Fluoride Status and Cardiometabolic Health: Findings from a Representative Survey among Children and Adolescents

Jessica A. Ballantyne, Gemma Coyle, Sneha Sarwar, Tilman Kühn*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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There is preliminary evidence to suggest a positive association between fluoride exposure and higher blood pressure among children, but population-based biomarker studies are lacking. Thus, data from the 2013/2014 and 2015/2016 cycles of the US-based National Health and Nutrition Examination Survey (NHANES) were analysed to evaluate the association between plasma fluoride concentrations and blood pressure among children and adolescents aged 8 to 19 years. Secondary analyses were carried out on fluoride status in relation to further markers of cardio-metabolic health, i.e., anthropometric indices, biomarkers of lipid and sugar metabolism, and C-reactive protein levels. There was a positive correlation between water fluoride content and plasma fluoride concentrations (Spearman’s r = 0.41, p 0.01). However, multivariable linear regression models did not show significant differences in adjusted mean values of systolic and diastolic blood pressure across increasing quartiles of fluoride concentrations. Further markers of cardio-metabolic health were not associated with fluoride status, with the exception of a weak inverse association between plasma fluoride and HbA1c levels. Higher plasma fluoride may not be a risk factor for increased blood pressure or impaired cardio-metabolic health among children in the USA, a non-fluoride endemic country, with wide-spread water fluoridation.
Original languageEnglish
Article number1459
Number of pages9
Early online date31 Mar 2022
Publication statusEarly online date - 31 Mar 2022


  • fluoride
  • blood pressure
  • HbA1c
  • lipids
  • CRP
  • children
  • adolescents
  • C-reactive protein


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