The δ13C Value of Fingerstick Blood Is a Valid, Reliable, and Sensitive Biomarker of Sugar-Sweetened Beverage Intake in Children and Adolescents

Abstract

Background: Reliance on self-reported dietary intake methods is a commonly cited research limitation, and dietary

Short-term changes in added sugar consumption by adolescents reflected in the carbon isotope ratio of fingerstick blood

“…Cook et al (2010) reported that the d 13 C value of plasma glucose was sensitive to AS intake in a previous meal but did not change in response to overall AS content of diet within a seven-day feeding period. However, these previous studies (except for Cook et al, 2010) may have underestimated the strength of associations of AS (or SSB) intake with the proposed d 13 C biomarker, due to the dietary under-reporting that occurs in both adults and youth (Kuhnle, 2012;Lioret et al, 2011;MacDougall et al, 2018;Rangan et al, 2014;Thompson et al, 2010;Ventura et al, 2006).…”

“…Positive correlations between AS intake and the δ 13 C value of plasma glucose (Cook et al, 2010), red blood cell (RBC) alanine (Choy et al, 2013), RBCs (Nash et al, 2014), and whole blood (Davy et al, 2011; Fakhouri et al, 2014; Yeung et al, 2010) have been reported. However, investigations have been limited to those which utilized self-reported dietary intake data (Chi et al, 2015; Choy et al, 2013; Davy et al, 2011; Fakhouri et al, 2014; MacDougall et al, 2018; Nash et al, 2013; Nash et al, 2014; Yeung et al, 2010) and one short-term controlled feeding study in adults (Cook et al, 2010). Of the two published investigations of the δ 13 C biomarker in children (Chi et al, 2015; MacDougall et al, 2018), only one assessed dietary intake (MacDougall et al, 2018).…”

“…However, investigations have been limited to those which utilized self-reported dietary intake data (Chi et al, 2015; Choy et al, 2013; Davy et al, 2011; Fakhouri et al, 2014; MacDougall et al, 2018; Nash et al, 2013; Nash et al, 2014; Yeung et al, 2010) and one short-term controlled feeding study in adults (Cook et al, 2010). Of the two published investigations of the δ 13 C biomarker in children (Chi et al, 2015; MacDougall et al, 2018), only one assessed dietary intake (MacDougall et al, 2018). Our recent comparison of biomarker values to self-reported SSB intake in 326 children and adolescents determined that the biomarker was able discriminate between high and low SSB consumers (MacDougall et al, 2018).…”

“…Of the two published investigations of the δ 13 C biomarker in children (Chi et al, 2015; MacDougall et al, 2018), only one assessed dietary intake (MacDougall et al, 2018). Our recent comparison of biomarker values to self-reported SSB intake in 326 children and adolescents determined that the biomarker was able discriminate between high and low SSB consumers (MacDougall et al, 2018). Controlled feeding studies are now needed to evaluate the validity of this technique for objectively assessing AS and SSB intake.…”

Association between change in self-reported sugar intake and a sugar biomarker (δ13C) in children at increased risk for type 1 diabetes

“…As most living organisms have a smaller 13 C: 12 C ratio than the Vienna Pee Dee Belemnite carbon standard, the measured δ 13 C values are generally negative. Previous literature demonstrates that there is a positive relationship between δ 13 C and added sugar intake, where greater intake is associated with greater (less negative) δ 13 C levels (3–5) . When examining change, one would expect that increasing sugar intake over time, as indicated by a positive (+) change in intake variable, would be associated with increasing δ 13 C, as indicated by a positive (+) change in the δ 13 C variable.…”