{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:19:14Z","timestamp":1770463154325,"version":"3.49.0"},"reference-count":45,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, Culture, Sports, Science and Technology of Japan","award":["JSPS KAKENHI (19K10119)"],"award-info":[{"award-number":["JSPS KAKENHI (19K10119)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Intake of fiber, as well as protein, and lipid preloading help to control postprandial glycemic elevation in people with type 2 diabetes and in healthy individuals. However, there are few studies on the awareness of meal sequence and nutrient intake status that consider oral conditions. This cross-sectional study aimed to determine the effects of meal sequences on nutrient intake status and whether these relationships were related to the number of teeth present. The subjects were recruited from the Medical and Dental Collaboration Center of Kanagawa Dental University Hospital between 2018 and 2021. Medical and dental examinations were performed, and a questionnaire was used to determine whether the diet consisted of vegetables, meat or fish, and carbohydrates in that order. Nutrient intake status was assessed using the brief-type self-administered diet history questionnaire. Data were collected from 238 participants. The group with awareness of meal sequence ingested increased nutrients such as n-3 fatty acids, total dietary fiber, calcium, and vitamin C. Saturated fatty acid intake increased in those with fewer teeth, while it was not significantly related to meal sequence. In conclusion, our results showed that meal sequence was associated with nutrient intake status. In addition, the intake of saturated fatty acids increased when many teeth were lost, regardless of meal sequence.<\/jats:p>","DOI":"10.3390\/nu15112602","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T01:33:54Z","timestamp":1685669634000},"page":"2602","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Influence of Meal Sequence and Number of Teeth Present on Nutrient Intake Status: A Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2643-1808","authenticated-orcid":false,"given":"Sayuri","family":"Kida","sequence":"first","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8498-4494","authenticated-orcid":false,"given":"Norio","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiya","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Yata","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taizo","family":"Iwane","sequence":"additional","affiliation":[{"name":"Center for Innovation Policy, Graduate School of Health Innovation, Kanagawa University of Human Services, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki-shi 210-0821, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5147-3711","authenticated-orcid":false,"given":"Tatsuo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Dental Sociology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsushi","family":"Tamaki","sequence":"additional","affiliation":[{"name":"Department of Functional Recovery of TMJ and Occlusion, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Minabe","sequence":"additional","affiliation":[{"name":"Bunkyou Dori Dental Clinic, 2-4-1 Anagawa, Chiba 263-0024, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motohiro","family":"Komaki","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Kanagawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,1]]},"reference":[{"key":"ref_1","unstructured":"Ministry of Health, Labor and Welfare (2020). Overview of the Dietary Reference Intakes for Japanese (2020)."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/dom.13503","article-title":"The impact of food order on postprandial glycaemic excursions in prediabetes","volume":"21","author":"Shukla","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3164\/jcbn.13-67","article-title":"Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes","volume":"54","author":"Imai","year":"2014","journal-title":"J. Clin. Biochem. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/dme.12073","article-title":"Eating vegetables before carbohydrates improves postprandial glucose excursions","volume":"30","author":"Imai","year":"2013","journal-title":"Diabet. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.diabet.2016.03.004","article-title":"Sustained effects of a protein and lipid preload on glucose tolerance in type 2 diabetes patients","volume":"42","author":"Filice","year":"2016","journal-title":"Diabetes Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.2337\/dc09-0723","article-title":"Effects of a protein preload on gastric emptying, glycemia, and gut hormones after a carbohydrate meal in diet-controlled type 2 diabetes","volume":"32","author":"Ma","year":"2009","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"511","DOI":"10.2337\/dc15-2298","article-title":"A Protein Preload Enhances the Glucose-Lowering Efficacy of Vildagliptin in Type 2 Diabetes","volume":"39","author":"Wu","year":"2016","journal-title":"Diabetes Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.14219\/jada.archive.2003.0353","article-title":"Tooth loss and dietary intake","volume":"134","author":"Hung","year":"2003","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1600-0528.2005.00200.x","article-title":"The association between tooth loss and the self-reported intake of selected CVD-related nutrients and foods among US women","volume":"33","author":"Hung","year":"2005","journal-title":"Commun. Dent. Oral Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1177\/154405910708601206","article-title":"Numbers of natural teeth, diet, and nutritional status in US adults","volume":"86","author":"Sheiham","year":"2007","journal-title":"J. Dent. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/joor.13177","article-title":"Food-related oral discomfort: A cross-sectional survey assessing the sensory dimension of oral discomfort in French independently living adults","volume":"48","author":"Braud","year":"2021","journal-title":"J. Oral Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jdsr.2021.07.002","article-title":"The association of oral function with dietary intake and nutritional status among older adults: Latest evidence from epidemiological studies","volume":"57","author":"Iwasaki","year":"2021","journal-title":"Jpn. Dent. Sci. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2147\/CCIDE.S288137","article-title":"Dietary Factors Affecting the Prevalence and Impact of Periodontal Disease","volume":"13","author":"Santonocito","year":"2021","journal-title":"Clin. Cosmet. Investig. Dent."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Najeeb, S., Zafar, M.S., Khurshid, Z., Zohaib, S., and Almas, K. (2016). The Role of Nutrition in Periodontal Health: An Update. Nutrients, 8.","DOI":"10.3390\/nu8090530"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"48","DOI":"10.3177\/jnsv.67.48","article-title":"The Association between Dietary Habits and Periodontal Disease in Young Adult Women","volume":"67","author":"Hosoda","year":"2021","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/j.1600-051X.2008.01249.x","article-title":"Periodontal inflamed surface area: Quantifying inflammatory burden","volume":"35","author":"Nesse","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2188\/jea.JE20110075","article-title":"Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults","volume":"22","author":"Kobayashi","year":"2012","journal-title":"J. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000440","DOI":"10.1136\/bmjdrc-2017-000440","article-title":"Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes","volume":"5","author":"Shukla","year":"2017","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Barber, T.M., Kabisch, S., Pfeiffer, A.F.H., and Weickert, M.O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12.","DOI":"10.3390\/nu12103209"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1017\/S095442241700004X","article-title":"Dietary fibre in Europe: Current state of knowledge on definitions, sources, recommendations, intakes and relationships to health","volume":"30","author":"Stephen","year":"2017","journal-title":"Nutr. Res. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/S0022-3913(97)70100-8","article-title":"Functional units, chewing, swallowing, and food avoidance among the elderly","volume":"77","author":"Hildebrandt","year":"1997","journal-title":"J. Prosthet. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/j.1741-2358.2005.00083.x","article-title":"The relationship between dietary intake and the number of teeth in elderly Japanese subjects","volume":"22","author":"Yoshihara","year":"2005","journal-title":"Gerodontology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1016\/j.clnu.2017.06.001","article-title":"Diet-borne systemic inflammation is associated with prevalent tooth loss","volume":"37","author":"Kotsakis","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/cdoe.12513","article-title":"Poor diet predicts periodontal disease development in 11-year follow-up study","volume":"48","author":"Jauhiainen","year":"2020","journal-title":"Commun. Dent. Oral Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12944-020-01267-x","article-title":"What is the impact of the adjunctive use of omega-3 fatty acids in the treatment of periodontitis? A systematic review and meta-analysis","volume":"19","author":"Kruse","year":"2020","journal-title":"Lipids Health Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Varela-L\u00f3pez, A., Giampieri, F., Bull\u00f3n, P., Battino, M., and Quiles, J.L. (2016). A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease. Molecules, 21.","DOI":"10.3390\/molecules21091183"},{"key":"ref_27","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. Commun. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Woelber, J.P., Bremer, K., Vach, K., K\u00f6nig, D., Hellwig, E., Ratka-Kr\u00fcger, P., Al-Ahmad, A., and Tennert, C. (2016). An oral health optimized diet can reduce gingival and periodontal inflammation in humans\u2014A randomized controlled pilot study. BMC Oral Health, 17.","DOI":"10.1186\/s12903-016-0257-1"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tabe, S., Nakayama, Y., Kobayashi, R., Oyama, K., Kitano, D., Ogihara, J., Senpuku, H., and Ogata, Y. (2022). Association between Dietary Habit and Clinical Parameters in Patients with Chronic Periodontitis Undergoing Supportive Periodontal Therapy. Nutrients, 14.","DOI":"10.3390\/nu14234993"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1007\/s00784-018-2669-6","article-title":"Combined effects of new complete denture fabrication and simplified dietary advice on nutrient intake in edentulous elderly patients for 6 months","volume":"23","author":"Kanazawa","year":"2019","journal-title":"Clin. Oral Investig."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kubota, S., Liu, Y., Iizuka, K., Kuwata, H., Seino, Y., and Yabe, D. (2020). A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes. Nutrients, 12.","DOI":"10.3390\/nu12092502"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"107450","DOI":"10.1016\/j.jdiacomp.2019.107450","article-title":"Dietary instructions focusing on meal-sequence and nutritional balance for prediabetes subjects: An exploratory, cluster-randomized, prospective, open-label, clinical trial","volume":"33","author":"Yabe","year":"2019","journal-title":"J. Diabetes Complicat."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Xie, C., Huang, W., Sun, Y., Xiang, C., Trahair, L., Jones, K.L., Horowitz, M., Rayner, C.K., and Wu, T. (2023). Disparities in the glycaemic and incretin responses to intraduodenal glucose infusion between healthy young men and women. J. Clin. Endocrinol. Metab., dgad176.","DOI":"10.1210\/clinem\/dgad176"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e1643","DOI":"10.1210\/clinem\/dgab828","article-title":"Plasma GLP-1 Response to Oral and Intraduodenal Nutrients in Health and Type 2 Diabetes-Impact on Gastric Emptying","volume":"107","author":"Xie","year":"2022","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3311","DOI":"10.1210\/jc.2018-02736","article-title":"Gastric Emptying in Patients with Well-Controlled Type 2 Diabetes Compared with Young and Older Control Subjects without Diabetes","volume":"104","author":"Watson","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e002534","DOI":"10.1136\/bmjdrc-2021-002534","article-title":"Efficacy of a meal sequence in patients with type 2 diabetes: A systematic review and meta-analysis","volume":"10","author":"Okami","year":"2022","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_37","unstructured":"Ministry of Health (2016). National Health and Nutrition Survey for Japanese (2016)."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1016\/j.jdent.2014.08.012","article-title":"Tooth loss and its association with dietary intake and diet quality in American adults","volume":"42","author":"Zhu","year":"2014","journal-title":"J. Dent."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1111\/j.1532-5415.2010.02909.x","article-title":"Association between dietary quality of rural older adults and self-reported food avoidance and food modification due to oral health problems","volume":"58","author":"Savoca","year":"2010","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1177\/0022034511405384","article-title":"Relationship between saturated fatty acids and periodontal disease","volume":"90","author":"Iwasaki","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S544","DOI":"10.2188\/jea.JE20090223","article-title":"Fatty acids intakes and serum lipid profiles: NIPPON DATA90 and the national nutrition monitoring","volume":"20","author":"Nakamura","year":"2010","journal-title":"J. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1001\/jamainternmed.2016.2417","article-title":"Association of specific dietary fats with total and cause-specific mortality","volume":"176","author":"Wang","year":"2016","journal-title":"JAMA Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.jacc.2020.05.077","article-title":"Saturated fats and health: A reassessment and proposal for food-based recommendations: JACC State-of-the-Art Review","volume":"76","author":"Astrup","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"397","DOI":"10.3945\/ajcn.112.037770","article-title":"Dietary intake of saturated fat by food source and incident cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis","volume":"96","author":"Mozaffarian","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1093\/ajcn\/87.5.1107","article-title":"Does social class predict diet quality?","volume":"87","author":"Darmon","year":"2008","journal-title":"Am. J. Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/11\/2602\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:47:15Z","timestamp":1760125635000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/11\/2602"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,1]]},"references-count":45,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["nu15112602"],"URL":"https:\/\/doi.org\/10.3390\/nu15112602","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,1]]}}}