Centenary year of scientific papers in the British Dental Journal.
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Biomedical subjects
Publications and source records attributed to J E Eastoe.
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Data are presented from a recent longitudinal study of dietary habits of English children aged 11-13 y, in relation to various factors which may have influenced the estimations of intake. A knowledge of such relationships may aid the design and interpretation of this and other dietary surveys. The factors studied included survey fatigue, learning effect, season of the year, day of the week and the subjects' knowledge of the study's purpose. Generally the relationships found were of minor importance, but the variable influence of some of these factors is apparent from a study of the relevant literature. This is one reason why dietary survey methodology is resistant to simplification. It is concluded that the dietary survey method used was adequate for the purpose of the study.
The study was conducted in seven schools on children initially aged 11.5 years. They recorded their diet on five occasions, each of three days, and received an annual dental examination, including radiography. Caries increments were low, mostly (58 per cent) in fissure surfaces. Correlations between caries increment and dietary factors were low due to the low caries increments observed and the large error associated with dietary data where analyses attempt to discriminate between individuals. The highest correlation was between caries increment and weight of daily intake of sugars (+0.143, p less than 0.01). Multivariate analyses revealed that this relationship could not be explained by differences in sex, social class, tooth-brushing habits or level of plaque as measured by gingival inflammation. Weight of sugar intake appeared to be more strongly correlated to caries than frequency of intake; concentration of sugars in foods was positively related, and sugars in snacks were more strongly related to caries than total dietary sugars. The 31 children who consumed most sugar (greater than 163 g/day) developed 5.0 DMFS during the 2 years, 0.9 DMFS per year more than the 31 children (3.2 DMFS during 2 years) who had the lowest sugar intake (less than 78 g/day).
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Children (405), initially of average age 11.5 years, recorded all food and drinks consumed for three consecutive days (with an interview on the fourth day) on five separate occasions over a 2-year period. Food tables (Paul & Southgate, 1978) enabled nutrient intakes to be calculated. The data collected were found to be of high reliability (Hackett et al. 1983). The mean energy intakes showed broad agreement with other recent British dietary surveys but were well below those recorded in the prewar study by Widdowson (1947) and the FAO/WHO (1973) recommended levels. They were slightly below the current Department of Health and Social Security (DHSS; 1979) recommended intakes. Over the 2-year period, the energy intake of the boys increased by 13% compared with an increase of only 7% in the girls. The iron and vitamin A intakes of all groups of children were low compared with current recommendations (DHSS, 1979). This seems to be a result of falling energy intake. Mean calcium intakes were also only marginally in excess of the recommended intake, and those of most of the girls would fall below the recommendation if the proposal to end the fortification of flour (DHSS, 1981) is implemented.
The contribution of the fortification of flour with calcium carbonate to the Ca intake of 375, 11-14-year-old Northumbrian children has been calculated. Mean Ca intakes were above those currently recommended for children of this age. The fortification of flour supplied 16% of the total Ca intakes. Without the fortification, the percentage of these children with intakes below the recommended intake would be more than double. This would include the majority of girls (particularly those of social classes III, IV and V). The recommendation to stop fortifying flour with calcium carbonate should be reviewed.
Between September 1979 and July 1981, 405 northern-English children, initially aged 11-12 years, each recorded all food and drink consumed on five occasions on each of three consecutive days. Sugars and nutrient intakes were calculated using food tables. The average total sugars intake was 118 g/d or 21% of the energy intake and 43% of the carbohydrate intake; these percentages were similar for both sexes, all social class groups and surveys. Sugars were found to be derived from a variety of food sources with confectionery being the single largest source. Sugars were fairly evenly consumed over the average day with a high amount in foods eaten between meals. Snacks accounted for 65% of the sugars intake but only 46% of the energy intake. Sugars intake and snacking therefore seem to have been major components of the eating habits of these children. If dietary changes towards lower sugars intakes are to be achieved a vigorous, informed health education campaign is necessary together with effective labelling of manufactured foods, the development of new products and the modification of some existing ones.
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Past progress in the chemistry of enamel proteins is reviewed and the current state of knowledge assessed. The matrix of young enamel is a complex system in which some 20 distinct components with molecular weights in the region of 3,000 to 16,000 are in dynamic equilibrium with much larger aggregates. During maturation, most of these components are selectively lost, more or less completely, from the enamel. 'Amelogenin' components rich in proline and histidine are removed first and 'tuft protein', characterized by high serine and glycine, is often partially retained in mature enamel. Some components have been isolated in a state approaching purity and a measure of agreement has been reached between laboratories concerning their characteristics. Partial amino acid sequences are known for two components, which contain phosphoserine. Though the mechanisms of mineralization and protein removal are not known, various possibilities are discussed. The essential unsolved problem is the nature of the overall protein system.
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