Novel strategies for improving dietary exposure assessment: Multiple-data fusion is a more accurate measure than the traditional single-biomarker approach

Abstract

HIGHLIGHTS• Improvements in dietary assessment will deal with weaknesses between diet and health.• Multi-metabolite biomarker panels offer a better estimation than single biomarkers.• Untargeted metabolomics enables the proposal of new multi-metabolite biomarker panels.• A series of challenges should be addressed before panels can reach their full potential.• The combined use of biomarker panels with questionnaires will enable increasing accuracy and precision in dietary assessment. ABSTRACTBackground: Accurate measurement of food intake is the cornerstone of understanding the links between diet and optimal health status or risk of disease. The utilization of metabolomics approaches is revolutionizing the field of dietary assessment by associating metabolic profiles with intake of specific foods or dietary patterns and/or investigating human health status in nutritional trials. Combining dietary biomarkers with conventional dietary assessment methods is considered a potential strategy for tackling the complexity of dietary exposure fingerprinting. Scope and approach:We discuss existing approaches among dietary assessment methods and dietary biomarkers. A combined approach taking into consideration data from dietary questionnaires with measurements of dietary biomarkers is emphasized. Key findings and conclusions:Trends in novel strategies for improving dietary exposure assessment will be influenced by the discovery and validation of dietary exposure biomarkers.Among different strategies, multi-metabolite biomarker panels enable more reliable estimation of dietary exposure than does the traditional single-biomarker approach. Therefore, a combined approach using data from dietary questionnaires along with measurements of dietary biomarkers is considered an excellent strategy for improving dietary exposure assessment.

Discovery of Intake Biomarkers of Lentils, Chickpeas, and White Beans by Untargeted LC–MS Metabolomics in Serum and Urine

“…[17] This suggests that the former may only be useful as a BFI when 24 h urine is available, whereas the others could be more useful as BFIs when only spot urines are accessible. However, increase in urinary excretions after the intake of other catechin-and proanthocyanidin-rich foods such as tea, cocoa, and grape products has also been observed in previous studies, [18] thereby limiting their specificity as candidate BFIs of lentils. Additionally, hydroxy-and oxoarginine (M25 and M26) urinary levels also increased with the intake of lentils.…”

“…[35] Therefore, this lack of specificity could limit its use as a single BFI, but we hypothesize that it could be considered within a multi-metabolite biomarker panel together with some of the other discriminating metabolites also observed in this study. [18] For example, combined with flavan-3-ol-derived metabolites, arginine-related compounds and hypaphorine increase the specificity for monitoring lentil consumption.…”

A Standardized Strategy for Simultaneous Quantification of Urine Metabolites to Validate Development of a Biomarker Panel Allowing Comprehensive Assessment of Dietary Exposure

“…[7] For application in the real world, the key need is to monitor simultaneously as wide a range of biomarkers as possible to determine the degree of overlap between foods during any validation process. [8] The issue is complicated because many food-derived chemicals undergo various modifications during digestion and absorption, or in subsequent tissue (liver) metabolism, so that the chemical nature of biomarkers in body fluids or urine differs from those in the ingested foods. [9] In human studies, urine is an easily accessible biofluid that contains relatively high concentrations of many dietary metabolites or their bio-transformation products.…”

Addressing the pitfalls when designing intervention studies to discover and validate biomarkers of habitual dietary intake

“…Urinary dietary exposure biomarkers are based on the concept that urinary excretion of specific metabolite(s) reflects, quantitatively, intake of a corresponding food or nutrient over a fixed period of time. In some cases, multi-metabolite biomarker panels may provide more reliable estimation of dietary exposure than a single-biomarker approach (reviewed by (Garcia-Aloy et al 2017 )). To add value to the assessment of habitual dietary intake, a dietary biomarker panel should contain markers for a wide range of commonly consumed foods and these markers should be specific and sensitive.…”