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Bad breath, bad news: How gum disease could worsen liver conditions

Chronic periodontal inflammation leads to the release of pro-inflammatory cytokines like TNF-alpha and IL-6, which have long been implicated in the progression of liver disease.

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There is growing recognition in medicine that what happens in one part of the body can ripple through others. That idea is now being explored in a surprising place: the mouth. A new review by an international group of researchers has examined the mounting evidence linking periodontal disease—commonly known as gum disease—to chronic liver conditions, including cirrhosis, metabolic dysfunction-associated steatotic liver disease (MASLD), and alcohol-related liver disease. Though the mouth and liver are separated by both distance and function, the paper makes a compelling case that these two systems are more connected than we thought.

Gum disease, especially in its more advanced form known as periodontitis, is a chronic inflammatory condition caused by bacterial infections in the tissues that support the teeth. It is one of the most common diseases worldwide, and its severity tends to increase with age, smoking, alcohol use, and poor access to dental care. For patients already struggling with liver disease—many of whom share these same risk factors—oral health often takes a back seat.

But ignoring the mouth could be a mistake. The review lays out multiple ways that periodontitis may aggravate liver disease. The first is via the “oral-gut-liver axis,” a term researchers use to describe the complex interplay between oral bacteria, the gut microbiome, and liver function. Pathogenic bacteria from the mouth can be swallowed or enter the bloodstream during everyday activities like chewing and brushing. Once in the gut, these microbes may alter the composition of the intestinal microbiome, leading to dysbiosis and increased gut permeability—also known as a “leaky gut.” This can allow bacterial products such as endotoxins to reach the liver, triggering inflammation and fibrogenesis.

Animal models offer further support for this theory. Studies have shown that oral administration of specific periodontal pathogens, such as Porphyromonas gingivalis, can exacerbate liver steatosis and inflammation in mice with pre-existing metabolic disease. These microbes, or their byproducts, have even been found in liver tissue, suggesting that translocation from the mouth to the liver is biologically plausible.

The immune system also plays a central role in this interaction. Chronic periodontal inflammation leads to the release of pro-inflammatory cytokines like TNF-alpha and IL-6, which have long been implicated in the progression of liver disease. Additionally, the review highlights the involvement of Th17 cells—a type of immune cell activated by oral pathogens that may migrate to the liver and worsen metabolic dysfunction. Together, these pathways form a vicious cycle: liver disease impairs oral health, while oral inflammation accelerates liver damage.

The clinical data, while still developing, supports this association. Patients with cirrhosis consistently show worse oral health than the general population, with higher rates of gingival overgrowth, attachment loss, and bone loss. The prevalence of periodontitis among patients awaiting liver transplantation can be as high as 72 percent. Studies have also found links between severe periodontal disease and increased mortality in cirrhosis patients.

For those with MASLD, the most common form of chronic liver disease, the evidence is also compelling. Population-level studies have found that people with advanced periodontitis are significantly more likely to have MASLD, even after adjusting for shared risk factors like obesity and diabetes. And in a small trial, periodontal treatment led to a short-term improvement in liver enzyme levels—a tantalizing hint that oral health interventions could influence liver function.

That said, the review authors caution that the research is still at an early stage. Much of the clinical data comes from observational studies, which cannot definitively prove cause and effect. There is also the challenge of disentangling shared lifestyle and socioeconomic factors that affect both oral and liver health. Still, the biological plausibility, consistency of findings, and preliminary interventional data make a strong case for paying more attention to the teeth and gums of patients with liver disease.

The review ends with a call for multidisciplinary collaboration. Gastroenterologists and hepatologists, who typically manage liver disease, may not think to ask about oral health or refer patients for dental care. Yet the data suggest they should. Similarly, dental professionals may not be aware of how their work could influence liver outcomes. Closer cooperation between these specialties could lead to earlier detection and better care.

Until more definitive evidence is available, one message is clear: brushing, flossing, and regular dental visits might be more important than we ever realized, especially for those living with chronic liver conditions. In the meantime, researchers are calling for larger, high-quality trials to test whether treating gum disease can slow liver disease progression or reduce complications. If the connection holds, the humble toothbrush could become an unexpected tool in the fight against liver failure.

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Women non-smokers around 50% more likely than men to develop COPD

Smoking is the principal cause of COPD. But despite significant falls in cigarette smoking over the past 50 years, it remains a leading cause of death, with the prevalence of COPD in women approaching that of men, say the researchers. 

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Women’ are around 50% more likely than men to develop COPD, the umbrella term for chronic lung conditions, such as emphysema and bronchitis, even if they have never smoked or smoked much less than their male counterparts, suggests observational research, published in the open access journal BMJ Open Respiratory Research.

The findings challenge the widely held belief that women’s increased vulnerability to cigarette smoke likely explains this disparity, conclude the researchers.

Smoking is the principal cause of COPD. But despite significant falls in cigarette smoking over the past 50 years, it remains a leading cause of death, with the prevalence of COPD in women approaching that of men, say the researchers. 

Women with COPD tend to have more severe symptoms, and at a younger age, than their male counterparts, prompting the suggestion that the explanation may lie in a heightened susceptibility to the effects of cigarette smoke, explain the researchers.

To clarify the associations between gender, cigarette smoke, and COPD, and to update previous estimates of the prevalence and impact of COPD, the researchers drew on a large nationally representative US survey of adults from the 2020 National Health Interview Survey (NHIS). 

Respondents (12,638 women and 10,390 men aged at least 40) were asked about their smoking history, what tobacco products they used, and whether they vaped.

Women reported lower rates of both current and former cigarette, cigar, and pipe smoking, and smokeless tobacco use than men, but similar rates of vaping.

The prevalence of COPD was just under 8% for women and 6.5% for men. Women with COPD were more likely to have never smoked cigarettes than men with COPD (26.5% vs just over 14%), and less likely to use other tobacco products except for e-cigarettes (26.5% vs 20%).

Women also reported smoking fewer daily cigarettes than men, averaging around 18 compared with around 22, and to have done so for fewer years. And they were less likely than men to have started smoking before the age of 15:19% vs 28%.

Yet the prevalence of COPD was higher among women who had ever smoked than it was among men: 16% vs 11.5%.  And among women who had never smoked the prevalence of COPD was almost twice as high as it was in male non-smokers: just over 3% compared with just over 1.5%. 

In further analysis, female gender was associated with a significantly (47%) higher risk of being diagnosed with COPD after accounting for potentially influential factors. 

This gender difference in risk persisted, irrespective of smoking history: among those who had never smoked, women were 62% more likely to be diagnosed with COPD, and among those who had ever smoked they were 43% more likely to do so. 

The researchers acknowledge that their study relied on self report rather than objectively measured data. And they lacked potentially important information on hormonal influences, family history, or infectious, occupational, and environmental exposures.

But they nevertheless suggest: “These findings should raise questions about whether differing susceptibility to tobacco smoke is the key factor driving the increased COPD prevalence in women in the USA. 

“If women were more susceptible to the effects of smoking, we would not expect to see a nearly identical risk per 10 pack-year exposure, nor would we expect to see a similarly increased relative risk among those who had never smoked.” 

And they conclude: “Our findings refine prior estimates of COPD among those without a smoking history and re-emphasise the high burden of COPD in women, underscoring the need for thoughtful efforts to prevent, diagnose, and treat their disease.” 

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Research suggests drinking coffee may reduce the risk of frailty

Habitual coffee consumption of 4-6 cups and over* (with one cup measuring at 125ml) per day is associated with a reduced risk of frailty.

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A new study published in the European Journal of Nutrition has suggested that habitual coffee consumption of 4-6 cups and over* (with one cup measuring at 125ml) per day is associated with a reduced risk of frailty.

The study, funded by the Institute for Scientific Information on Coffee (ISIC) is the first to analyze the relationship between coffee consumption and the underlying components of frailty.

Coffee consumption has previously been linked to reducing the risk of some of the natural symptoms of ageing, such as improving cognitive function2 and mitigating against inflammatory related diseases. This latest research adds to the growing knowledge base within this area, exploring the benefits of regular coffee consumption over an extended period of time. 

For this study, researchers conducted a detailed analysis over a long seven-year follow-up period, surveying 1,161 adults aged 55+ years through the Longitudinal Aging Study Amsterdam (LASA). 

The relationship between coffee consumption and the presence and incidence of frailty was investigated. Frailty status was evaluated using Fried’s five-component frailty phenotype4,which is defined by the presence of three or more of the following symptoms: weight loss, weakness, exhaustion, slow gait (walking) speed, and low physical activity.

The results of this study indicate that higher habitual coffee consumption is associated with lower overall odds of frailty. These findings can be considered alongside the European Food Safety Authority’s (EFSA) scientific opinion that up to 400mg of caffeine (3-5 cups of coffee) per day is a moderate and safe amount5.

The researchers explain that coffee’s effect on reducing frailty can partly be attributed to the role of antioxidants in coffee, which may help to reduce inflammation, sarcopenia (muscle loss), and prevention of muscle damage. Coffee may also help to improve regulating insulin sensitivity and glucose uptake in older people.

The study’s lead author, Margreet R. Olthof, Associate Professor at the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, commented: “Drinking coffee is a key part of many people’s daily routine, and as people age they are constantly looking for ways to maintain their health. Our findings highlight the possible beneficial association between daily coffee consumption and reduced risk of frailty in later life in the older population. Coffee consumption may thus enhance healthy aging, but it is important we also explore further dietary interventions, to ensure older adults can continue to live fulfilling lives.” 

* Moderate coffee consumption can be defined as 3–5 cups per day, based on the European Food Safety Authority’s review of caffeine safety.

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Landers opens first Cavite store in Vermosa

Landers Superstore, the fastest growing membership store in the country, proudly marks another milestone with the grand opening of Landers Vermosa – its first-ever store in the province and its 15th store nationwide.

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Premium membership shopping has finally arrived in Cavite.

Landers Superstore, the fastest growing membership store in the country, proudly marks another milestone with the grand opening of Landers Vermosa – its first-ever store in the province and its 15th store nationwide.

Conveniently located inside Ayala Vermosa’s sprawling estate and lifestyle hub in Imus, Cavite, the newest Landers store offers a fresh and elevated way of shopping for Caviteños, complete with massive savings, world-class finds, and exclusive membership perks, all under one roof. It is also the largest Landers store to date at 12,900 sqm, promising a bigger and better experience for every member who walks through its doors.

Welcoming Landers in Cavite

Landers Vermosa opened with an exciting grand launch that brought together members of the media, content creators, and special guests for a first look at the newest and biggest Landers Superstore. The attendees were in high spirits as they explored the spacious store and enjoyed exclusive product samplings and guided tours.

During the event, Landers Deputy Chief Executive Officer Bill Cummings delivered heartfelt opening remarks, expressing his excitement for the new store and his appreciation for the warm welcome from the Cavite community, noting that over 60,000 members had already signed up prior to opening day – a clear sign of the anticipation surrounding the launch.

The celebration also highlighted the strong collaboration between Landers Superstore and Ayala Land, along with the support of the city government of Imus, led by Mayor Alex Advincula. The event underscored Landers’ commitment to bringing world-class shopping experiences to more Filipino families, starting with the vibrant and growing community in Cavite.

What to expect at Landers Vermosa

At Landers Vermosa, members can look forward to filling their carts with high-quality local and imported products—from daily essentials to unique international finds. Beyond shopping, the store offers a host of exclusive perks that make every visit more rewarding. Members can enjoy free haircuts or blow-dry services at Federal Barbers, low-priced medicine and wellness products at Capital Care Pharmacy, up to P10 off per liter at Landers-Caltex gas stations, and up to 50% off on Solane LPG refills.

Members of Landers Vermosa will gain access to all of Landers Superstore’s massive sale events like Super Crazy Sale and 50% Off Produce Sale, which offer unbeatable savings on a wide range of products. To complete the experience, members can enjoy regular in-store activities every month and free product samplings that are perfect for the whole family.

Sign up for Landers membership

Be among the first to explore this exciting new shopping destination and enjoy all the perks that come with being a Landers member.

If you’re not yet a member, now’s the perfect time to sign up! Memberships are currently on sale at 50% off—just P350 for a full year of exclusive savings and benefits. Promo runs until May 31.

Looking for even more value? Apply for the Landers Cashback Everywhere Credit Card and get up to 5% cashback on all Landers purchases, plus earn rewards wherever you shop.

Landers Vermosa is here with more perks, more savings, and more reasons to love shopping in the South. See you in-store.

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