The Role of Diet and Periodontitis in Preserved Ratio Impaired Spirometry: A Mediation Analysis

Why It Matters

Linking diet and oral health to early lung dysfunction highlights modifiable risk factors that could curb progression to chronic obstructive pulmonary disease and reduce healthcare burden.

Key Takeaways

• Pro‑inflammatory diet raises PRISm odds (OR 1.17).
• Higher oxidative balance score lowers PRISm risk (OR 0.96).
• Periodontitis increases PRISm likelihood (OR 1.61).
• Periodontitis mediates only ~6‑10% of diet‑PRISm link.

Pulse Analysis

Preserved ratio impaired spirometry (PRISm) sits at the intersection of early lung dysfunction and systemic inflammation, serving as a warning sign for future chronic obstructive pulmonary disease. Researchers increasingly view PRISm not just as a pulmonary metric but as a marker of broader metabolic stress, making it a focal point for preventive health strategies aimed at high‑risk populations.

In the NHANES cohort, two dietary metrics— the Dietary Inflammatory Index and the Oxidative Balance Score—provided contrasting signals. A pro‑inflammatory diet modestly heightened PRISm odds, while a diet rich in antioxidants and anti‑oxidative nutrients lowered risk. These findings reinforce the growing evidence that nutritional patterns shape respiratory health through inflammatory pathways, suggesting that clinicians could incorporate dietary counseling into lung‑function monitoring programs.

Periodontitis, a chronic oral infection, emerged as an independent predictor of PRISm and accounted for only a small fraction of the diet‑related effects. The modest mediation underscores that while oral health contributes to systemic inflammation, most of the diet‑PRISm relationship operates through other mechanisms. Validation in a Chinese hospital cohort confirmed the protective role of oxidative balance but not the DII association, highlighting geographic and lifestyle nuances. Together, the data point to integrated preventive approaches—combining anti‑inflammatory nutrition with rigorous oral‑health care—to mitigate early lung impairment and its downstream economic impact.