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Ahn SV, Park JK. The association between carbon and nitrogen stable isotope ratios of human hair and hypertension. Clin Hypertens 2023; 29:4. [PMID: 36721223 PMCID: PMC9890701 DOI: 10.1186/s40885-022-00228-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/31/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The relationship between stable isotope ratios and dietary protein sources has been reported. However, few studies have examined the effect of stable isotope ratios on metabolic risk in humans. We investigated whether the stable isotope ratios of carbon and nitrogen in human hair are associated with blood pressure and hypertension. METHODS We conducted a cross-sectional study of 392 subjects (228 men and 164 women). Hair samples of the subjects were used for the measurement of stable isotope ratios of carbon (δ13C) and nitrogen (δ15N). RESULTS The δ13C and δ15N values showed positive correlations with diastolic blood pressure in the subjects without antihypertensive medication. In the subjects without antihypertensive medication, the multivariable-adjusted odds ratio (95% confidence interval) for hypertension was 1.55 (1.04-2.30) per 1‰ increase in δ15N and 1.22 (0.86-1.73) per 1‰ increase in δ13C, respectively. However, in the subjects with antihypertensive medication, neither δ13C nor δ15N values showed a significant association with hypertension. CONCLUSIONS The stable isotopic ratio of nitrogen in scalp hair is independently associated with hypertension in subjects without antihypertensive medication. The hair δ15N value might be used as a surrogate marker to screen a high-risk population for hypertension.
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Affiliation(s)
- Song Vogue Ahn
- grid.255649.90000 0001 2171 7754Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea
| | - Jong-Ku Park
- grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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2
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O'Brien DM, Sagi-Kiss V, Palma-Duran SA, Cunningham C, Barrett B, Johnston CS, Midthune D, Kipnis V, Freedman LS, Tasevska N. An evaluation of the serum carbon isotope ratio as a candidate predictive biomarker of the dietary animal protein ratio (animal protein/total protein) in a 15-day controlled feeding study of US adults. Am J Clin Nutr 2022; 115:1134-1143. [PMID: 35030258 PMCID: PMC8970990 DOI: 10.1093/ajcn/nqac004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/10/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The serum natural abundance carbon isotope ratio (CIR) was recently identified as a candidate biomarker of animal protein intake in postmenopausal women. Such a biomarker would help clarify the relation between dietary protein source (plant or animal) and chronic disease risk. OBJECTIVES We aimed to evaluate the performance of the serum CIR as a biomarker of dietary protein source in a controlled feeding study of men and women of diverse age and BMI. METHODS We conducted a 15-d feeding study of 100 adults (age: 18-70 y, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes. Serum was collected at the end of the feeding period for biomarker measurements. RESULTS Median [IQR] animal protein intake was 67 g/d [55-88 g/d], which was 64% of total protein. The serum CIR was positively correlated with animal protein and inversely correlated with plant protein intake, leading to a strong correlation (r2 = 0.76) with the dietary animal protein ratio (APR; animal/total protein). Regressing serum CIR on the APR, serum nitrogen isotope ratio (NIR), gender, age, and body weight generated an R2 of 0.78. Following the measurement error model for predictive biomarkers, the resulting regression equation was then inverted to develop a calibrated biomarker equation for APR. Added sugars ratio (added/total sugars intake) and corn intakes also influenced the serum CIR but to a much lesser degree than the APR; variations in these intakes had only small effects on biomarker-estimated APR. CONCLUSIONS Based on our findings in this US cohort of mixed sex and age, we propose the serum CIR alongside NIR as a predictive dietary biomarker of the APR. We anticipate using this biomarker to generate calibrated estimates based on self-reported intake and ultimately to obtain more precise disease risk estimates according to dietary protein source.
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Affiliation(s)
| | - Virag Sagi-Kiss
- Present address for VS-K: School of Medicine, Imperial College London, London, United Kingdom
| | | | | | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, USA
| | - Carol S Johnston
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Douglas Midthune
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Victor Kipnis
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - Laurence S Freedman
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Natasha Tasevska
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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3
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Rafiq T, Azab SM, Teo KK, Thabane L, Anand SS, Morrison KM, de Souza RJ, Britz-McKibbin P. Nutritional Metabolomics and the Classification of Dietary Biomarker Candidates: A Critical Review. Adv Nutr 2021; 12:2333-2357. [PMID: 34015815 PMCID: PMC8634495 DOI: 10.1093/advances/nmab054] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/20/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
Recent advances in metabolomics allow for more objective assessment of contemporary food exposures, which have been proposed as an alternative or complement to self-reporting of food intake. However, the quality of evidence supporting the utility of dietary biomarkers as valid measures of habitual intake of foods or complex dietary patterns in diverse populations has not been systematically evaluated. We reviewed nutritional metabolomics studies reporting metabolites associated with specific foods or food groups; evaluated the interstudy repeatability of dietary biomarker candidates; and reported study design, metabolomic approach, analytical technique(s), and type of biofluid analyzed. A comprehensive literature search of 5 databases (PubMed, EMBASE, Web of Science, BIOSIS, and CINAHL) was conducted from inception through December 2020. This review included 244 studies, 169 (69%) of which were interventional studies (9 of these were replicated in free-living participants) and 151 (62%) of which measured the metabolomic profile of serum and/or plasma. Food-based metabolites identified in ≥1 study and/or biofluid were associated with 11 food-specific categories or dietary patterns: 1) fruits; 2) vegetables; 3) high-fiber foods (grain-rich); 4) meats; 5) seafood; 6) pulses, legumes, and nuts; 7) alcohol; 8) caffeinated beverages, teas, and cocoas; 9) dairy and soya; 10) sweet and sugary foods; and 11) complex dietary patterns and other foods. We conclude that 69 metabolites represent good candidate biomarkers of food intake. Quantitative measurement of these metabolites will advance our understanding of the relation between diet and chronic disease risk and support evidence-based dietary guidelines for global health.
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Affiliation(s)
- Talha Rafiq
- Medical Sciences Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Sandi M Azab
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, Canada
- Department of Pharmacognosy, Alexandria University, Alexandria, Egypt
| | - Koon K Teo
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
| | - Sonia S Anand
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | - Russell J de Souza
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada
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Hedrick VE, Halliday TM, Davy BM, Zoellner JM, Jahren AH. A Single-Carbon Stable Isotope Ratio Model Prediction Equation Can Estimate Self-Reported Added Sugars Intake in an Adult Population Living in Southwest Virginia. Nutrients 2021; 13:3842. [PMID: 34836098 PMCID: PMC8617603 DOI: 10.3390/nu13113842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
The δ13C value of blood is a novel proposed biomarker of added sugars (AS) intake. AS prediction equations using either a single- (δ13C) or dual-isotope model (δ13C and δ15N) were previously developed in an adult population with high AS intake living in southwest Virginia (reference group). The purpose of this investigation was to test the δ13C single- and δ13C and δ15N dual-isotope prediction equations for AS intake in adults with a lower mean AS intake and different demographic characteristics (test group). The blood samples for the reference (n = 257 for single-isotope, n = 115 for dual-isotope) and test groups (n = 56) were analyzed for δ13C and δ15N values using natural abundance stable isotope mass spectrometry and were compared to reported dietary AS intake. When the δ13C single-isotope equation was applied to the test group, predicted AS intake was not significantly different from reported AS intake (mean difference ± standard error = -3.6 ± 5.5 g, Z = -0.55, p = 0.51). When testing the dual-isotope equation, predicted AS was different from reported AS intake (mean difference ± SEM = 13.0 ± 5.4 g, Z = -2.95, p = 0.003). δ13C value was able to predict AS intake using a blood sample within this population subset. The single-isotope prediction equation may be an alternative method to assess AS intake and is more objective, cost-feasible, and efficient than traditional dietary assessment methods. However, more research is needed to assess this biomarker with rigorous study designs such as controlled feeding.
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Affiliation(s)
- Valisa E. Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Tanya M. Halliday
- Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT 84112, USA;
| | - Brenda M. Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Jamie M. Zoellner
- Department of Public Health Sciences, University of Virginia, Christiansburg, VA 24073, USA;
| | - A. Hope Jahren
- Centre for Earth Evolution and Dynamics, University of Oslo, 0371 Oslo, Norway;
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Assessing sugar-sweetened beverage intakes, added sugar intakes and BMI before and after the implementation of a sugar-sweetened beverage tax in South Africa. Public Health Nutr 2021; 24:2900-2910. [PMID: 33315006 PMCID: PMC9884749 DOI: 10.1017/s1368980020005078] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide insight into the context and public health implications of the South African sugar-sweetened beverage (SSB) tax (Health Promotion Levy; HPL) by describing SSB and added sugar intakes, as well as BMI, 1 year prior to, at the time of and 1 year after implementation of the HPL. DESIGN Longitudinal dietary intake was assessed using a quantitative food frequency questionnaire (QFFQ) and BMI was measured via anthropometry. SETTING Soweto, Johannesburg, South Africa. PARTICIPANTS Adolescents, young adults and middle-aged adults (n 617). RESULTS At baseline, median SSB intakes were 36 ml/d, 214 ml/d and 750 ml/d for those in low, medium and high consumption tertiles, respectively. SSB intake decreased by two times/week in medium consumers and seven times/week in high consumers between baseline and 12 months, equivalent to 107 ml/d and 536 ml/d reductions, respectively. These reduced levels were maintained in the following year (i.e. to 24 months). There was an overall decrease in the amount of energy consumed as added sugar in the low (-48 kJ/d), medium (-153 kJ/d) and high (-106 kJ/d) SSB consumption groups between baseline and 24 months; however, the percentage of total energy consumed as added sugar remained relatively consistent (between 10 and 11 %). There were small overall increases in BMI across low (0·6 kg/m2), medium (0·9 kg/m2) and high (1·0 kg/m2) SSB tertiles between baseline and 24 months. CONCLUSIONS These findings suggest reductions in SSB and added sugar consumption contemporaneous to the introduction of the HPL - particularly for those with higher baseline intakes.
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Te Morenga L, Kruimer D, McLean R, Sabadel AJM, van Hale R, Tatin X, Hindmarsh JH, Mann J, Merriman T. Associations Between Sugars Intakes and Urinary Sugars Excretion and Carbon Stable Isotope Ratios in Red Blood Cells as Biomarkers of Sugars Intake in a Predominantly Māori Population. Front Nutr 2021; 8:637267. [PMID: 34277677 PMCID: PMC8278019 DOI: 10.3389/fnut.2021.637267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 05/21/2021] [Indexed: 12/31/2022] Open
Abstract
Determining the extent to which added sugars intake contribute to non-communicable disease in various populations is challenging because it is difficult to accurately measure intakes. Biomarkers may provide a reliable and easily measured method of assessing intakes. In a predominantly Māori population we compared various sugars intake estimates derived from a 36 item sugar-specific food frequency questionnaire (FFQ) with biomarkers of sugars intake; urinary sugars excretion in random spot collections (n = 153) and carbon stable isotope ratios (n = 36) in red blood cells (RBCs, δ13CRBC) and in the alanine fraction of the RBCs (δ13Calanine). Estimated 24 h urinary sucrose+fructose excretion was statistically significantly correlated with intakes of total sugars (r = 0.23), sucrose (r = 0.26) and added sugars from sugar-sweetened beverages (SSBs; r = 0.26). δ13Calanine was correlated with added sugars (r = 0.40). In log linear multiple regression models adjusted with HbA1C and eGFR δ13Calanine predicted added sugars intakes (r 2 = 0.29) and estimated 24 h urinary sucrose+fructose excretion predicted intakes of total sugars (r 2 = 0.14), sucrose (r 2 = 0.17), added sugars (r 2 = 0.17) and sugars from SSBs (r 2 = 0.14). These biomarkers have potential for improving assessment of sugars intake in New Zealand populations enabling monitoring of the effectiveness of sugar reduction strategies designed to reduce risk of NCDs. However, further validation is required to confirm these preliminary findings.
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Affiliation(s)
- Lisa Te Morenga
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand.,Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand
| | - Devonia Kruimer
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand
| | - Rachael McLean
- Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Robert van Hale
- Department of Chemistry, University of Otago, Dunedin, New Zealand
| | | | | | - Jim Mann
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,Riddet Centre of Research Excellence, University of Otago, Dunedin, New Zealand.,Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Tony Merriman
- Edgar Diabetes and Obesity Research, University of Otago, Dunedin, New Zealand.,Department of Biochemistry, University of Otago, Dunedin, New Zealand
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7
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Johnson JJ, Shaw PA, Oh EJ, Wooller MJ, Merriman S, Yun HY, Larsen T, Krakoff J, Votruba SB, O'Brien DM. The carbon isotope ratios of nonessential amino acids identify sugar-sweetened beverage (SSB) consumers in a 12-wk inpatient feeding study of 32 men with varying SSB and meat exposures. Am J Clin Nutr 2021; 113:1256-1264. [PMID: 33676366 PMCID: PMC8106756 DOI: 10.1093/ajcn/nqaa374] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The carbon isotope ratios (CIRs) of individual amino acids (AAs) may provide more sensitive and specific biomarkers of sugar-sweetened beverages (SSBs) than total tissue CIR. Because CIRs turn over slowly, long-term controlled-feeding studies are needed in their evaluation. OBJECTIVE We assessed the responses of plasma and RBC CIRAA's to SSB and meat intake in a 12-wk inpatient feeding study. METHODS Thirty-two men (aged 46.2 ± 10.5 y) completed the feeding study at the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix, Arizona. The effects of SSB, meat, and fish intake on plasma and RBC CIRAA's were evaluated in a balanced factorial design with each dietary variable either present or absent in a common weight-maintaining, macronutrient-balanced diet. Fasting blood samples were collected biweekly from baseline. Dietary effects on the postfeeding CIR of 5 nonessential AAs (CIRNEAA's) and 4 essential AAs (CIREAA's) were analyzed using multivariable regression. RESULTS In plasma, 4 of 5 CIRNEAA's increased with SSB intake. Of these, the CIRAla was the most sensitive (β = 2.81, SE = 0.38) to SSB intake and was not affected by meat or fish intake. In RBCs, all 5 CIRNEAA's increased with SSBs but had smaller effect sizes than in plasma. All plasma CIREAA's increased with meat intake (but not SSB or fish intake), and the CIRLeu was the most sensitive (β = 1.26, SE = 0.23). CIRs of leucine and valine also increased with meat intake in RBCs. Estimates of turnover suggest that CIRAA's in plasma, but not RBCs, were in equilibrium with the diets by the end of the study. CONCLUSIONS The results of this study in men support CIRNEAA's as potential biomarkers of SSB intake and suggest CIREAA's as potential biomarkers of meat intake in US diets. This trial was registered at clinicaltrials.gov/ct2/show/NCT01237093 as NCT01237093.
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Affiliation(s)
| | - Pamela A Shaw
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Eric J Oh
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Matthew J Wooller
- Alaska Stable Isotope Facility, Water and Environmental Research Center, Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, AK, USA,Department of Marine Biology, College of Fisheries and Ocean Sciences, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Sean Merriman
- Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Hee Young Yun
- Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Thomas Larsen
- Department of Archaeology, Max Planck Institute for the Science of Human History, Jena, Germany
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA
| | - Susanne B Votruba
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA
| | - Diane M O'Brien
- Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, USA
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8
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Yazbeck R, Howarth GS, Kosek M, Davidson GP, Butler RN. Breath 13CO 2-evidence for a noninvasive biomarker to measure added refined sugar uptake. J Appl Physiol (1985) 2021; 130:1025-1032. [PMID: 33444124 DOI: 10.1152/japplphysiol.00648.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Increased consumption of added sucrose and high-fructose corn syrup in the human diet has been associated with increasing incidence of obesity and metabolic disease. There are currently no reliable, objective biomarkers for added sugar intake that could be used in individuals or population settings. 13C is a stable isotope of carbon, and measurement of blood 13C content has been proposed as a marker of added sugar consumption. This study aimed to determine if breath 13CO2 could represent an alternative, noninvasive biomarker to monitor added sugar intake. We undertook retrospective analyses of eight preclinical and human 13C-breath studies to define baseline breath 13CO2 characteristics. All samples were analyzed using isotope ratio mass spectrometry, and breath 13CO2 was expressed as the delta value, δ expressed as parts per thousand (‰). All data are expressed as mean ± SEM, with statistical significance considered at P < 0.05. Breath δ13CO2 was significantly elevated in a cumulative manner in rats and mice that consumed a diet containing at least 15% sucrose. Mice fed an American rodent chow diet containing 50% sucrose and 15% corn starch had a significantly higher breath δ13CO2 compared with rodents consuming an Australian rodent chow diet. Furthermore, breath δ13CO2 was significantly increased in a dose-dependent manner in humans that ingested a bolus dose of sucrose. These findings suggest application for baseline breath δ13CO2 as a noninvasive biomarker for added sugar consumption, with broad application for longitudinal assessment of population sugar intake and obesity management strategies.NEW & NOTEWORTHY We have found that breath 13CO2 is increased in rats and mice consuming diets high in sucrose. We also found that human breath 13CO2 is increased in humans consuming increasing amounts of sucrose. Our collective findings suggest that breath 13CO2 represents a potential marker of added dietary sugar consumption.
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Affiliation(s)
- Roger Yazbeck
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - Gordon S Howarth
- School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy Campus, South Australia
| | - Margaret Kosek
- Centre for Paediatric and Adolescent Gastroenterology, Children, Youth and Women's Health Service, North Adelaide, South Australia
| | - Geoffrey P Davidson
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Ross N Butler
- Discipline of Paediatrics, University of Adelaide, Adelaide, South Australia
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9
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Lacombe RJS, Bazinet RP. Natural abundance carbon isotope ratio analysis and its application in the study of diet and metabolism. Nutr Rev 2020; 79:869-888. [PMID: 33141222 DOI: 10.1093/nutrit/nuaa109] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Due to differences in carbon assimilation pathways between plants, there are subtle but distinct variations in the carbon isotope ratios of foods and animal products throughout the food supply. Although it is well understood that the carbon isotope ratio composition of the diet influences that of the consumers' tissues, the application of natural abundance carbon isotope ratio analysis in nutrition has long been underappreciated. Over the past decade, however, several studies have investigated the utility of carbon isotope ratio analysis for evaluation of nutritional biomarker status, primarily focusing on its application as an objective indicator of sugar and animal protein intake. More recently, research investigating the application of natural abundance measurements has been extended to study fatty acid metabolism and has yielded encouraging results. Collectively, data from large-scale observational studies and experimental animal studies highlight the potential for carbon isotope ratio analysis as an additional and effective tool to study diet and metabolism. The purpose of this review is to provide an overview of natural abundance carbon isotope ratio analysis, its application to studying nutrition, and an update of the research in the field.
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Affiliation(s)
- R J Scott Lacombe
- Dell Pediatric Research Institute, University of Texas at Austin, Austin, Texas, USA.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Richard P Bazinet
- Dell Pediatric Research Institute, University of Texas at Austin, Austin, Texas, USA
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10
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Louie JCY. Objective Biomarkers for Total Added Sugar Intake - Are We on a Wild Goose Chase? Adv Nutr 2020; 11:1429-1436. [PMID: 32805008 PMCID: PMC7666891 DOI: 10.1093/advances/nmaa093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/09/2020] [Indexed: 12/27/2022] Open
Abstract
Misreporting of added sugar intake has been the major criticism of studies linking high added sugar consumption to adverse health outcomes. Despite the advancement in dietary assessment methodologies, the bias introduced by self-reporting can never be completely eliminated. The search for an objective biomarker for total added sugar intake has therefore been a topic of interest. In this article, the reasons this search may be a wild goose chase will be outlined and discussed. The limitations and inability of the 2 candidate biomarkers, namely urinary sucrose and fructose and δ¹³C isotope, which are based on the 2 only possible ways (i.e., difference in metabolism and plant sources) to identify added sugar based on current knowledge in human physiology and food and nutritional sciences, are discussed in detail. Validation studies have shown that these 2 candidate biomarkers are unlikely to be suitable for use as a predictive or calibration biomarker for total added sugar intake. Unless advancement in our understanding in human physiology and food and nutritional sciences leads to new potential ways to distinguish between naturally occurring and added sugars, it is extremely unlikely that any accurate objective added sugar biomarker could be found. It may be time to stop the futile effort in searching for such a biomarker, and resources may be better spent on further improving and innovating dietary assessment methods to minimize the bias introduced by self-reporting.
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11
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Maruvada P, Lampe JW, Wishart DS, Barupal D, Chester DN, Dodd D, Djoumbou-Feunang Y, Dorrestein PC, Dragsted LO, Draper J, Duffy LC, Dwyer JT, Emenaker NJ, Fiehn O, Gerszten RE, B Hu F, Karp RW, Klurfeld DM, Laughlin MR, Little AR, Lynch CJ, Moore SC, Nicastro HL, O'Brien DM, Ordovás JM, Osganian SK, Playdon M, Prentice R, Raftery D, Reisdorph N, Roche HM, Ross SA, Sang S, Scalbert A, Srinivas PR, Zeisel SH. Perspective: Dietary Biomarkers of Intake and Exposure-Exploration with Omics Approaches. Adv Nutr 2020; 11:200-215. [PMID: 31386148 PMCID: PMC7442414 DOI: 10.1093/advances/nmz075] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
While conventional nutrition research has yielded biomarkers such as doubly labeled water for energy metabolism and 24-h urinary nitrogen for protein intake, a critical need exists for additional, equally robust biomarkers that allow for objective assessment of specific food intake and dietary exposure. Recent advances in high-throughput MS combined with improved metabolomics techniques and bioinformatic tools provide new opportunities for dietary biomarker development. In September 2018, the NIH organized a 2-d workshop to engage nutrition and omics researchers and explore the potential of multiomics approaches in nutritional biomarker research. The current Perspective summarizes key gaps and challenges identified, as well as the recommendations from the workshop that could serve as a guide for scientists interested in dietary biomarkers research. Topics addressed included study designs for biomarker development, analytical and bioinformatic considerations, and integration of dietary biomarkers with other omics techniques. Several clear needs were identified, including larger controlled feeding studies, testing a variety of foods and dietary patterns across diverse populations, improved reporting standards to support study replication, more chemical standards covering a broader range of food constituents and human metabolites, standardized approaches for biomarker validation, comprehensive and accessible food composition databases, a common ontology for dietary biomarker literature, and methodologic work on statistical procedures for intake biomarker discovery. Multidisciplinary research teams with appropriate expertise are critical to moving forward the field of dietary biomarkers and producing robust, reproducible biomarkers that can be used in public health and clinical research.
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Affiliation(s)
- Padma Maruvada
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Johanna W Lampe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - David S Wishart
- Departments of Biological Sciences and Computing Science, University of Alberta, Edmonton, Alberta, Canada
| | - Dinesh Barupal
- West Coast Metabolomics Center, UC Davis Genome Center, University of California, Davis, Davis, CA, USA
| | - Deirdra N Chester
- Division of Nutrition, Institute of Food Safety and Nutrition at the National Institute of Food and Agriculture, USDA, Washington, DC, USA
| | - Dylan Dodd
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
| | - Yannick Djoumbou-Feunang
- Departments of Biological Sciences and Computing Science, University of Alberta, Edmonton, Alberta, Canada
| | - Pieter C Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, USA
| | - Lars O Dragsted
- Department of Nutrition, Exercise, and Sports, Section of Preventive and Clinical Nutrition, University of Copenhagen, Copenhagen, Denmark
| | - John Draper
- Institute of Biological Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, Ceredigion, United Kingdom
| | - Linda C Duffy
- National Institutes of Health, National Center for Complementary and Integrative Health, Bethesda, MD, USA
| | - Johanna T Dwyer
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD, USA
| | - Nancy J Emenaker
- National Institutes of Health, National Cancer Institute, Rockville, MD, USA
| | - Oliver Fiehn
- West Coast Metabolomics Center, UC Davis Genome Center, University of California, Davis, Davis, CA, USA
| | - Robert E Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Departments of Nutrition; Epidemiology and Statistics, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Robert W Karp
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - David M Klurfeld
- Department of Nutrition, Food Safety/Quality, USDA—Agricultural Research Service, Beltsville, MD, USA
| | - Maren R Laughlin
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - A Roger Little
- National Institutes of Health, National Institute on Drug Abuse, Bethesda, MD, USA
| | - Christopher J Lynch
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Steven C Moore
- National Institutes of Health, National Cancer Institute, Rockville, MD, USA
| | - Holly L Nicastro
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Diane M O'Brien
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - José M Ordovás
- Nutrition and Genomics Laboratory, Jean Mayer–USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Stavroula K Osganian
- National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Mary Playdon
- Department of Nutrition and Integrative Physiology, University of Utah and Division of Cancer Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ross Prentice
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Daniel Raftery
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | - Helen M Roche
- Nutrigenomics Research Group, School of Public Health, Physiotherapy and Sports Science, UCD Institute of Food and Health, Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland
| | - Sharon A Ross
- National Institutes of Health, National Cancer Institute, Rockville, MD, USA
| | - Shengmin Sang
- Laboratory for Functional Foods and Human Health, Center for Excellence in Post-Harvest Technologies, North Carolina A&T State University, North Carolina Research Campus, Nutrition Research Building, Kannapolis, NC, USA
| | - Augustin Scalbert
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Biomarkers Group, Lyon, France
| | - Pothur R Srinivas
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Steven H Zeisel
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, USA
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Votruba SB, Shaw PA, Oh EJ, Venti CA, Bonfiglio S, Krakoff J, O'Brien DM. Associations of plasma, RBCs, and hair carbon and nitrogen isotope ratios with fish, meat, and sugar-sweetened beverage intake in a 12-wk inpatient feeding study. Am J Clin Nutr 2019; 110:1306-1315. [PMID: 31515553 PMCID: PMC6885477 DOI: 10.1093/ajcn/nqz208] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/31/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Naturally occurring carbon and nitrogen stable isotope ratios [13C/12C (CIR) and 15N/14N (NIR)] are promising dietary biomarkers. As these candidate biomarkers have long tissue residence times, long-term feeding studies are needed for their evaluation. OBJECTIVE Our aim was to evaluate plasma, RBCs, and hair CIR and NIR as biomarkers of fish, meat, and sugar-sweetened beverage (SSB) intake in a 12-wk dietary intervention. METHODS Thirty-two men (aged 46.2 ± 10.5 y; BMI: 27.2 ± 4.0 kg/m2) underwent a 12-wk inpatient dietary intervention at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in Phoenix, Arizona. The effects of fish, meat, and SSB intake on CIR and NIR were evaluated using a balanced factorial design, with each intake factor at 2 levels (present/absent) in a common, background diet (50% carbohydrate, 30% fat, 20% protein). Fasting blood samples were taken biweekly from baseline, and hair samples were collected at baseline and postintervention. Data were analyzed using multivariable regression. RESULTS The postintervention CIR of plasma was elevated when diets included meat (β = 0.89, 95% CI: 0.73,1.05) and SSBs (β = 0.48, 95% CI: 0.32, 0.64). The postintervention NIR of plasma was elevated when diets included fish (β = 0.85, 95% CI: 0.64, 1.05) and meat (β = 0.61, 95% CI: 0.42, 0.8). Results were similar for RBCs and hair. Postintervention RBC CIR and NIR had strong associations with baseline, suggesting that turnover to the intervention diets was incomplete after 12 wk. Estimates of isotopic turnover rate further confirmed incomplete turnover of RBCs. CONCLUSIONS CIR was associated with meat and SSBs, and more strongly with meat. NIR was associated with fish and meat, and more strongly with fish. Overall, CIR and NIR discriminated between dietary fish and meat, and to a lesser extent SSBs, indicating their potential utility as biomarkers of intake in US diets. Approaches to make these biomarkers more specific are needed. This trial was registered at clinicaltrials.gov as NCT01237093.
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Affiliation(s)
- Susanne B Votruba
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA,Address correspondence to SBV (e-mail: )
| | - Pamela A Shaw
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric J Oh
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Colleen A Venti
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA
| | - Susan Bonfiglio
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA
| | - Jonathan Krakoff
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases/NIH, Phoenix, AZ, USA
| | - Diane M O'Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, USA
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Liu SV, Moore LB, Halliday TM, Jahren AH, Savla J, Hedrick VE, Marinik EL, Davy BM. Short-term changes in added sugar consumption by adolescents reflected in the carbon isotope ratio of fingerstick blood. Nutr Health 2018; 24:251-259. [PMID: 30231801 PMCID: PMC9817487 DOI: 10.1177/0260106018799522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Consumption of added sugars (AS) and sugar-sweetened beverages (SSB) may adversely affect adolescents' weight and cardiovascular disease risk. Reliance on self-reported dietary assessment methods is a common research limitation, which could be overcome by dietary intake biomarkers. AIM The investigation was a proof-of-concept study to evaluate the proposed carbon isotope ratio (δ13C) biomarker of AS intake in adolescents, using a controlled feeding design. METHODS Participants (n = 33, age 15.3 years, 53% female) underwent two seven-day controlled feeding periods in a randomly assigned order. Diets were matched in composition except for AS content (5% or 25% of total energy). Fasting fingerstick blood samples were collected daily during each diet period. RESULTS Fingerstick δ13C values changed from day 1 to 8 by -0.05 ± 0.071‰ on 5% AS, and +0.03 ± 0.083‰ on 25% AS (p ≤ 0.001). Reliability was demonstrated between day 7 and 8 δ13C values on the 5% (ICC = 0.996, p ≤ 0.001) and 25% (ICC = 0.997, p ≤ 0.001) AS diets. CONCLUSIONS Larger scale investigations are warranted to determine if this technique could be applied to population-level research in order to help assess the effectiveness of interventions aimed at reducing the consumption of AS or SSB intake.
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Affiliation(s)
- Sarah V Liu
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
| | - Lori B Moore
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
| | - Tanya M Halliday
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
| | - A Hope Jahren
- Centre for Earth Evolution and Dynamics, University of Oslo, Norway
| | - Jyoti Savla
- Department of Human Development and Center for Gerontology, Virginia Tech, Blacksburg, USA
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
| | - Elaina L Marinik
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
| | - Brenda M Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, USA
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14
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Yun HY, Lampe JW, Tinker LF, Neuhouser ML, Beresford SAA, Niles KR, Mossavar-Rahmani Y, Snetselaar LG, Van Horn L, Prentice RL, O'Brien DM. Serum Nitrogen and Carbon Stable Isotope Ratios Meet Biomarker Criteria for Fish and Animal Protein Intake in a Controlled Feeding Study of a Women's Health Initiative Cohort. J Nutr 2018; 148:1931-1937. [PMID: 30239866 PMCID: PMC6280000 DOI: 10.1093/jn/nxy168] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/14/2018] [Accepted: 07/03/2018] [Indexed: 11/13/2022] Open
Abstract
Background Natural abundance stable isotope ratios are candidate biomarkers of dietary intake that have not been evaluated in a controlled feeding study in a US population. Objectives Our goals were to evaluate dietary associations with serum carbon (CIR), nitrogen (NIR), and sulfur (SIR) isotope ratios in postmenopausal women, and to evaluate whether statistical models of dietary intake that include multiple isotopes and participant characteristics meet criteria for biomarker evaluation. Methods Postmenopausal women from the Women's Health Initiative (n = 153) were provided a 2-wk controlled diet that approximated each individual's habitual food intake. Dietary intakes of animal protein, fish/seafood, red meat, poultry, egg, dairy, total sugars, added sugars, sugar-sweetened beverages (SSBs), and corn products were characterized during the feeding period with the use of the Nutrition Data System for Research (NDS-R). The CIR, NIR, and SIR were measured in sera collected from fasting women at the beginning and the end of the feeding period. Linear models based on stable isotope ratios and participant characteristics predicted dietary intake. The criterion used for biomarker evaluation was R2 ≥ 0.36, based on the study's power to detect true associations with R2 ≥ 0.50. Results The NIR was associated with fish/seafood intake and met the criterion for biomarker evaluation (R2 = 0.40). The CIR was moderately associated with intakes of red meat and eggs, but not to the criterion for biomarker evaluation, and was not associated with intake of sugars (total, added, or SSB). A model of animal protein intake based on the NIR, CIR, and participant characteristics met the criterion for biomarker evaluation (R2 = 0.40). Otherwise, multiple isotopes did not improve models of intake, and improvements from including participant characteristics were modest. Conclusion Serum stable isotope ratios can, with participant characteristics, meet biomarker criteria as measures of fish/seafood and animal protein intake in a sample of postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Hee Young Yun
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, University of Washington, Seattle, WA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, University of Washington, Seattle, WA
| | - Shirley A A Beresford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, University of Washington, Seattle, WA
| | - Kristine R Niles
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- School of Public Health, University of Washington, Seattle, WA
| | - Diane M O'Brien
- Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK
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Valenzuela LO, O'Grady SP, Enright LE, Murtaugh M, Sweeney C, Ehleringer JR. Evaluation of childhood nutrition by dietary survey and stable isotope analyses of hair and breath. Am J Hum Biol 2018; 30:e23103. [PMID: 29388286 DOI: 10.1002/ajhb.23103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 08/19/2017] [Accepted: 01/08/2018] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES The natural abundances of carbon, nitrogen, and sulfur stable isotopes in hair, and of carbon isotopes in breath serve as quantitative biomarkers of protein and carbohydrate sources, but applicability of isotopes for evaluating children's diet has not been demonstrated. In this study, we sought to describe the stable isotope patterns observed in the hair and breath of children and to assess dietary variations in relation to age and ethnicity, hypothesizing that these would reflect dietary differences across age and ethnic groups and would correlate with intake variables derived from a Food Frequency Questionnaire. METHODS Data were obtained from a cross-sectional study of non-Hispanic white (N = 115) and Hispanic (N = 97) children, aged 9-16 years, in Salt Lake City, Utah. Sampling included a hair sample, breath samples (AM and PM), and a youth/adolescent food questionnaire (YAQ). Hair was analyzed for carbon (δ13 C), nitrogen (δ15 N), and sulfur (δ34 S) isotopes, and breath samples for δ13 CAM/PM of respired CO2 . RESULTS Non-Hispanic whites had lower δ13 C, δ15 N, δ13 CAM , and δ13 CPM values than Hispanics. Hair δ13 C and δ15 N values were correlated with protein sources, particularly for non-Hispanics. Breath δ13 C values were correlated with carbohydrate sources, particularly for Hispanic students. Non-Hispanic white students reported greater intake of total protein, animal protein, dairy, and grain than Hispanic students. Hispanic students reported higher intake of carbohydrates, particularly sweetened beverages. CONCLUSION While YAQ and stable isotope data reflected strong cultural influences in diet, no significant gender-based nor age-based differences were detected. Significant covariation between YAQ and isotopes existed and demonstrate the potential of stable isotopes for characterizing children's diet.
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Affiliation(s)
- Luciano O Valenzuela
- Department of Biology, University of Utah, 257 South 1400 East, Salt Lake City, Utah 84112.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Laboratorio de Ecología Evolutiva Humana, Facultad de Ciencias Sociales, Universidad Nacional del Centro de la Provincia de Buenos Aires, Unidad de Enseñanza Universitaria Quequén, Calle 508 N° 881, Quequén, Buenos Aires, CP 7631, Argentina
| | - Shannon P O'Grady
- Department of Biology, University of Utah, 257 South 1400 East, Salt Lake City, Utah 84112
| | - Lindsey E Enright
- Department of Biology, University of Utah, 257 South 1400 East, Salt Lake City, Utah 84112
| | - Maureen Murtaugh
- Division of Epidemiology, University of Utah, 295 Chipeta Way, Salt Lake City, Utah 84108
| | - Carol Sweeney
- Division of Epidemiology, University of Utah, 295 Chipeta Way, Salt Lake City, Utah 84108
| | - James R Ehleringer
- Department of Biology, University of Utah, 257 South 1400 East, Salt Lake City, Utah 84112
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16
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MacDougall CR, Hill CE, Jahren AH, Savla J, Riebl SK, Hedrick VE, Raynor HA, Dunsmore JC, Frisard MI, Davy BM. The δ13C Value of Fingerstick Blood Is a Valid, Reliable, and Sensitive Biomarker of Sugar-Sweetened Beverage Intake in Children and Adolescents. J Nutr 2018; 148:147-152. [PMID: 29378049 PMCID: PMC6251656 DOI: 10.1093/jn/nxx017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 09/28/2017] [Accepted: 10/13/2017] [Indexed: 12/24/2022] Open
Abstract
Background Reliance on self-reported dietary intake methods is a commonly cited research limitation, and dietary misreporting is a particular problem in children and adolescents. Objective indicators of dietary intake, such as dietary biomarkers, are needed to overcome this research limitation. The added sugar (AS) biomarker δ13C, which measures the relative abundance of 13C to 12C, has demonstrated preliminary validity in adults. Objective The purpose of this investigation was to determine the comparative validity, test-retest reliability, and sensitivity of the δ13C biomarker to detect AS and sugar-sweetened beverage (SSB) intake using fingerstick blood samples in children and adolescents. Methods Children (aged 6-11 y, n = 126, 56% male, mean ± SD age: 9 ± 2 y) and adolescents (aged 12-18 y, n = 200, 44% male, mean ± SD age: 15 ± 2 y) completed 4 testing sessions within a 3-wk period. Participants' height, weight, demographic characteristics, and health history were determined at the first session; 24-h recalls were obtained at each visit and fingerstick blood samples were collected at visits 1 and 3. Samples were analyzed for δ13C value using natural abundance stable isotope mass spectrometry. δ13C value was compared with dietary outcomes in the full sample, and in child and adolescent subgroups. t Tests and correlational analyses were used to assess biomarker validity and reliability, whereas logistic regression and area under the receiver-operator characteristic curve (AUC) were used to evaluate sensitivity. Results Reported mean ± SD AS consumption was 82.2 ± 35.8 g/d and 329 ± 143 kcal/d, and SSB consumption was 222 ± 243 mL/d and 98 ± 103 kcal/d. Mean δ13C value was -19.65 ± 0.69‰, and was lower in children than in adolescents (-19.80 ± 0.67‰ compared with -19.56 ± 0.67‰, P = 0.002). δ13C values were similar across sessions (visit 1: -19.66 ± 0.68‰; visit 3: -19.64 ± 0.68‰; r = 0.99, P < 0.001) and were associated (P < 0.001) with intake of total AS (grams, kilocalories: r = 0.29) and SSB (milliliters, kilocalories: r = 0.35). The biomarker was able to better discriminate between high and low SSB consumers than high and low AS consumers, as demonstrated by the AUC (0.75 and 0.62, respectively). Conclusions The δ13C biomarker is a promising, minimally invasive, objective biomarker of SSB intake in children and adolescents. Further evaluation using controlled feeding designs is warranted. Registered at clinicaltrials.gov as NCT02455388.
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Affiliation(s)
- Carly R MacDougall
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Catelyn E Hill
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | | | - Jyoti Savla
- Department of Human Development, Virginia Tech, Blacksburg, VA
| | - Shaun K Riebl
- Department of Nutrition, University of North Carolina, Chapel Hill, NC
| | - Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Hollie A Raynor
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN
| | | | - Madlyn I Frisard
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
| | - Brenda M Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Rollo ME, Williams RL, Burrows T, Kirkpatrick SI, Bucher T, Collins CE. What Are They Really Eating? A Review on New Approaches to Dietary Intake Assessment and Validation. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0182-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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18
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Chi DL, Hopkins S, O'Brien D, Mancl L, Orr E, Lenaker D. Association between added sugar intake and dental caries in Yup'ik children using a novel hair biomarker. BMC Oral Health 2015; 15:121. [PMID: 26452647 PMCID: PMC4600323 DOI: 10.1186/s12903-015-0101-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 10/01/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Dental caries (tooth decay) is a significant public health problem in Alaska Native children. Dietary added sugars are considered one of the main risk factors. In this cross-sectional pilot study, we used a validated hair-based biomarker to measure added sugar intake in Alaska Native Yup'ik children ages 6-17 years (N = 51). We hypothesized that added sugar intake would be positively associated with tooth decay. METHODS A 66-item parent survey was administered, a hair sample was collected from each child, and a dental exam was conducted. Added sugar intake (grams/day) was measured from hair samples using a linear combination of carbon and nitrogen ratios. We used linear and log-linear regression models with robust standard errors to test our hypothesis that children with higher added sugar intake would have a higher proportion of carious tooth surfaces. RESULTS The mean proportion of carious tooth surfaces was 30.8 % (standard deviation: 23.2 %). Hair biomarker-based added sugar intake was associated with absolute (6.4 %; 95 % CI: 1.2 %, 11.6 %; P = .02) and relative increases in the proportion of carious tooth surfaces (24.2 %; 95 % CI: 10.6 %, 39.4 %; P < .01). There were no associations between self-reported measures of sugar-sweetened food and beverage intake and tooth decay. CONCLUSIONS Added sugar intake as assessed by hair biomarker was significantly and positively associated with tooth decay in our sample of Yup'ik children. Self-reported dietary measures were not associated tooth decay. Most added sugars were from sugar-sweetened fruit drinks consumed at home. Future dietary interventions aimed at improving the oral health of Alaska Native children should consider use of objective biomarkers to assess and measure changes in home-based added sugar intake, particularly sugar-sweetened fruit drinks.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington School of Dentistry, Box 357475, Seattle, WA, 98195, USA.
| | - Scarlett Hopkins
- University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA.
| | - Diane O'Brien
- University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA.
| | - Lloyd Mancl
- Department of Oral Health Sciences, University of Washington School of Dentistry, Box 357475, Seattle, WA, 98195, USA.
| | - Eliza Orr
- University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA.
| | - Dane Lenaker
- Yukon Kuskokwim Health Corporation, Dentistry Department, Bethel, AK, USA.
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Park JK, Ahn SV, Kim MK, Lee KS, Koh SB, Bong YS. The association between carbon and nitrogen stable isotope ratios of human hair and metabolic syndrome. Clin Chim Acta 2015; 450:72-7. [PMID: 26238186 DOI: 10.1016/j.cca.2015.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 07/12/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND It has been reported that stable isotope ratios can be used as biomarkers for animal protein intake. Meat consumption and high protein intake could be risk factors for metabolic disorders. We investigated whether the stable isotope ratios of carbon and nitrogen are associated with metabolic syndrome. METHODS We conducted a cross-sectional study of 399 subjects (233 men and 166 women). Hair samples from 399 subjects were measured for stable isotope ratios of carbon (δ(13)C) and nitrogen (δ(15)N). RESULTS The δ(15)N values progressively increased with the number of components of the metabolic syndrome present in study subjects (P for trend 0.047). In multivariable models, δ(15)N values were positively associated with the presence of metabolic syndrome (odds ratio, 1.53; 95% confidence interval, 1.09-2.14), whereas δ(13)C values were not (odds ratio, 0.97; 95% confidence interval, 0.72-1.30). The odds ratio (95% confidence interval) for metabolic syndrome comparing the highest to the lowest quartiles of δ(15)N values was 2.64 (1.17-5.92). CONCLUSIONS The nitrogen, but not carbon, stable isotopic ratio of hair is independently associated with the presence of metabolic syndrome. The hair δ(15)N value might be a surrogate marker for clustering of risk factors in metabolic syndrome.
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Affiliation(s)
- Jong-Ku Park
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea; Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea
| | - Song Vogue Ahn
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea; Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea.
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 133-791, South Korea
| | - Kwang-Sik Lee
- Division of Earth and Environmental Science, Korea Basic Science Institute, Ochang 363-883, South Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea; Institute of Genomic Cohort, Wonju College of Medicine, Yonsei University, Wonju 220-710, South Korea
| | - Yeon-Sik Bong
- Division of Earth and Environmental Science, Korea Basic Science Institute, Ochang 363-883, South Korea
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Urinary Sugars--A Biomarker of Total Sugars Intake. Nutrients 2015; 7:5816-33. [PMID: 26184307 PMCID: PMC4517032 DOI: 10.3390/nu7075255] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/23/2015] [Accepted: 07/08/2015] [Indexed: 01/09/2023] Open
Abstract
Measurement error in self-reported sugars intake may explain the lack of consistency in the epidemiologic evidence on the association between sugars and disease risk. This review describes the development and applications of a biomarker of sugars intake, informs its future use and recommends directions for future research. Recently, 24 h urinary sucrose and fructose were suggested as a predictive biomarker for total sugars intake, based on findings from three highly controlled feeding studies conducted in the United Kingdom. From this work, a calibration equation for the biomarker that provides an unbiased measure of sugars intake was generated that has since been used in two US-based studies with free-living individuals to assess measurement error in dietary self-reports and to develop regression calibration equations that could be used in future diet-disease analyses. Further applications of the biomarker include its use as a surrogate measure of intake in diet-disease association studies. Although this biomarker has great potential and exhibits favorable characteristics, available data come from a few controlled studies with limited sample sizes conducted in the UK. Larger feeding studies conducted in different populations are needed to further explore biomarker characteristics and stability of its biases, compare its performance, and generate a unique, or population-specific biomarker calibration equations to be applied in future studies. A validated sugars biomarker is critical for informed interpretation of sugars-disease association studies.
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Hedrick VE, Zoellner JM, Jahren AH, Woodford NA, Bostic JN, Davy BM. A Dual-Carbon-and-Nitrogen Stable Isotope Ratio Model Is Not Superior to a Single-Carbon Stable Isotope Ratio Model for Predicting Added Sugar Intake in Southwest Virginian Adults. J Nutr 2015; 145:1362-9. [PMID: 25855120 PMCID: PMC4442118 DOI: 10.3945/jn.115.211011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/13/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND An objective measure of added sugar (AS) and sugar-sweetened beverage (SSB) intake is needed. The δ(13)C value of finger-stick blood is a novel validated biomarker of AS/SSB intake; however, nonsweetener corn products and animal protein also carry a δ(13)C value similar to AS sources, which may affect blood δ(13)C values. The δ(15)N value of blood has been proposed as a "correction factor" for animal protein intake. OBJECTIVES The objectives were to 1) identify foods associated with δ(13)C and δ(15)N blood values, 2) determine the contribution of nonsweetener corn to the diet relative to AS intake, and 3) determine if the dual-isotope model (δ(13)C and δ(15)N) is a better predictor of AS/SSB intake than δ(13)C alone. METHODS A cross-sectional sample of southwest Virginian adults (n = 257; aged 42 ± 15 y; 74% overweight/obese) underwent dietary intake assessments and provided finger-stick blood samples, which were analyzed for δ(13)C and δ(15)N values by using natural abundance stable isotope mass spectrometry. Statistical analyses included ANOVAs, paired-samples t tests, and multiple linear regressions. RESULTS The mean ± SD daily AS intake was 88 ± 59 g and nonsweetener corn intake was 13 ± 13 g. The mean δ(13)C value was -19.1 ± 0.9‰, which was significantly correlated with AS and SSB intakes (r = 0.32 and 0.39, respectively; P ≤ 0.01). The δ(13)C value and nonsweetener corn intake and the δ(15)N value and animal protein intake were not correlated. AS intake was significantly greater than nonsweetener corn intake (mean difference = 76.2 ± 57.2 g; P ≤ 0.001). The δ(13)C value was predictive of AS/SSB intake (β range: 0.28-0.35; P ≤ 0.01); however, δ(15)N was not predictive and minimal increases in R(2) values were observed when the δ(15)N value was added to the model. CONCLUSIONS The data do not provide evidence that the dual-isotope method is superior for predicting AS/SSB intakes within a southwest Virginian population. Our results support the potential of the δ(13)C value of finger-stick blood to serve as an objective measure of AS/SSB intake. This trial was registered at clinicaltrials.gov as NCT02193009.
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Affiliation(s)
- Valisa E Hedrick
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA; and
| | - Jamie M Zoellner
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA; and
| | - A Hope Jahren
- School of Earth and Ocean Science and Technology, University of Hawaii at Manoa, Honolulu, HI
| | - Natalie A Woodford
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA; and
| | - Joshua N Bostic
- School of Earth and Ocean Science and Technology, University of Hawaii at Manoa, Honolulu, HI
| | - Brenda M Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA; and
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22
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Bostic JN, Palafox SJ, Rottmueller ME, Jahren AH. Effect of baking and fermentation on the stable carbon and nitrogen isotope ratios of grain-based food. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2015; 29:937-947. [PMID: 26407308 DOI: 10.1002/rcm.7178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/17/2015] [Accepted: 02/21/2015] [Indexed: 06/05/2023]
Abstract
RATIONALE Isotope ratio mass spectrometry (IRMS) is used extensively to reconstruct general attributes of prehistoric and modern diets in both humans and animals. In order to apply these methods to the accurate determination of specific intakes of foods/nutrients of interest, the isotopic signature of individually consumed foods must be constrained. For example, 86% of the calories consumed in the USA are derived from processed and prepared foods, but the relationship between the stable isotope composition of raw ingredients and the resulting products has not been characterized. METHODS To examine the effect of common cooking techniques on the stable isotope composition of grain-based food items, we prepared yeast buns and sugar cookies from standardized recipes and measured bulk δ(13) C and δ(15) N values of samples collected throughout a 75 min fermentation process (buns) and before and after baking at 190°C (buns and cookies). Simple isotope mixing models were used to determine if the isotopic signatures of 13 multi-ingredient foods could be estimated from the isotopic signatures of their constituent raw ingredients. RESULTS No variations in δ(13) C or δ(15) N values were detected between pre- and post-baked yeast buns (pre: -24.78‰/2.61‰, post: -24.75‰/2.74‰), beet-sugar cookies (pre: -24.48‰/3.84‰, post: -24.47‰/3.57‰), and cane-sugar cookies (pre: -19.07‰/2.97‰, post: -19.02‰/3.21‰), or throughout a 75 min fermentation process in yeast buns. Using isotopic mass balance equations, the δ(13) C/δ(15) N values of multi-ingredient foods were estimated from the isotopic composition of constituent raw ingredients to within 0.14 ± 0.13‰/0.24 ± 0.17‰ for gravimetrically measured recipes and 0.40 ± 0.38‰/0.58 ± 0.53‰ for volumetrically measured recipes. CONCLUSIONS Two common food preparation techniques, baking and fermentation, do not substantially affect the carbon or nitrogen isotopic signature of grain-based foods. Mass-balance equations can be used to accurately estimate the isotopic signature of multi-ingredient food items for which quantitative ingredient information is available.
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Affiliation(s)
- Joshua N Bostic
- Department of Geology and Geophysics, University of Hawaii at Manoa, Honolulu, HI, 96822, USA
| | - Sherilyn J Palafox
- Department of Geology and Geophysics, University of Hawaii at Manoa, Honolulu, HI, 96822, USA
| | - Marina E Rottmueller
- Department of Geology and Geophysics, University of Hawaii at Manoa, Honolulu, HI, 96822, USA
| | - A Hope Jahren
- Department of Geology and Geophysics, University of Hawaii at Manoa, Honolulu, HI, 96822, USA
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23
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Abstract
Diet is a leading modifiable risk factor for chronic disease, but it remains difficult to measure accurately due to the error and bias inherent in self-reported methods of diet assessment. Consequently, there is a pressing need for more objective biomarkers of diet for use in health research. The stable isotope ratios of light elements are a promising set of candidate biomarkers because they vary naturally and reproducibly among foods, and those variations are captured in molecules and tissues with high fidelity. Recent studies have identified valid isotopic measures of short- and long-term sugar intake, meat intake, and fish intake in specific populations. These studies provide a strong foundation for validating stable isotopic biomarkers in the general US population. Approaches to improve specificity for specific foods are needed; for example, by modeling intake using multiple stable isotope ratios or by isolating and measuring specific molecules linked to foods of interest.
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Affiliation(s)
- Diane M O'Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology and Department of Biology and Wildlife, University of Alaska, Fairbanks, Alaska 99775-7000;
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24
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Evaluation of a novel biomarker of added sugar intake (δ 13C) compared with self-reported added sugar intake and the Healthy Eating Index-2010 in a community-based, rural U.S. sample. Public Health Nutr 2015; 19:429-36. [PMID: 25901966 DOI: 10.1017/s136898001500107x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The δ 13C value of human blood is an emerging novel biomarker of added sugar (AS) intake for adults. However, no free-living, community-based assessments of comparative validity of this biomarker have been conducted. The purpose of the present investigation was to determine if Healthy Eating Index-2010 (HEI-2010) score, SoFAAS score (HEI-2010 sub-component for solid fat, alcohol and AS), AS and sugar-sweetened beverage (SSB) intakes were associated with δ 13C value of fingerstick blood in a community-based sample of adults, while controlling for relevant demographics. DESIGN A cross-sectional analysis of data obtained from assessments of BMI, dietary intake using 24 h recalls and a fingerstick blood sample was completed. Statistical analyses included descriptive statistics, multiple linear regression and one-way ANOVA. SETTING Rural Southwest Virginia, U.S.A. SUBJECTS Adults (n 216) aged >18 years who consumed at least 837 kJ/d (200 kcal/d) from SSB. RESULTS This sample of adult participants with low socio-economic status demonstrated a mean HEI-2010 score of 43.4 (sd 12.2), mean SoFAAS score of 10.2 (sd 5.7), mean AS intake of 93 (sd 65) g/d and mean blood δ 13C value of -18.88 (sd 0.7) ‰. In four separate regression models, HEI-2010 (R 2=0.16), SoFAAS (R 2=0.19), AS (R 2=0.15) and SSB (R 2=0.14) predicted δ 13C value (all P≤0.001). Age was also predictive of δ 13C value, but not sex or race. CONCLUSIONS These findings suggest that fingerstick δ 13C value has the potential to be a minimally invasive method for assessing AS and SSB intake and overall dietary quality in community-based settings. Strengths, limitations and future areas of research for using an objective δ 13C biomarker in diet-related public health studies are discussed.
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25
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Patel PS, Cooper AJM, O'Connell TC, Kuhnle GGC, Kneale CK, Mulligan AM, Luben RN, Brage S, Khaw KT, Wareham NJ, Forouhi NG. Serum carbon and nitrogen stable isotopes as potential biomarkers of dietary intake and their relation with incident type 2 diabetes: the EPIC-Norfolk study. Am J Clin Nutr 2014; 100:708-18. [PMID: 24990425 PMCID: PMC4095667 DOI: 10.3945/ajcn.113.068577] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Stable-isotope ratios of carbon (¹³C/¹²C, expressed as δ¹³C) and nitrogen (¹⁵N/¹⁴N, or δ¹⁵N) have been proposed as potential nutritional biomarkers to distinguish between meat, fish, and plant-based foods. OBJECTIVE The objective was to investigate dietary correlates of δ¹³C and δ¹⁵N and examine the association of these biomarkers with incident type 2 diabetes in a prospective study. DESIGN Serum δ¹³C and δ¹⁵N (‰) were measured by using isotope ratio mass spectrometry in a case-cohort study (n = 476 diabetes cases; n = 718 subcohort) nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population-based cohort. We examined dietary (food-frequency questionnaire) correlates of δ¹³C and δ¹⁵N in the subcohort. HRs and 95% CIs were estimated by using Prentice-weighted Cox regression. RESULTS Mean (±SD) δ¹³C and δ¹⁵N were -22.8 ± 0.4‰ and 10.2 ± 0.4‰, respectively, and δ¹³C (r = 0.22) and δ¹⁵N (r = 0.20) were positively correlated (P < 0.001) with fish protein intake. Animal protein was not correlated with δ¹³C but was significantly correlated with δ¹⁵N (dairy protein: r = 0.11; meat protein: r = 0.09; terrestrial animal protein: r = 0.12, P ≤ 0.013). δ¹³C was inversely associated with diabetes in adjusted analyses (HR per tertile: 0.74; 95% CI: 0.65, 0.83; P-trend < 0.001], whereas δ¹⁵N was positively associated (HR: 1.23; 95% CI: 1.09, 1.38; P-trend = 0.001). CONCLUSIONS The isotope ratios δ¹³C and δ¹⁵N may both serve as potential biomarkers of fish protein intake, whereas only δ¹⁵N may reflect broader animal-source protein intake in a European population. The inverse association of δ¹³C but a positive association of δ¹⁵N with incident diabetes should be interpreted in the light of knowledge of dietary intake and may assist in identifying dietary components that are associated with health risks and benefits.
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Affiliation(s)
- Pinal S Patel
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Andrew J M Cooper
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Tamsin C O'Connell
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Gunter G C Kuhnle
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Catherine K Kneale
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Angela M Mulligan
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Robert N Luben
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Soren Brage
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Kay-Tee Khaw
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Nicholas J Wareham
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
| | - Nita G Forouhi
- From the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom (PSP, AJMC, SB, NJW, and NGF); the Department of Archaeology & Anthropology, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO); the McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom (TCO and CKK); the University of Reading, Reading, United Kingdom (GGCK); and the Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (AMM, RNL, K-TK, and GGCK)
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26
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Fakhouri THI, Jahren AH, Appel LJ, Chen L, Alavi R, Anderson CAM. Serum carbon isotope values change in adults in response to changes in sugar-sweetened beverage intake. J Nutr 2014; 144:902-5. [PMID: 24717368 PMCID: PMC4018953 DOI: 10.3945/jn.113.186213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Serum carbon isotope values [13C-to-12C serum carbon isotope ratio (δ(13)C)], which reflect consumption of corn- and cane-based foods, differ between persons consuming high and low amounts of sugar-sweetened beverages (SSBs). In this study, we determined whether serum δ(13)C changes in response to change in SSB intake during an 18-mo behavioral intervention trial. Data were from a subset of 144 participants from the PREMIER trial, a completed behavioral intervention (Maryland, 1998-2004). SSB intake was assessed using 2 24-h dietary recall interviews. Blinded serum samples were assayed for δ(13)C by natural abundance stable isotope mass spectroscopy. Multiple linear regression models with generalized estimating equations and robust variance estimation were used. At baseline, mean SSB intake was 13.8 ± 14.2 fl oz/d, and mean δ(13)C serum value was -19.3 ± 0.6 units per mil (designated ‰). A reduction of 12 oz (355 mL)/d SSB (equivalent to 1 can of soda per day) was associated with 0.17‰ (95% CI: 0.08‰, 0.25‰ P < 0.0001) reduction in serum δ(13)C values over 18 mo (equivalent to a 1% reduction in δ(13)C from baseline). After adjusting for potential confounders, a reduction of 12 oz/d SSB (equivalent to 1 can of soda per day), over an 18-mo period, was associated with 0.12‰ (95% CI: 0.01‰, 0.22‰ P = 0.025) reduction in serum δ(13)C. These findings suggest that serum δ(13)C can be used as a measure of dietary changes in SSB intake.
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Affiliation(s)
| | - A. Hope Jahren
- School of Earth and Ocean Science and Technology, University of Hawaii, Honolulu, HI
| | - Lawrence J. Appel
- Department of Epidemiology and,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Liwei Chen
- Program of Epidemiology, Louisiana State University School of Public Health, New Orleans, LA; and
| | - Reza Alavi
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Cheryl A. M. Anderson
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA,To whom correspondence should be addressed. E-mail:
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27
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Nash SH, Kristal AR, Hopkins SE, Boyer BB, O’Brien DM. Stable isotope models of sugar intake using hair, red blood cells, and plasma, but not fasting plasma glucose, predict sugar intake in a Yup'ik study population. J Nutr 2014; 144:75-80. [PMID: 24198311 PMCID: PMC3861795 DOI: 10.3945/jn.113.182113] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 08/21/2013] [Accepted: 10/16/2013] [Indexed: 11/14/2022] Open
Abstract
Objectively measured biomarkers will help to resolve the controversial role of sugar intake in the etiology of obesity and related chronic diseases. We recently validated a dual-isotope model based on RBC carbon (δ(13)C) and nitrogen (δ(15)N) isotope ratios that explained a large percentage of the variation in self-reported sugar intake in a Yup'ik study population. Stable isotope ratios can easily be measured from many tissues, including RBCs, plasma, and hair; however, it is not known how isotopic models of sugar intake compare among these tissues. Here, we compared self-reported sugar intake with models based on RBCs, plasma, and hair δ(13)C and δ(15)N in Yup'ik people. We also evaluated associations of sugar intake with fasting plasma glucose δ(13)C. Finally, we evaluated relations between δ(13)C and δ(15)N values in hair, plasma, RBCs, and fasting plasma glucose to allow comparison of isotope ratios across tissue types. Models using RBCs, plasma, or hair isotope ratios explained similar amounts of variance in total sugar, added sugar, and sugar-sweetened beverage intake (∼53%, 48%, and 34%, respectively); however, the association with δ(13)C was strongest for models based on RBCs and hair. There were no associations with fasting plasma glucose δ(13)C (R(2) = 0.03). The δ(13)C and δ(15)N values of RBCs, plasma, and hair showed strong, positive correlations; the slopes of these relations did not differ from 1. This study demonstrates that RBC, plasma, and hair isotope ratios predict sugar intake and provides data that will allow comparison of studies using different sample types.
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Affiliation(s)
- Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | | | | | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
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28
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Isotopic estimates of sugar intake are related to chronic disease risk factors but not obesity in an Alaska native (Yup'ik) study population. Eur J Clin Nutr 2013; 68:91-6. [PMID: 24219893 PMCID: PMC3947290 DOI: 10.1038/ejcn.2013.230] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 09/26/2013] [Accepted: 09/27/2013] [Indexed: 11/09/2022]
Abstract
Background Sugar intake may be causally associated with chronic disease risk, either directly or by contributing to obesity. However, evidence from observational studies is mixed, in part due to the error and bias inherent in self-reported measures of sugar intake. Objective biomarkers may clarify the relationship between sugar intake and chronic disease risk. We have recently validated a biomarker of sugar intake in an Alaska Native (Yup’ik) study population that incorporates red blood cell carbon and nitrogen isotope ratios in a predictive model. Objective This study tested associations of isotopic estimates of sugar intake with BMI, waist circumference (WC), and a broad array of other physiological and biochemical measures of chronic disease risk in Yup’ik people. Subjects/Methods In a cross-sectional sample of 1076 Yup’ik people, multiple linear regression was used to examine associations of sugar intake with BMI, WC and other chronic disease risk factors. Results Isotopic estimates of sugar intake were not associated with BMI (P = 0.50) or WC (P = 0.85). They were positively associated with blood pressure, triglycerides, and leptin, and inversely associated with total-, HDL- and LDL-cholesterol and adiponectin. Conclusions Isotopic estimates of sugar intake were not associated with obesity, but were adversely associated with other chronic disease risk factors in this Yup’ik study population. This first use of stable isotope markers of sugar intake may influence recommendations for sugar intake by Yup’ik people; however, longitudinal studies are required to understand associations with chronic disease incidence.
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29
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Comparison and validation of 2 analytical methods for measurement of urinary sucrose and fructose excretion. Nutr Res 2013; 33:696-703. [PMID: 24034568 DOI: 10.1016/j.nutres.2013.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 05/25/2013] [Accepted: 05/29/2013] [Indexed: 12/21/2022]
Abstract
Urinary sugars excretion has been proposed as a potential biomarker for intake of sugars. In this study, we compared 2 analytical methods (gas chromatography [GC] and enzymatic reactions-UV absorption) for quantifying urinary fructose and sucrose using 24-hour urine samples from a randomized crossover controlled feeding study. All samples were successfully quantified by the GC method; however, 21% and 1.9% of samples were below the detection limit of the enzymatic method for sucrose and fructose, respectively. Although the correlation between the 2 methods was good for fructose (Pearson correlation, 0.71), the correlation was weak for sucrose (Pearson correlation, 0.27). We favor the GC method because of its better sensitivity, simplicity, and the ability to quantify fructose and sucrose directly in the same run. Of the 106 samples from 53 participants with complete urine collection after 2 study diets, 24-hour urinary fructose excretion was significantly associated with fructose intake. The sum of 24-hour urinary fructose and sucrose was significantly associated with total sugars consumption. However, variation in intakes of sugars explained only a modest amount of variation in urinary sugars excretion. In the unadjusted models, fructose intake explained 24.3% of urinary fructose excretion, and intake of total sugars explained 16.3% of the sum of urinary fructose and sucrose. The adjusted models explained 44.3% of urinary fructose excretion and 41.7% of the sum of urinary fructose and sucrose. Therefore, we caution using these biomarkers to predict sugars consumption before other factors that determine urinary sugars excretion are understood.
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30
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Choy K, Nash SH, Kristal AR, Hopkins S, Boyer BB, O’Brien DM. The carbon isotope ratio of alanine in red blood cells is a new candidate biomarker of sugar-sweetened beverage intake. J Nutr 2013; 143:878-84. [PMID: 23616504 PMCID: PMC3652884 DOI: 10.3945/jn.112.172999] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
An objective dietary biomarker would help clarify the contribution of sugar-sweetened beverage (SSB) intake to obesity and chronic disease risk. Previous studies have proposed the carbon isotope ratio (δ(13)C) as a biomarker of SSB intake but found associations that were of modest size and confounded by other components of the diet. We investigated whether the δ(13)C values of nonessential amino acids (δ(13)CNEAA) in RBCs could provide valid biomarkers that are more specific to SSBs. We assessed the associations of RBC δ(13)CNEAA with SSB intake in a study population of 68 Yup'ik people, using gas chromatography/combustion/isotope ratio mass spectrometry to measure δ(13)CNEAA and four 24-h dietary recalls to assess intake. Among RBC nonessential amino acids, alanine δ(13)C (δ(13)Calanine) was strongly correlated with intake of SSBs, added sugar, and total sugar (r = 0.70, 0.59, and 0.57, respectively; P < 0.0001) but uncorrelated with other dietary sources of elevated δ(13)C. We also evaluated whether sweetener intake could be noninvasively assessed using hair δ(13)Calanine in a subset of the study population (n = 30). Hair δ(13)Calanine was correlated with RBC δ(13)Calanine (r = 0.65; P < 0.0001) and showed similar associations with SSB intake. These results show that δ(13)Calanine in RBCs provides a valid and specific biomarker of SSB intake for the Yup'ik population and suggest RBCs and hair δ(13)Calanine as candidate biomarkers of SSB intake for validation in the general U.S. population. Ultimately, these biomarkers could clarify our understanding of whether and how SSB intake contributes to chronic disease.
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Affiliation(s)
- Kyungcheol Choy
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
| | - Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | | | - Scarlett Hopkins
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
| | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology, and
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and,To whom correspondence should be addressed. E-mail:
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Abstract
Light element isotope signatures have been used to study food webs in many ecological niches, including those of ancient humans, but to a far lesser extent in modern humans. A recent paper presented results from a pilot study testing the utility of carbon isotope ratio analysis of alanine to measure an individual's sugar intake in the United States. A strong correlation was found between the enrichment of (13)C in alanine and sugar-sweetened beverage consumption. This candidate biomarker of sugar consumption deserves further consideration as an objective marker for use in the study of the relationship between sugar intake and health.
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Affiliation(s)
- Dale A Schoeller
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
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Nash SH, Kristal AR, Bersamin A, Hopkins SE, Boyer BB, O’Brien DM. Carbon and nitrogen stable isotope ratios predict intake of sweeteners in a Yup'ik study population. J Nutr 2013; 143:161-5. [PMID: 23256142 PMCID: PMC3542907 DOI: 10.3945/jn.112.169425] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The carbon isotope ratio (δ¹³C) is elevated in corn- and cane sugar-based foods and has recently shown associations with sweetener intake in multiple U.S. populations. However, a high carbon isotope ratio is not specific to corn- and sugar cane-based sweeteners, as other foods, including meats and fish, also have elevated δ¹³C. This study examines whether the inclusion of a second marker, the nitrogen isotope ratio (δ¹⁵N), can control for confounding dietary effects on δ¹³C and improve the validity of isotopic markers of sweetener intake. The study participants are from the Yup'ik population of southwest Alaska and consume large and variable amounts of fish and marine mammals known to have elevated carbon and nitrogen isotope ratios. Sixty-eight participants completed 4 weekly 24-h recalls followed by a blood draw. RBC δ¹³C and δ¹⁵N were used to predict sweetener intake, including total sugars, added sugars, and sugar-sweetened beverages. A model including both δ¹³C and δ¹⁵N explained more than 3 times as much of the variation in sweetener intake than did a model using only δ¹³C. Because carbon and nitrogen isotope ratios are simultaneously determined in a single, high-throughput analysis, this dual isotope marker provides a simple method to improve the validity of stable isotope markers of sweetener intake with no additional cost. We anticipate that this multi-isotope approach will have utility in any population where a stable isotope biomarker is elevated in several food groups and there are appropriate "covariate" isotopes to control for intake of foods not of research interest.
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Affiliation(s)
- Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and,To whom correspondence should be addressed. E-mail:
| | | | - Andrea Bersamin
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | | | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology, and,Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK; and
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Hedrick VE, Dietrich AM, Estabrooks PA, Savla J, Serrano E, Davy BM. Dietary biomarkers: advances, limitations and future directions. Nutr J 2012; 11:109. [PMID: 23237668 PMCID: PMC3568000 DOI: 10.1186/1475-2891-11-109] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 12/12/2012] [Indexed: 01/24/2023] Open
Abstract
The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.
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Affiliation(s)
- Valisa E Hedrick
- Department of Human Nutrition, Foods and Exercise, 221 Wallace Hall (0430), Virginia Tech, Blacksburg, Virginia 24061, USA.
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Nash SH, Bersamin A, Kristal AR, Hopkins SE, Church RS, Pasker RL, Luick BR, Mohatt GV, Boyer BB, O’Brien DM. Stable nitrogen and carbon isotope ratios indicate traditional and market food intake in an indigenous circumpolar population. J Nutr 2012; 142:84-90. [PMID: 22157543 PMCID: PMC3237231 DOI: 10.3945/jn.111.147595] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The transition of a society from traditional to market-based diets (termed the nutrition transition) has been associated with profound changes in culture and health. We are developing biomarkers to track the nutrition transition in the Yup'ik Eskimo population of Southwest Alaska based on naturally occurring variations in the relative abundances of carbon and nitrogen stable isotopes (δ(15)N and δ(13)C values). Here, we provide three pieces of evidence toward the validation of these biomarkers. First, we analyzed the δ(15)N and δ(13)C values of a comprehensive sample of Yup'ik foods. We found that δ(15)N values were elevated in fish and marine mammals and that δ(13)C values were elevated in market foods containing corn or sugar cane carbon. Second, we evaluated the associations between RBC δ(15)N and δ(13)C values and self-reported measures of traditional and market food intake (n = 230). RBC δ(15)N values were correlated with intake of fish and marine mammals (r = 0.52; P < 0.0001). RBC δ(13)C values were correlated with intake of market foods made from corn and sugar cane (r = 0.46; P < 0.0001) and total market food intake (r = 0.46; P < 0.0001). Finally, we assessed whether stable isotope ratios captured population-level patterns of traditional and market intake (n = 1003). Isotopic biomarkers of traditional and market intake were associated with age, community location, sex, and cultural identity. Self-report methods showed variations by age and cultural identity only. Thus, stable isotopes show potential as biomarkers for monitoring dietary change in indigenous circumpolar populations.
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Affiliation(s)
- Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife,To whom correspondence should be addressed. E-mail:
| | - Andrea Bersamin
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | - Alan R. Kristal
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Rebecca S. Church
- Center for Alaska Native Health Research, Institute of Arctic Biology
| | - Renee L. Pasker
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | | | - Gerald V. Mohatt
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Psychology, University of Alaska, Fairbanks, AK; and
| | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
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35
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Davy BM, Jahren AH, Hedrick VE, Comber DL. Association of δ¹³C in fingerstick blood with added-sugar and sugar-sweetened beverage intake. ACTA ACUST UNITED AC 2011; 111:874-8. [PMID: 21616200 DOI: 10.1016/j.jada.2011.03.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 12/15/2010] [Indexed: 12/01/2022]
Abstract
A reliance on self-reported dietary intake measures is a common research limitation, thus the need for dietary biomarkers. Added-sugar intake may play a role in the development and progression of obesity and related comorbidities; common sweeteners include corn and sugar cane derivatives. These plants contain a high amount of ¹³C, a naturally occurring stable carbon isotope. Consumption of these sweeteners, of which sugar-sweetened beverages are the primary dietary source, might be reflected in the δ¹³C value of blood. Fingerstick blood represents an ideal substrate for bioassay because of its ease of acquisition. The objective of this investigation was to determine if the δ¹³C value of fingerstick blood is a potential biomarker of added-sugar and sugar-sweetened beverage intake. Individuals aged 21 years and older (n = 60) were recruited to attend three laboratory visits; assessments completed at each visit depended upon a randomly assigned sequence (sequence one or two). The initial visit included assessment of height, weight, and dietary intake (sequence one: beverage intake questionnaire, sequence two: 4-day food intake record). Sequence one participants completed a food intake record at visit two, and nonfasting blood samples were obtained via routine fingersticks at visits one and three. Sequence two participants completed a beverage intake questionnaire at visit two, and provided fingerstick blood samples at visits two and three. Samples were analyzed for δ¹³C value using natural abundance stable isotope mass spectrometry. δ¹³C value was compared to dietary outcomes in all participants, as well as among those in the highest and lowest tertile of added-sugar intake. Reported mean added-sugar consumption was 66 ± 5 g/day, and sugar-sweetened beverage consumption was 330 ± 53 g/day and 134 ± 25 kcal/day. Mean fingerstick δ¹³C value was -19.94‰ ± 0.10‰, which differed by body mass index status. δ¹³C value was associated (all P < 0.05) with intake of total added sugars (g, r = 0.37; kcal, r = 0.37), soft drinks (g, r = 0.26; kcal, r = 0.27), and total sugar-sweetened beverage (g, r = 0.28; kcal, r = 0.35). The δ¹³C value in the lowest and the highest added-sugar intake tertiles were significantly different (mean difference = -0.48‰; P = 0.028). Although there are several potential dietary sources for blood carbon, the δ¹³C value of fingerstick blood shows promise as a noninvasive biomarker of added-sugar and sugar-sweetened beverage intake based on these findings.
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Affiliation(s)
- Brenda M Davy
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, Va, USA.
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