2011","journal-title":"Arch. Oral Biol."},{"key":"ref_162","doi-asserted-by":"crossref","unstructured":"Park, H.S., Nam, H.S., Seo, H.S., and Hwang, S.J. (2015). Change of periodontal inflammatory indicators through a 4-week weight control intervention including caloric restriction and exercise training in young Koreans: A pilot study. BMC Oral Health, 15.","DOI":"10.1186\/s12903-015-0094-7"},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1002\/JPER.21-0575","article-title":"Effects of periodontitis and periodontal treatment on systemic inflammatory markers and metabolic profile in obese and non-obese rats","volume":"93","author":"Pereira","year":"2022","journal-title":"J. Periodontol."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/jcpe.12365","article-title":"Effect of overweight\/obesity on response to periodontal treatment: Systematic review and a meta-analysis","volume":"42","author":"Papageorgiou","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_165","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Jia, R., Zhang, Y., Sun, X., Mei, Y., Zou, R., Niu, L., and Dong, S. (2023). Effect of non-surgical periodontal treatment on cytokines\/adipocytokines levels among periodontitis patients with or without obesity: A systematic review and meta-analysis. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03383-3"},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1159\/000289203","article-title":"TNF-alpha and obesity","volume":"11","author":"Tzanavari","year":"2010","journal-title":"Curr. Dir. Autoimmun."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1902\/jop.2014.140266","article-title":"Effects of scaling and root planing on clinical response and serum levels of adipocytokines in patients with obesity and chronic periodontitis","volume":"86","author":"Feres","year":"2015","journal-title":"J. Periodontol."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1002\/JPER.19-0534","article-title":"Evaluation of recurrence of periodontal disease after treatment in obese and normal weight patients: Two-year follow-up","volume":"91","author":"Zuza","year":"2020","journal-title":"J. Periodontol."},{"key":"ref_169","first-page":"158","article-title":"Effect of Overweight and Obesity on Periodontal Treatment Intensity","volume":"8","author":"Kaye","year":"2023","journal-title":"JDR Clin. Trans. Res."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1111\/jcpe.13030","article-title":"Dietary therapy and non-surgical periodontal treatment in obese patients with chronic periodontitis","volume":"45","author":"Silvestre","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1902\/jop.2011.110230","article-title":"Response to Periodontal Therapy in Patients Who Had Weight Loss After Bariatric Surgery and Obese Counterparts: A Pilot Study","volume":"83","author":"Lakkis","year":"2012","journal-title":"J. Periodontol."},{"key":"ref_172","first-page":"1159","article-title":"Cytokines and particle-induced inflammatory cell recruitment","volume":"105","author":"Driscoll","year":"1997","journal-title":"Environ. Health Perspect."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/BF01877210","article-title":"Cytokines and the immune response","volume":"8","author":"Schellekens","year":"1996","journal-title":"Biotherapy"},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"e20190314","DOI":"10.1084\/jem.20190314","article-title":"Inflammasome signaling and regulation of interleukin-1 family cytokines","volume":"217","author":"Chan","year":"2020","journal-title":"J. Exp. Med."},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.molmed.2019.01.006","article-title":"Is Resolution the End of Inflammation?","volume":"25","author":"Feehan","year":"2019","journal-title":"Trends Mol. Med."},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"d12","DOI":"10.2741\/A171","article-title":"Cytokines in acute and chronic inflammation","volume":"2","author":"Feghali","year":"1997","journal-title":"Front. Biosci."},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1056\/NEJM199902113400607","article-title":"Acute-phase proteins and other systemic responses to inflammation","volume":"340","author":"Gabay","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"e12970","DOI":"10.1111\/sji.12970","article-title":"An inflammation classification system using cytokine parameters","volume":"93","author":"Roe","year":"2021","journal-title":"Scand. J. Immunol."},{"key":"ref_179","unstructured":"(2025, March 12). Physical Activity. Available online: https:\/\/www.who.int\/health-topics\/physical-activity#tab=tab_1."},{"key":"ref_180","doi-asserted-by":"crossref","unstructured":"Suzuki, K., Tominaga, T., Ruhee, R.T., and Ma, S. (2020). Characterization and Modulation of Systemic Inflammatory Response to Exhaustive Exercise in Relation to Oxidative Stress. Antioxidants, 9.","DOI":"10.3390\/antiox9050401"},{"key":"ref_181","doi-asserted-by":"crossref","unstructured":"Suzuki, K. (2019). Chronic Inflammation as an Immunological Abnormality and Effectiveness of Exercise. Biomolecules, 9.","DOI":"10.3390\/biom9060223"},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"122","DOI":"10.23937\/2469-5718\/1510122","article-title":"Characterization of Exercise-Induced Cytokine Release, the Impacts on the Body, the Mechanisms and Modulations","volume":"5","author":"Suzuki","year":"2019","journal-title":"Int. J. Sports Exerc. Med."},{"key":"ref_183","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1055\/s-2007-972833","article-title":"Effects of exhaustive endurance exercise and its one-week daily repetition on neutrophil count and functional status in untrained men","volume":"17","author":"Suzuki","year":"1996","journal-title":"Int. J. Sports Med."},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1249\/01.mss.0000175054.99588.b1","article-title":"Muscle cytokine mRNA changes after 2.5 h of cycling: Influence of carbohydrate","volume":"37","author":"Nieman","year":"2005","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_185","doi-asserted-by":"crossref","unstructured":"Suzuki, K. (2018). Cytokine Response to Exercise and Its Modulation. Antioxidants, 7.","DOI":"10.3390\/antiox7010017"},{"key":"ref_186","first-page":"72","article-title":"Eccentric exercise-induced delayed-onset muscle soreness and changes in markers of muscle damage and inflammation","volume":"19","author":"Kanda","year":"2013","journal-title":"Exerc. Immunol. Rev."},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1113\/jphysiol.2005.089193","article-title":"Fibre-type specificity of interleukin-6 gene transcription during muscle contraction in rat: Association with calcineurin activity","volume":"566","author":"Banzet","year":"2005","journal-title":"J. Physiol."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1152\/japplphysiol.00629.2001","article-title":"Raised plasma G-CSF and IL-6 after exercise may play a role in neutrophil mobilization into the circulation","volume":"92","author":"Yamada","year":"2002","journal-title":"J. Appl. Physiol. (1985)"},{"key":"ref_189","doi-asserted-by":"crossref","unstructured":"Nieman, D.C., Zwetsloot, K.A., Lomiwes, D.D., Meaney, M.P., and Hurst, R.D. (2016). Muscle glycogen depletion following 75-km of cycling is not linked to increased muscle IL-6, IL-8, and MCP-1 mRNA expression and protein content. Front. Physiol., 7.","DOI":"10.3389\/fphys.2016.00431"},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1113\/jphysiol.2003.042374","article-title":"Glucose ingestion attenuates interleukin-6 release from contracting skeletal muscle in humans","volume":"549","author":"Febbraio","year":"2003","journal-title":"J. Physiol."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1113\/jphysiol.2003.044883","article-title":"IL-6 gene expression in human adipose tissue in response to exercise\u2014effect of carbohydrate ingestion","volume":"550","author":"Keller","year":"2003","journal-title":"J. Physiol."},{"key":"ref_192","doi-asserted-by":"crossref","unstructured":"Ferreira, R.d.O., dos Santos, V.R.N., Sousa, J.M.M., Peinado, B.R.R., Souza-Monteiro, D., Bittencourt, L.O., Lima, M.L.d.S., R\u00f6sing, C.K., Collares, F.M., and de Ara\u00fajo, A.A. (2024). Physical training minimizes immunological dysfunction, oxidative stress and tissue destruction on experimental periodontitis in rats. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0303374"},{"key":"ref_193","doi-asserted-by":"crossref","first-page":"129841","DOI":"10.1155\/2013\/129841","article-title":"Personalized lifestyle medicine: Relevance for nutrition and lifestyle recommendations","volume":"2013","author":"Minich","year":"2013","journal-title":"Sci. World J."},{"key":"ref_194","doi-asserted-by":"crossref","unstructured":"Ferreira, R.d.O., Corr\u00eaa, M.G., Magno, M.B., Almeida, A.P.C.P.S.C., Fagundes, N.C.F., Rosing, C.K., Maia, L.C., and Lima, R.R. (2019). Physical Activity Reduces the Prevalence of Periodontal Disease: Systematic Review and Meta-Analysis. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.00234"},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1902\/jop.2010.100017","article-title":"Relationship Between Obesity and Physical Fitness and Periodontitis","volume":"81","author":"Shimazaki","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_196","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1034\/j.1600-051X.1999.261006.x","article-title":"Associations of medical status and physical fitness with periodontal disease","volume":"26","author":"Wakai","year":"1999","journal-title":"J. Clin. Periodontol."},{"key":"ref_197","doi-asserted-by":"crossref","unstructured":"You, Y., Chen, Y., Wei, M., Tang, M., Lu, Y., Zhang, Q., and Cao, Q. (2024). Mediation Role of Recreational Physical Activity in the Relationship between the Dietary Intake of Live Microbes and the Systemic Immune-Inflammation Index: A Real-World Cross-Sectional Study. Nutrients, 16.","DOI":"10.3390\/nu16060777"},{"key":"ref_198","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_199","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1111\/jcpe.13669","article-title":"The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011\u20132012","volume":"49","author":"Almohamad","year":"2022","journal-title":"J. Clin. Periodontol."},{"key":"ref_200","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1002\/JPER.23-0070","article-title":"The association of work physical activity and recreational physical activity with periodontitis in the NHANES (2009\u20132014)","volume":"94","author":"Pu","year":"2023","journal-title":"J. Periodontol."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/5\/200\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:24:56Z","timestamp":1760030696000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/5\/200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":200,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["dj13050200"],"URL":"https:\/\/doi.org\/10.3390\/dj13050200","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]}}}