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Tripicchio GL, Smethers AD, Johnson JJ, Olenginski J, O'Brien DM, Fisher JO, Nova VA, Nash SH. The Carbon Stable Isotope Ratio as an Objective Biomarker of Added Sugar Intake: A Scoping Review of Current Evidence in Human Nutrition. Adv Nutr 2024:100281. [PMID: 39094908 DOI: 10.1016/j.advnut.2024.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/05/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024] Open
Abstract
Objective biomarkers of dietary intake are needed to advance nutrition research. The carbon stable isotope ratio (C13/C12; CIR) holds promise as an objective biomarker of added sugar (AS) and sugar-sweetened beverage (SSB) intake. This systematic scoping review presents the current evidence on CIRs from human studies. Search results (through April 12, 2024) yielded 6297 studies and 24 final articles. Studies were observational (n = 12), controlled feeding (n = 10), or dietary interventions (n = 2). CIRs were sampled from blood (n = 23), hair (n = 5), breath (n = 2), and/or adipose tissue (n = 1). Most (n = 17) conducted whole tissue (that is, bulk) analysis, 8 used compound specific isotope analysis (CSIA), and/or 2 studies used methods appropriate for analyzing breath. Studies were conducted in 3 concentrated geographic regions of the United States (n = 7 Virginia; n = 5 Arizona; n = 4 Alaska), with only 2 studies conducted in other countries. Studies that used CSIA to examine the CIR from the nonessential amino acid alanine (CIR-Ala; n = 4) and CIR analyzed from breath (n = 2) provided the most robust evidence for CIR as an objective biomarker of AS and SSBs (R2 range 0.36-0.91). Studies using bulk analysis of hair or blood showed positive, but modest and more variable associations with AS and SSBs (R2 range 0.05-0.48). Few studies showed no association, particularly in non-United States populations and those with low AS and SSB intakes. Two studies provided evidence for CIR to detect changes in SSB intake in response to dietary interventions. Overall, the most compelling evidence supports CIR-Ala as an objective indicator of AS intake and breath CIR as an indicator of short-term AS intake. Considering how to adjust for underlying dietary patterns remains an important area of future work and emerging methods using breath and CSIA warrant additional investigation. More evidence is needed to refine the utility and specificity of CIRs to measure AS and SSB intake.
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Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, Temple University, PA, United States; Department of Social and Behavioral Sciences, Temple University, PA, United States.
| | - Alissa D Smethers
- Department of Social and Behavioral Sciences, Temple University, PA, United States
| | - Jessica J Johnson
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Jordan Olenginski
- Center for Obesity Research and Education, Temple University, PA, United States; Drexel University College of Medicine, PA, United States
| | - Diane M O'Brien
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Jennifer O Fisher
- Center for Obesity Research and Education, Temple University, PA, United States; Department of Social and Behavioral Sciences, Temple University, PA, United States
| | - Vitalina A Nova
- Social Sciences and Clark Library, University of Michigan, Ann Arbor, MI, United States
| | - Sarah H Nash
- Department of Epidemiology, University of Iowa, IA, United States
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Stable Isotope Abundance and Fractionation in Human Diseases. Metabolites 2021; 11:metabo11060370. [PMID: 34207741 PMCID: PMC8228638 DOI: 10.3390/metabo11060370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/01/2021] [Accepted: 06/05/2021] [Indexed: 01/02/2023] Open
Abstract
The natural abundance of heavy stable isotopes (13C, 15N, 18O, etc.) is now of considerable importance in many research fields, including human physiology. In fact, it varies between tissues and metabolites due to isotope effects in biological processes, that is, isotope discriminations between heavy and light isotopic forms during enzyme or transporter activity. The metabolic deregulation associated with many diseases leads to alterations in metabolic fluxes, resulting in changes in isotope abundance that can be identified easily with current isotope ratio technologies. In this review, we summarize the current knowledge on changes in natural isotope composition in samples (including various tissues, hair, plasma, saliva) found in patients compared to controls, caused by human diseases. We discuss the metabolic origin of such isotope fractionations and highlight the potential of using isotopes at natural abundance for medical diagnosis and/or prognostic.
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