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Medically reviewed by Dr. Shani Saks, D.O. on Sept. 12, 2023

An Okinawan-based Nordic diet effectively reduced gingival bleeding on probing scores and HbA1c levels and decreased the serum levels of certain cytokines compared to a standard hospital care diet.

The Okinawan-based Nordic diet (OBND) is rich in vitamins, minerals, fiber, and proteins and low in carbohydrates and calories. This study aimed to assess the differences in periodontal and endocrinological outcomes and serum levels of inflammatory markers, including CRP and a routine 24-cytokine panel, across OBND and standard hospital care diets given to type 2 diabetes patients. The findings, published in the journal BMC Oral Health, indicate that OBND reduces gingival bleeding on probing scores, HbA1c, and serum inflammation markers compared to a standard hospital care diet in type 2 diabetes patients.

Study Characteristics

A total of 14 participants were included in the test group given OBND, and 16 participants were included in the control group. The average age of the participants was 68.6 ± 6.4 years, and the average time since diagnosis of type 2 diabetes was 12.5 ± 9.7 years.

Significant Reductions in HbA1c, LDL, and Cholesterol Levels

There were no baseline differences across test and control groups for the dental and medical variables measured. In both groups, there was a statistically significant decrease in serum levels of HbA1c, low-density lipoproteins (LDL), and cholesterol. Control and OBND group participants had similar quantities of remaining teeth. Bleeding on probing (BOP) changed from 32.9% to 14.3% in the OBND group and from 50% to 25% in the control group.

Participants in the OBND Group Showed Significant Improvements

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Participants in the OBND group demonstrated relatively greater reductions in weight, LDL levels, waist circumference, and diastolic blood pressure. The changes in the percentage BOP, serum levels of HbA1c, and probing pocket depths were similar across the two groups.

Changes in Serum Cytokines in Test and Control Groups

There were different patterns of changes in serum cytokines in the control and OBND groups. Compared to the control group, the OBND group participants demonstrated a significant decrease in the serum levels of serum eotaxin, platelet-derived growth factor subunit B, interleukin 17A, interferon-gamma, interferon-inducible protein 10, monocyte chemoattractant protein-1, and interleukin 9.


Persson, G. R., Widén, C., Wohlfart, B., Sjöberg, K., Steen, S., Coleman, M. D., & Holmer, H. (2023). Impact of an Okinawa/Nordic based diet on endocrinological and periodontal conditions in individuals with type 2 diabetes. A randomized case-control study. BMC oral health, 23(1), 544. https://doi.org/10.1186/s12903-023-03272-m9