The Breath Carbon Isotope Ratio Reflects Short-term Added-Sugar Intake in a Dose-Response, Crossover Feeding Study of 12 Healthy Adults

Abstract

Background Objective dietary biomarkers are urgently needed for a wider range of foods and nutrients. The breath carbon isotope ratio (CIR; measured as δ13C values) has potential as a noninvasive measure of short-term added sugar (AS) intake but has not been evaluated in a controlled-feeding study. Objective The aim was to evaluate the effect of short-term AS intake on breath CIR in a dose-response, randomized, crossover feeding study. Methods Six men and 6 women, aged 25 to 60 y, were randomly assigned to a balanced sequence of 5 dietary treatments. Three treatments delivered low (0 g/d), medium (75 g/d), or high (150 g/d) amounts of AS over the course of a single day's breakfast and lunch and 2 switched high and low intake amounts between breakfast and lunch. Experimental meals delivered 60% of daily energy and added-sugar targets. There was a washout period of 1–2 wk between treatments. Breath was collected at 2-h intervals from 08:00 (fasting) to 16:00 h. Breath CIR was measured using cavity ring-down spectroscopy, and the effects of dietary treatments and baseline were evaluated using multivariate linear regression. Results Breath CIR showed a significant response to increasing AS intake at all sampling time points (all P < 0.0001), with a dose-response of 0.030 (95% CI: 0.024, 0.037) ‰/g. Fasting breath CIR (baseline) influenced postfeeding breath CIR at all sampling time points (P < 0.0001); however, effect sizes were largest in the morning. For afternoon-collected samples (14:00 and 16:00), the effect of recent AS intake (lunch) was 4-fold greater than the effect of previous added-sugar intake (breakfast). Conclusions These findings support the potential of the breath CIR as a biomarker of short-term AS intake in healthy US adults. More work is needed to evaluate other potential dietary effects and whether multiple breath collections could capture daily AS intake.

Breath Stable Isotope Analysis Serves as a Non-invasive Analytical Tool to Demonstrate Dietary Changes in Adolescent Students Over Time

“…They also examined δ 13 C breath samples from healthy adult participants (n = 3) every 10 min following a meal high in added sugar. δ 13 C breath samples rapidly increased over the first hour, remained steady for 2 h, and declined an hour before lunch (16). While both studies agree that immediate δ 13 C breath measurements reflect recently consumed carbohydrates and simple sugars, their findings differ on the amount of time that a previous meal could influence the subsequent meal δ 13 C breath values.…”

“…Scholler found that labeled glucose and sugars peaked in breath 13 CO 2 excretion around 4 h and remain in the breath for up to 8 h (27). While the O'Brien study found that following a meal δ 13 C breath peaked after 2 h and decreased 4 h after the meal; however δ 13 C breath 4 h post meal did not return to the pre-feeding values, which could suggest some carry over to the next meal (16).…”

“…Stable isotope biomarkers have readily been used to learn about diets in many disciplines ranging from animal ecology to anthropology (11)(12)(13)(14)(15). They are also gaining credence and popularity among nutrition and health research (10,16,17). In particular, carbon (δ 13 C) isotope ratios have been used because they display predictable and natural patterns that are linked to protein, carbohydrate, and lipid consumption (18,19).…”

“…Early studies were interested in understanding the baseline variation in breath δ 13 C for metabolic labeling studies (27). Recent, analytical advancements have sparked a renewed interest in δ 13 C breath measurements for metabolic and dietary studies (16,(28)(29)(30)(31).…”

“…The analysis of δ 13 C breath has been of interest to examine carbohydrate intake over short time scales (hours) and may reflect foods that have been immediately eaten (carbohydrates and simple sugars) or stored reserves (lipids) (31,32). Recently, O'Brien et al examined using δ 13 C breath as a marker of short term added sugar intake in adult participants in a controlled setting (16).…”