A Dual-Carbon-and-Nitrogen Stable Isotope Ratio Model Is Not Superior to a Single-Carbon Stable Isotope Ratio Model for Predicting Added Sugar Intake in Southwest Virginian Adults ,

Abstract

The data do not provide evidence that the dual-isotope method is superior for predicting AS/SSB intakes within a southwest Virginian population. Our results support the potential of the δ(13)C value of finger-stick blood to serve as an objective measure of AS/SSB intake. This trial was registered at clinicaltrials.gov as NCT02193009.

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

“…To address this, the δ 15 N value was tested as a covariate to control for meat intake using methods proposed elsewhere (31, 32, 50). However for this study, the addition of δ 15 N did not enhance the ability of δ 13 C values to predict AS intake, as was previously seen in populations of mostly white US residents (40). The limitations of self-reported dietary assessment methodologies, including misreporting, are also acknowledged (23).…”

“…Furthermore, the δ 13 C value in whole blood cannot distinguish between corn consumption and corn-derivative consumption (33,35,49). However, we and others have reported no significant differences in the relation between δ 13 C and SSB consumption when using corn consumption as a covariate (40,44). An additional complication may be livestock fed corn products, which are then ingested as meat.…”

“…Blood samples were analyzed in triplicate for δ 13 C value via natural abundance stable isotope mass spectrometry (Isoprime; Micromass UK Ltd), as described previously (29). δ 15 N values, measuring the relative abundance of 15 N to 14 N, were also determined and evaluated as possible covariates to control for the potential confounders of meat (i.e., livestock consuming corn feed) consumption on δ 13 C values (32,40). Total variability across the 3 measurements was within 0.04‰.…”

New markers of dietary added sugar intake

“…Because more than half of AS is consumed in the form of SSB, and the majority of the AS consumed in many countries is ultimately derived from corn and cane plants, the δ 13 C value of human blood may be affected by SSB intake [15**,18*]. Analysis of δ 15 N is sometimes concurrently performed with δ 13 C analysis; the resulting dual isotope model may be used to correct for the potential confounding effect of meat consumption, as much livestock is fed upon corn, a C 4 plant [19,20]. …”

“…Disadvantages include the potential confounding effects of non-sweetener corn and meat consumption which may or may not be an issue depending upon the study population [19,20], an inability to reflect all dietary sources of AS (e.g., beet sugar), the potential impact of additives or preservatives to samples such as blood or urine [15**,21**], and analytical equipment requirements. However, analytical challenges may be more feasible in the future with the availability of an easily operable instrument that will be within the financial reach of most hospitals.…”