Diabetes and hyperglycemia increase periodontitis risk, severity, and extent. Increased whole-grain and fiber intakes are associated with improved insulin sensitivity and may therefore affect periodontitis risk. Objective: The objective was to examine the associations between whole-grain and fiber intakes and periodontitis risk. Design: We prospectively followed 34 160 male US health professionals aged 40 -75 y at the outset. We updated medical and lifestyle information biennially with

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... aires and diet every 4 y by using a validated food-frequency questionnaire. We excluded men reporting periodontitis, myocardial infarction, stroke, and hypercholesterolemia before 1986 and those with incomplete dietary data. All diabetics were excluded. Periodontitis was determined by a report of professionally diagnosed disease and validated by a diagnosis of periodontitis by a periodontist from a blinded review of radiographs. Results: Men in the highest quintile of whole-grain intake were 23% less likely to get periodontitis than were those in the lowest quintile (multivariate RR: 0.77; 95% CI: 0.66, 0.89; P for trend 0.001) after adjustment for age, smoking, body mass index, alcohol intake, physical activity, and total energy intake. Periodontitis was not associated with refined-grain intake (multivariate RR comparing extreme quintiles of intake: 1.04; 95% CI: 0.89, 1.23; P for trend ҃ 0.37). Cereal fiber was inversely related to periodontitis risk (multivariate RR comparing extreme quintiles of intake: 0.85; 95% CI: 0.73, 0.99; P for trend ҃ 0.03), but the association was not significant after adjustment for whole-grain intake. Conclusion: Increasing whole grain in the diet without increasing total energy intake may reduce periodontitis risk. Am J Clin Nutr 2006;83:1395-400.