d13C Added Sugar Intake Biomarker: Determining Validity in Children

说明(申请人提供)：摄入含能量的添加糖(AS)，特别是含糖饮料(SSB)，被认为是导致体重增加的因素。在儿童和青少年中，总砷摄入量占总能量的~16%，或~300-400千卡/天；SSB占总砷摄入量的~50%。尽管得到了主要卫生组织的认可，但AS及其主要食物来源SSB在肥胖症和相关共病的发生和发展中的作用仍然存在争议。这一领域的一个常见研究局限是依赖自我报告的饮食摄入量测量，这在研究儿童时带来了额外的挑战。因此，人们认识到需要客观的方法来评估膳食摄入量，例如砷摄入量的生物标记物。我们已经确定手指血d13C作为成人生物标记物的有效性，并旨在将我们的创新生物标记物扩展到儿童饮食研究。我们建议使用两种方法来确定手指血d13C作为儿童生物标记物的有效性和可靠性。首先，受控喂养组件(研究1)将提供验证生物标志物与实际砷摄入量的必要数据，并确定其检测砷摄入量水平的能力。其次，一个横断面部分(研究2)将把生物标志物与自我报告的摄入量数据进行比较，这些数据的收集方法类似于国家营养监测方法(即NHANES)。研究一将包括30名12-18岁的青少年，他们将按随机顺序分别摄入高AS(总能量25%)和低AS(总能量5%)饮食7天。研究2将包括325名6-18岁的儿童，他们将完成五个实验室课程。记录辅助的24小时饮食召回将在其中四个疗程中完成，以评估习惯摄入量，并将在其中两个疗程中采集手指血样。在这两项研究中，将通过量化受控饮食中的非甜味剂玉米消费量(研究1)和自我报告的饮食召回中的非甜味剂玉米消费量(研究2)，以及通过评估手指样本的氮稳定同位素组成？15N，来解决非甜味剂玉米和动物产品消费的潜在混杂影响。为了促进对膳食评估方法的现有知识，研究1将评估尿糖和尿d13C，这将允许直接比较现有的生物标志物(尿蔗糖、果糖)和新的生物标志物(尿和指棒d13C)。几十年来，AS在健康中的作用一直存在争议，依赖自我报告的摄入量数据是该领域经常被引用的缺陷。我们的发现可以极大地推进有关儿童和青少年摄入砷对健康影响的研究。

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.