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. 2025 Jun 27;12:1621658. doi: 10.3389/fnut.2025.1621658

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Copyright © 2025 Hu, Zhang and Liu.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Flowchart illustrating participant selection for a study using NHANES data from 1999 to 2020. Starts with 107,620 participants aged 20 and above. After exclusions due to missing data, 89,221 participants remain. Following further exclusions, 41,374 participants are included in the final analysis. Final participants include 41,020 without periodontal disease (PD) and 354 with PD. — Flowchart of participants in this study.