d13C Added Sugar Intake Biomarker: Determining Validity in Children

描述（由申请人提供）：含能量的添加糖（AS），特别是含糖饮料（SSB）的消耗被认为是体重增加的贡献者。在儿童和青少年中，总AS摄入量占总能量的约16%，或约300-400千卡/天; SSB占总AS摄入量的约50%。虽然被主要的健康组织所认可，但AS及其主要食物来源SSB在肥胖和相关共病的发展和进展中的作用仍然存在争议。在这一领域的一个常见的研究限制是依赖于自我报告的饮食摄入量的措施，这在研究儿童时提出了额外的挑战。因此，需要客观的方法来评估饮食摄入量，如生物标志物的AS消费，已被公认。我们已经建立了成人手指针刺血液d13 C AS生物标志物的有效性，并旨在将我们的创新生物标志物扩展到儿童饮食研究。我们建议使用两种方法建立儿童手指针刺血d13 C AS生物标志物的有效性和可靠性。首先，控制喂养成分（研究1）将提供验证生物标志物与实际AS摄入量所需的数据，并确定其检测AS摄入量水平的能力。第二，横断面部分（研究2）将比较生物标志物与自我报告的摄入量数据，这些数据是以类似于国家营养监测方法的方法收集的（即，NHANES）。研究1将包括30名12-18岁的青少年，他们将以随机顺序消耗高AS（25%总能量）和低AS（5%总能量）饮食各7天。研究2将包括325名6-18岁的儿童，他们将完成5次实验室会议。记录辅助的24小时饮食回忆将在四个会议上完成，以评估习惯性AS摄入量，并将在两个会议上获得手指针刺血样。在两项研究中，将通过定量控制饮食（研究1）和自我报告的饮食召回（研究2）中的无甜味剂玉米消费量，以及通过评估手指针刺样本的氮稳定同位素组成<$15 N，来解决无甜味剂玉米和动物产品消费的潜在混杂效应。为了推进现有的饮食评估方法的知识，将在研究1中评估尿糖和尿d13 C，这将允许直接比较生物标志物-现有的（尿蔗糖，果糖）和新的（尿和手指针刺d13 C）。AS在健康中的作用几十年来一直存在争议，依赖自我报告的摄入量数据是这一领域经常被引用的缺陷。我们的研究结果可以显着推进解决儿童和青少年摄入AS对健康影响的研究。

DESCRIPTION (provided by applicant): Consumption of energy-containing added sugars (AS) and in particular, sugar-sweetened beverages (SSB), have been suggested as contributors to weight gain. In children and adolescents, total AS intake represents ~16% of total energy, or ~300-400 kcal/d; SSB comprise ~50% of total AS intake. Although recognized by major health organizations, the role of AS and their primary food source, SSB, in the development and progression of obesity and related co-morbidities remains controversial. A common research limitation in this area is a reliance on self-reported measures of dietary intake, which present additional challenges when studying children. Thus, the need for objective methods to assess dietary intake, such as biomarkers of AS consumption, has been recognized. We have established the validity of the fingerstick blood d13C AS biomarker in adults, and aim to expand our innovative biomarker to studies of diet in children. We propose to establish the validity and reliability of the fingerstick blood d13C AS biomarker in children using two approaches. First, a controlled feeding component (Study 1) will provide data necessary for validation of the biomarker with actual AS intake, and determine its ability to detect levels of AS intake. Second, a cross-sectional component (Study 2) will compare the biomarker to self-reported intake data, collected in a method similar to national nutritional surveillance methodology (i.e., NHANES). Study 1 will include 30 adolescents aged 12-18 yrs, who will consume both a high AS (25% total energy) and low AS (5% total energy) diet for 7 days each, in a random order. Study 2 will include 325 children aged 6-18 yrs, who will complete five laboratory sessions. Record- assisted 24-hr dietary recalls will be completed at four of the sessions to assess habitual AS intake, and fingerstick blood samples will be obtained at two of the sessions. The potential confounding effects of non- sweetener corn and animal product consumption will be addressed in both studies by quantifying non- sweetener corn consumption in the controlled diets (Study 1) and in self-reported dietary recalls (Study 2), and by assessing the nitrogen stable isotope composition ¿15N of fingerstick samples. To advance existing knowledge of dietary assessment approaches, urinary sugars and urine d13C will be assessed in Study 1, which will permit a direct comparison of biomarkers - existing (urinary sucrose, fructose) and novel (urine and fingerstick d13C ). The role of AS in health has been contentious for decades, and the reliance on self-reported intake data is an often-cited flaw in this area. Our findings could significantly advance research addressing the health impacts of AS intake in children and adolescents.