Effect of Exercise Intensity on the Obesity-Associated Risk of Periodontitis in Korean Adults

Background: This study aimed to investigate the association between obesity and periodontitis among Korean adults and examine whether the intensity of physical activity modifies this relationship.Methods: The analysis included 11,230 adults aged 19 years and older who participated in the 7th Korea National Health and Nutrition Examination Survey between 2016 and 2018.Periodontal status was assessed using the community periodontal index, and obesity was defined as a body mass index of 23.0 kg/m 2 or greater.Physical activity intensity was categorized as none, moderate, or high.Multivariable logistic regression analyses, including interaction terms, were conducted to assess the moderating effect of exercise intensity on the association between obesity and periodontitis.Results: Obesity was significantly associated with high-risk periodontitis, and this association varied according to exercise intensity.The adjusted odds ratios for obesity were 1.23 (95% confidence interval [CI]: 1.091.40)among non-exercisers, 1.43 (95% CI: 1.091.87)among those engaging in moderate-intensity exercise only, and 2.21 (95% CI: 1.273.85)among those engaging in high-intensity exercise only.Conclusion: Obesity is a significant risk factor for periodontitis in Korean adults, and the intensity of physical activity modifies this relationship.Contrary to expectations, high-intensity exercise may increase the risk of periodontal disease in individuals with obesity.These findings underscore the importance of personalized exercise recommendations and the need to consider metabolic and behavioral factors in oral health promotion strategies.