Background Many studies have reported associations between individual foods or nutrients and fluorosis. No studies, however, have reported the association between dietary quality and fluorosis.
Objective This study evaluates the relationship between Dietary Quality Index-International (DQI-I) and coal-burning fluorosis.
Methods This 1:1 matched case-control study was conducted in Zhijin, Guizhou with a sample size of 200 cases of fluorosis and 200 age-and gender-matched controls. Participants were 18-70 years old and lived in Zhijin for more than 10 years without orthopedic diseases. Sociodemographic characteristics, and lifestyle closely related to coal-burning fluorosis were collected using questionnaires by face-to-face interviews, and dietary consumption was assessed by the Food Frequency Questionnaire. Energy and nutrient intakes were computed based on the China Food Composition data, and scored according to DQI-I. Logistic regression analysis models were constructed to assess the association between DQI-I and coal-burning fluorosis.
Results In present study, a total of 200 pairs of eligible cases and controls were enrolled, in which 76.99% participants were female. The average ages (mean±SD) of the case group and the control group were (49.82±13.43) and (49.68±13.48) years, respectively. The average DQI-I score of the case group was 49.00±7.69, and the average DQI-I score of the control group was 53.08±7.62. The scores of dietary diversity, adequacy, and balance of the control group were higher than those of the case group. There were statistical differences in food diversity, adequacy of vegetables, fruits, dietary fiber, protein, iron, calcium, and vitamin C, and overall dietary balance between the two groups (P < 0.05). After adjusting for energy, education level, and not washing corn and pepper before eating, the diversity score, adequacy score, and proportion of energy intake from saturated fatty acid were still negatively correlated with the risk of coal-burning fluorosis (P < 0.001); the ORs (95%CIs) were 0.844 (0.776-0.919), 0.894 (0.842-0.949), and 0.801 (0.723-0.889), respectively.
Conclusion A higher DQI-I score is associated with a lower risk of coal-burning fluorosis. Improving dietary quality may assist the prevention and treatment effect of fluorosis.
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