Background & Aims
Painful temporomandibular disorders (p-TMD) represent a prevalent source of non-odontogenic chronic orofacial pain [1]. While factors like sex, age, and psychosocial elements, are recognized contributors to p-TMD, the influence of nutrition remains insufficiently explored. Diet quality may potentially influence chronic musculoskeletal conditions [2]. In addition, headaches have been shown to be present in 82.8% of p-TMD patients [3]. This study aims to explore the relation between fetal exposures through maternal nutrition and the development of p-TMD and headaches later in young adulthood.
Methods
The study used data from the Danish National Birth Cohort (DNBC), which enrolled 101,042 pregnancies from 1996 to 2002 [4, 5]. Two data collection points were analyzed: 1) Nutritional information of pregnant women assessed via a food frequency questionnaire (FFQ) and a previously developed healthy eating index (HEI) [6]; 2) DNBC offspring’s p-TMD and headache (?1day of headache per month) data were collected through a self-administered survey at age 18-23 years, for whom nutritional data had previously been obtained through a FFQ at age 14 [6] (n = 33,412). Nutritional data was categorized into quartiles to establish four levels of nutritional status (Q1 lowest/unhealthiest to Q4 the highest/healthiest). Logistic regression analyses, both crude and adjusted for confounding factors (participants’ sex and maternal socio-occupational status (SOS) at the time of pregnancy) were conducted. Inverse probability weighting (IPW) addressed potential participation bias.
Results
Of the 33,412 individuals invited, 11,982 (35.8%) completed the TMD pain screener. Crude and adjusted regression analyses indicated no significant association between maternal HEI and offspring’s p-TMD status. However, significant associations were found between maternal HEI and reporting ?1 headache per month in young adulthood: 1) in the crude analysis: Q4 (OR=0.83, [95% C.I. 0.73-0.94], P=0.003) and Q3 (OR=0.84, [95% C.I. 0.75-0.94], P=0.002) were significantly less likely to report headaches, compared to the lowest quartile (Q1); 2) after adjusting for sex, maternal SOS, and employing IPW, significant associations persisted for Q4 (OR=0.86, [95% C.I. 0.74-0.99], P=0.038) and Q3 (OR=0.86, [95% C.I. 0.75-0.98], P=0.029). In fully adjusted models, the specific maternal dietary domains significantly associated with headache risk included total meat scores (OR=0.98, [95% C.I. 0.97-0.99], P=0.016) and saturated fatty acids (OR=0.92 [95% C.I. 0.86-0.97], P=0.040).
Conclusions
No association was found between maternal nutrition and p-TMD. Findings suggest that offspring of mothers with lower HEI scores, i.e., poorer diet, during pregnancy, were at a significantly increased risk of reporting one or more headaches per month in young adulthood. Dietary domains, such as, total meat scores and saturated fatty acids, were identified as significant contributors to the observed association with headache risk. Analysis of these specific domains suggests that lower fetal exposure to saturated fatty acids and meat is associated with less likelihood of developing headaches later in life.
References
1.Maixner W, Diatchenko L, Dubner R, Fillingim RB, Greenspan JD, Knott C, et al. Orofacial pain prospective evaluation and risk assessment study–the OPPERA study. J Pain. 2011;12(11 Suppl):T4-11.e1-2. Epub 2011/12/07. doi: 10.1016/j.jpain.2011.08.002. PubMed PMID: 22074751; PubMed Central PMCID: PMCPMC3233836.
2.Elma Ö, Yilmaz ST, Deliens T, Clarys P, Nijs J, Coppieters I, et al. Chronic Musculoskeletal Pain and Nutrition: Where Are We and Where Are We Heading? PM & R : the journal of injury, function, and rehabilitation. 2020;12(12):1268-78. Epub 2020/02/23. doi: 10.1002/pmrj.12346. PubMed PMID: 32086871.
3.Yakkaphan P, Smith JG, Chana P, Renton T, Lambru G. Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. 2022;5:25158163221097352. doi: 10.1177/25158163221097352.
4.Olsen J, Melbye M, Olsen SF, Sørensen TI, Aaby P, Andersen AM, et al. The Danish National Birth Cohort–its background, structure and aim. Scandinavian journal of public health. 2001;29(4):300-7. Epub 2002/01/05. doi: 10.1177/14034948010290040201. PubMed PMID: 11775787.
5.Statens Serum Institut About the DNBC https://www.dnbc.dk/data-available [updated 20 Feb 2020; cited 2022 6 Jun].
6.Bjerregaard AA, Halldorsson TI, Tetens I, Olsen SF. Mother’s dietary quality during pregnancy and offspring’s dietary quality in adolescence: Follow-up from a national birth cohort study of 19,582 mother-offspring pairs. PLoS medicine. 2019;16(9):e1002911. Epub 2019/09/13. doi: 10.1371/journal.pmed.1002911. PubMed PMID: 31513597; PubMed Central PMCID: PMCPMC6742222.
Presenting Author
Cristina Rocha Exposto
Poster Authors
Cristina Exposto
PhD Student
Aarhus University
Lead Author
Mojdeh Mansoori
Aarhus University
Lead Author
Bodil Hammer Beck
Aarhus University, Department of Public Health - Epidemiology
Lead Author
Sjurdur Frodi Olsen
Statens Serum Institut, Department of Epidemiology Research
Lead Author
Anne Ahrendt Bjerregaard
Bispebjerg and Frederiksberg Hospital, Center for Clinical Research and Prevention
Lead Author
Lene Baad-Hansen
Aarhus University
Lead Author
Topics
- Joint Pain