It is hard to eat a healthy diet if you can't chew properly. A diet that is full of fiber is key to good cardiovascular health, but it can require chewing power. People who have trouble chewing are more likely to be at risk for cardiovascular disease (CV), particularly older people, a new study suggests.

It's not something we think of much, but the inability to chew food well is a modifiable risk factor that can have a negative effect on a person’s risk of developing CV. To study this relationship, researchers at the University of Paris School of Dentistry examined the chewing capacity of over 5,000 people.

Tooth loss is not the only cause of reduced chewing capacity in older adults. A reduction in the amount of saliva, whether a side effect of aging or a side effect of medication, can make chewing difficult.

None of the participants, mean age 59 years, had any signs of cardiovascular disease. Their behavioral health — any smoking, their body mass index, physical activity level and diet — was assessed. Their biological health was also evaluated based on their total cholesterol, blood sugar and blood pressure. During the oral examination, their chewing capacity was determined and given a score.

A person was classified as having ideal cardiovascular health when they had five or more of the seven criteria for behavioral and biological health.

Better chewing capacity was associated with nonsmokers, BMI less than 25 and a diet high in fruits, vegetables and fish, and containing less than 1,500 milligrams of sodium per day.

“Our finding of an association between chewing capacity and CV [health] raises several public health implications. Tooth loss and its main cause, i.e., oral diseases, are highly prevalent worldwide, but largely preventable by promoting regular dental care networks and lower sugar-containing food availability,” the researchers wrote.

Strategies aimed at maintaining chewing capacity, such as preventing tooth loss in the first place and using dental prosthesis to replace missing teeth, could help improve CV health in adulthood.

Tooth loss is not the only cause of reduced chewing capacity in older adults. A reduction in the amount of saliva, whether a side effect of aging or a side effect of medication, can make chewing difficult. Poorly fitting dentures can contribute to the problem as well.

Older adults who experience problems chewing should not hesitate to talk to their doctor or dentist about the problem. Consulting with a registered dietitian/nutritionist could also help a person with chewing difficulties figure out how to get all of their required nutrition within their chewing limitations.

The study was published in Clinical Nutrition.