Latest Epidemiological Data Shows That the More 'Teeth You Can Chew With (Chewing Function)', the Lower the Risk of Hypertension by 18%, and About 20% of This Mechanism Is Mediated by Good Blood Sugar Control (Lowering HbA1c)

A recent analysis using a massive set of epidemiological data from the United States has demonstrated that the “decline in chewing function” caused by tooth loss and a shift towards softer diets accompanying aging functions not merely as a localized oral problem, but as a common upstream factor that increases systemic cardiovascular risks such as hypertension and diabetes. In particular, the group with a large number of chewable teeth had an 18% lower risk of developing hypertension compared to the group without, and a full 18.0% of that risk reduction can be explained by the metabolic pathway of “improvement in HbA1c (glycated hemoglobin).”

Details on the “mediating effect of HbA1c in the relationship between chewing function and hypertension,” which is the core of this study, can be confirmed in the news summary and related paper materials.

Improvement in Chewing Function Lowers Hypertension Risk by 18%, Mediated by HbA1c | CareNet Academia https://academia.carenet.com/share/news/a377fcdc-2687-4931-8b0b-22f4be6ac4dd

A Clear Negative Correlation Between Chewing Function (FTUs) Scores and Hypertension

The study was conducted as an observational study targeting adults, using the vast dataset from the National Health and Nutrition Examination Survey (NHANES) in the United States from 2005 to 2018.

In the analysis, “Functional Tooth Units (FTUs)” were adopted as an index to objectively quantify an individual’s chewing ability. FTUs are calculated by counting the number of pairs of premolars and molars that correctly occlude (bite against each other) in the upper and lower jaws, directly reflecting the physical ability to grind food.

Based on the FTUs scores, subjects were classified from “optimal chewing function (10-12 units)” to “severely impaired chewing function (less than 3 units),” and the relationship with the prevalence of hypertension was examined. As a result, the following trends were strongly confirmed:

• Even after adjusting for confounding factors (age, sex, smoking history, BMI, etc.), the group maintaining optimal chewing function had an adjusted odds ratio of 0.82 for hypertension compared to the impaired group.
• In other words, it was statistically proven that simply possessing normal oral function, being able to chew food sufficiently, significantly lowers the overall risk of hypertension by 18%.

The Mechanism by Which Sugar Metabolism (HbA1c) “Mediates” Blood Pressure Regulation

Furthermore, the research team applied a statistical method called “Mediation Analysis” to elucidate the mechanism of why high chewing function directly lowers blood pressure.

What was revealed as a result was the existence of a biological cascade where “the improvement in sugar metabolism through chewing intervention ensures the elasticity of the vascular endothelium.”

• The Link Between Chewing and Sugar Metabolism: As mentioned earlier, chewing solid foods well promotes the secretion of GLP-1 from the digestive tract, increasing initial insulin secretion and thereby stabilizing the postprandial blood sugar curve. This suppresses the chronic accumulation of “HbA1c,” which is produced when excess sugar in the blood binds to hemoglobin in red blood cells.
• Ripple Effect on Vascular Endothelial Function: Chronic hyperglycemia (high HbA1c) causes direct damage (glycation stress and accumulation of AGEs) to the endothelial cells of blood vessels, leading to vascular stiffening. Conversely, maintaining good blood sugar control through chewing acts as a powerful defensive wall to prevent the loss of vascular elasticity.
• Proportion of the Mediating Effect: According to the analysis model of this study, it was shown that “18.0%” of the hypertension risk reduction (total effect) in the group with optimal chewing function is directly explained by indirect effects (mediating effects) via metabolic pathways such as HbA1c.

An Approach to Systemic Cardiovascular Disease Prevention

These findings suggest that dental and oral care (including the restoration of occlusion through dentures and implants) and “intervention in chewing,” such as consciously increasing the number of chews in daily dietary life, have a significance that goes far beyond merely aiding digestion.

The conclusion reached is that maintaining and increasing the number of chews is clinically recommended as an extremely safe and highly cost-effective “anti-aging strategy for systemic metabolic and circulatory management” to suppress daily blood sugar spikes without relying on pharmacotherapy, and to ultimately prevent fatal cardiovascular disease events such as hypertension and arteriosclerosis before they occur.