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Tasevska N, Palma-Duran SA, Sagi-Kiss V, Commins J, Barrett B, Kipnis V, Midthune D, O'Brien DM, Freedman LS. Urinary Sucrose and Fructose From Spot Urine May Be Used as a Predictive Biomarker of Total Sugar Intake-Findings From a Controlled Feeding Study. J Nutr 2023; 153:1816-1824. [PMID: 37030594 PMCID: PMC10308266 DOI: 10.1016/j.tjnut.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/28/2023] [Accepted: 04/04/2023] [Indexed: 04/10/2023] Open
Abstract
BACKGROUND Recently, we confirmed 24-h urinary sucrose plus fructose (24 uSF) as a predictive biomarker of total sugar intake. However, the collection of 24-h urine samples has limited feasibility in population studies. OBJECTIVE We investigated the utility of the urinary sucrose plus fructose (uSF) biomarker measured in spot urine as a measure of 24 uSF biomarker and total sugar intake. METHODS Hundred participants, 18-70 y of age, from the Phoenix Metropolitan Area completed a 15-d feeding study. For 2 of the 8 collected 24-h urine samples, each spot urine sample was collected in a separate container. We considered 4 timed voids of the day [morning (AM) void: first void 08:30-12:30; afternoon (PM) void: first void 12:31-17:30; evening (EVE) void: first void 17:31-12:00; and next-day (ND) void: first void 04:00-12:00]. We investigated the performance of uSF from 1 void, and uSF combined from 2 and 3 voids as a measure of 24 uSF and sugar intake. RESULTS The biomarker averaged from PM/EVE void strongly correlated with 24 uSF (partial r = 0.75). The 24 uSF predicted from the PM/EVE combination was significantly associated with observed sugar intake and was selected for building the calibrated biomarker equation (marginal R2 = 0.36). Spot urine-based calibrated biomarker, ie, biomarker-estimated sugar intake was moderately correlated with the 15-d mean-observed sugar intake (r = 0.50). CONCLUSIONS uSF measured from a PM and EVE void may be used to generate biomarker-based sugar intake estimate when collecting 24-h urine samples is not feasible, pending external validation.
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Affiliation(s)
- Natasha Tasevska
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States.
| | - Susana A Palma-Duran
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Virag Sagi-Kiss
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - John Commins
- Information Management Services, Inc., Rockville, MD, United States
| | - Brian Barrett
- Information Management Services, Inc., Rockville, MD, United States
| | - Victor Kipnis
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Douglas Midthune
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Diane M O'Brien
- Department of Biology and Wildlife, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, United States
| | - Laurence S Freedman
- Biostatistics Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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Weinhold KR, Andridge RR, Bomser JA, Sasaki GY, Bruno RS, Orchard TS. Sugars measured enzymatically in a fasting overnight urine sample are not sensitive biomarkers of dietary added sugar intake in postmenopausal women. Nutr Health 2022:2601060221106819. [PMID: 35679080 DOI: 10.1177/02601060221106819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Restricting dietary sugar is a leading recommendation, but limited biomarkers assessing intake exist. Although 24-h urinary sucrose (U-Suc) and urinary fructose (U-Fruc) excretion has been used with mixed success, collection is burdensome. AIM This study aimed to test the sensitivity of an enzymatic assay of U-Suc and U-Fruc to detect changing added sugar intake using low-burden overnight urine samples in 30 postmenopausal women. METHODS Women consumed usual dietary intake during day 1 and usual intake plus a sugar sweetened beverage during day 2. Weighed, photographed food records assessed intake. Enzymatic assay measured U-Suc and U-Fruc from fasting overnight samples; liquid chromatography mass spectrometry (LC-MS) validated U-Suc findings. RESULTS Dietary added sugars increased significantly during day 2 (p < 0.001), but urinary sugars were not significantly increased. Enzymatic assay detected urinary sugars in 75% (U-Suc) and 35% (U-Fruc) of samples. Dietary sucrose was not associated with U-Suc, however dietary fructose was significantly associated with U-Fruc [β = 0.031; p < 0.05] among women with detectable urinary sugars. Participants with detectable U-Fruc consumed more energy from added sugars [12.6% kcal day 1; 21.5% kcal day 2] than participants with undetectable U-Fruc [9.3% kcal day 1; 17.4% kcal day 2], p < 0.05. Using LC-MS, U-Suc predicted sucrose and added sugar intake [β = 0.017, β = 0.013 respectively; both p < 0.05]. CONCLUSIONS Urinary sugars measured enzymatically from overnight urine samples were not sensitive biomarkers of changing added sugar intake in postmenopausal women. However, urinary fructose measured by enzymatic assay or LC-MS may differentiate low versus high added sugar consumers.
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Affiliation(s)
- Kellie R Weinhold
- Human Sciences Department, College of Education and Human Ecology, 2647The Ohio State University, Columbus, OH, USA
| | - Rebecca R Andridge
- Division of Biostatistics, College of Public Health, 2647The Ohio State University, Columbus, OH, USA
| | - Joshua A Bomser
- Human Sciences Department, College of Education and Human Ecology, 2647The Ohio State University, Columbus, OH, USA
| | - Geoffrey Y Sasaki
- Human Sciences Department, College of Education and Human Ecology, 2647The Ohio State University, Columbus, OH, USA
| | - Richard S Bruno
- Human Sciences Department, College of Education and Human Ecology, 2647The Ohio State University, Columbus, OH, USA
| | - Tonya S Orchard
- Human Sciences Department, College of Education and Human Ecology, 2647The Ohio State University, Columbus, OH, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Moore LB, Liu SV, Halliday TM, Neilson AP, Hedrick VE, Davy BM. Urinary Excretion of Sodium, Nitrogen, and Sugar Amounts Are Valid Biomarkers of Dietary Sodium, Protein, and High Sugar Intake in Nonobese Adolescents. J Nutr 2017; 147:2364-2373. [PMID: 28931586 PMCID: PMC5697967 DOI: 10.3945/jn.117.256875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/26/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Objective indicators of dietary intake (e.g., biomarkers) are needed to overcome the limitations of self-reported dietary intake assessment methods in adolescents. To our knowledge, no controlled feeding studies to date have evaluated the validity of urinary sodium, nitrogen, or sugar excretion as dietary biomarkers in adolescents.Objective: This investigation aimed to evaluate the validity of urinary sodium, nitrogen, and total sugars (TS) excretion as biomarkers for sodium, protein, and added sugars (AS) intake in nonobese adolescents.Methods: In a crossover controlled feeding study design, 33 adolescents [12-18 y of age, 47 ± 25th percentile (mean ± SD) of body mass index (BMI; in kg/m2) for age] consumed 5% AS [low added sugars (LAS)] and 25% AS [high added sugars (HAS)] isocaloric, macronutrient-matched (55% carbohydrate, 30% fat, and 15% protein) diets for 7 d each, in a randomly assigned order, with a 4-wk washout period between diets. On the final 2 d of each diet period, 24-h urine samples were collected. Thirty-two adolescents completed all measurements (97% retention).Results: Urinary sodium was not different from the expected 90% recovery (mean ± SD: 88% ± 18%, P = 0.50). Urinary nitrogen was correlated with protein intake (r = 0.69, P < 0.001), although it was below the 80% expected recovery (62% ± 7%, P < 0.001). Urinary TS values were correlated with AS intake during the HAS diet (r = 0.77, P < 0.001) and had a higher R2 value of 0.28 than did AS intake (R2 = 0.36). TS excretion differed between LAS (0.226 ± 0.09 mg/d) and HAS (0.365 ± 0.16 mg/d) feeding periods (P < 0.001).Conclusions: Urinary sodium appears to be a valid biomarker for sodium intake in nonobese adolescents. Urinary nitrogen is associated with protein intake, but nitrogen excretion rates were less than previously reported for adults, possibly owing to adolescent growth rates. TS excretion reflects AS at 25% AS intake and was responsive to the change in AS intake. Thus, urinary biomarkers are promising objective indicators of dietary intake in adolescents, although larger-scale feeding trials are needed to confirm these findings. This trial was registered at clinicaltrials.gov as NCT02455388.
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Affiliation(s)
- Lori B Moore
- Departments of Human Nutrition, Foods, and Exercise and
| | - Sarah V Liu
- Departments of Human Nutrition, Foods, and Exercise and
| | | | | | | | - Brenda M Davy
- Departments of Human Nutrition, Foods, and Exercise and
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