Relative validation of 24-h urinary hippuric acid excretion as a biomarker for dietary flavonoid intake from fruit and vegetables in healthy adolescents
- 258 Downloads
A biomarker for dietary flavonoid intake from fruit and vegetables (FlavFV) is needed to elucidate the relevance of flavonoids from these sources for the prevention of chronic diseases. Urinary hippuric acid (HA)—a major metabolite of flavonoids—is promising in this respect as it was shown to satisfyingly indicate fruit and vegetable consumption in different age groups. Therefore, we validated urinary HA as a biomarker for intake of FlavFV.
Analyses included data from 287 healthy adolescents of the DONALD Study (aged 9–16 years) for whom a minimum of two pairs of HA measurements from 24-h urine samples (test method) and FlavFV intake estimated from 3-day weighed dietary records (reference method) existed. Agreement between both methods was assessed by Spearman correlation and cross-classification analyses. Possible confounders of the association were identified by linear regression models. Analyses were performed using a split-sample approach allowing for consecutive exploration (n = 192) and confirmation (n = 95) of results.
Agreement between urinary HA excretion and FlavFV intake was moderate according to correlation analysis in the exploratory sample (runadjusted = 0.47, P < 0.0001). Yet, 79 % of the subjects were classified into same/adjacent quartiles, and only 5 % were misclassified into opposite quartiles. These findings were corroborated by analyses in the confirmatory sample (runadjusted = 0.64; 88 % in same/adjacent vs. 4 % in opposite quartiles). Body surface area (BSA) was the only relevant covariate in the exploratory sample, and its adjustment improved cross-classification estimates in both subsamples.
BSA-adjusted 24-h urinary HA excretion represents a suitable biomarker of habitual FlavFV intake in healthy adolescents.
Keywords24-h Urine Adolescents Biomarker of intake Flavonoids Hippuric acid Relative validation
The DONALD Study is supported by the Ministry of Innovation, Science, Research and Technology of the State of North-Rhine-Westphalia, Germany. This analysis was funded by the Wereld Kanker Onderzoek Fonds (WCRF NL), as part of the WCRF international grant programme (Grant No. 2013/975).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The DONALD Study was approved by the Ethics Committee of the University of Bonn, Germany.
All assessments in the DONALD Study were performed with parental written informed consent.
- 1.Arts ICW, Hollman PCH (2005) Polyphenols and disease risk in epidemiologic studies. Am J Clin Nutr 81(1 Suppl):317S–325SGoogle Scholar
- 6.Toromanovic J, Kovac-Besovic E, Sapcanin A, Tahirovic I, Rimpapa Z, Kroyer G, Sofic E (2008) Urinary hippuric acid after ingestion of edible fruits. Bosn J Basic Med Sci 8(1):38–43Google Scholar
- 8.DuPont MS, Bennett RN, Mellon FA, Williamson G (2002) Polyphenols from alcoholic apple cider are absorbed, metabolized and excreted by humans. J Nutr 132(2):172–175Google Scholar
- 12.Willett WC (2013) Nutritional epidemiology, 3rd edn. In: Monographs in epidemiology and biostatistics, vol 40. Oxford University Press, OxfordGoogle Scholar
- 14.Henning SM, Wang P, Abgaryan N, Vicinanza R, de Oliveira DM, Zhang Y, Lee R, Carpenter CL, Aronson WJ, Heber D (2013) Phenolic acid concentrations in plasma and urine from men consuming green or black tea and potential chemopreventive properties for colon cancer. Mol Nutr Food Res 57(3):483–493CrossRefGoogle Scholar
- 19.Remer T, Neubert A, Maser-Gluth C (2002) Anthropometry-based reference values for 24-h urinary creatinine excretion during growth and their use in endocrine and nutritional research. Am J Clin Nutr 75:561–569Google Scholar
- 20.Tomokuni K, Ogata M (1972) Direct colorimetric determination of hippuric acid in urine. Clin Chem 18(4):349–351Google Scholar
- 22.Bhagwat S, Haytowitz DB, Wasswa-Kintu SI, Holden JM (2013) USDA develops a database for flavonoids to assess dietary intakes. In: 36th National Nutrient Databank Conference. Procedia Food Sci vol 2, pp 81–86Google Scholar
- 23.U.S. Department of Agriculture (2004) USDA database for the proanthocyanidin content of selected foods. http://www.ars.usda.gov/Services/docs.htm?docid=24953. Accessed 23 Sept 2014
- 24.U.S. Department of Agriculture (2008) USDA database for the isoflavone content of selected foods, Release 2.0. http://www.ars.usda.gov/Services/docs.htm?docid=24953. Accessed 23 Sept 2014
- 25.U.S. Department of Agriculture (2014) USDA database for the flavonoid content of selected foods, Release 3.1. http://www.ars.usda.gov/Services/docs.htm?docid=24953. Accessed 23 Sept 2014
- 26.Zamora-Ros R, Andres-Lacueva C, Lamuela-Raventos RM, Berenguer T, Jakszyn P, Barricarte A, Ardanaz E, Amiano P, Dorronsoro M, Larranaga N, Martinez C, Sanchez MJ, Navarro C, Chirlaque MD, Tormo MJ, Quiros JR, Gonzalez CA (2010) Estimation of dietary sources and flavonoid intake in a Spanish adult population (EPIC-Spain). J Am Diet Assoc 110(3):390–398CrossRefGoogle Scholar
- 28.Matthews RH, Garrison YJ (1975) Food yields summarized by different stages of preparation. Rev. Agriculture handbook no. 102. U.S. Department of Agriculture, Agricultural Research Service, WashingtonGoogle Scholar
- 30.Kleinbaum DG, Kupper LL, Nizam A, Rosenberg ES (2008) Applied regression analysis and other multivariable methods. Duxbury applied series, 4th edn. Brooks/Cole, BelmontGoogle Scholar
- 36.Valentova K, Stejskal D, Bednar P, Vostalova J, Cihalik C, Vecerova R, Koukalova D, Kolar M, Reichenbach R, Sknouril L, Ulrichova J, Simanek V (2007) Biosafety, antioxidant status, and metabolites in urine after consumption of dried cranberry juice in healthy women: a pilot double-blind placebo-controlled trial. J Agric Food Chem 55(8):3217–3224CrossRefGoogle Scholar
- 37.Zamora-Ros R, Rabassa M, Cherubini A, Urpi-Sarda M, Llorach R, Bandinelli S, Ferrucci L, Andres-Lacueva C (2011) Comparison of 24-h volume and creatinine-corrected total urinary polyphenol as a biomarker of total dietary polyphenols in the Invecchiare InCHIANTI study. Anal Chim Acta 704(1–2):110–115CrossRefGoogle Scholar
- 38.Medina-Remon A, Barrionuevo-Gonzalez A, Zamora-Ros R, Andres-Lacueva C, Estruch R, Martinez-Gonzalez M, Diez-Espino J, Lamuela-Raventos RM (2009) Rapid Folin–Ciocalteu method using microtiter 96-well plate cartridges for solid phase extraction to assess urinary total phenolic compounds, as a biomarker of total polyphenols intake. Anal Chim Acta 634(1):54–60CrossRefGoogle Scholar
- 40.Krogholm KS, Bysted A, Brantsaeter AL, Jakobsen J, Rasmussen SE, Kristoffersen L, Toft U (2012) Evaluation of flavonoids and enterolactone in overnight urine as intake biomarkers of fruits, vegetables and beverages in the Inter99 cohort study using the method of triads. Br J Nutr 108(10):1904–1912CrossRefGoogle Scholar
- 41.Brantsaeter AL, Haugen M, Rasmussen SE, Alexander J, Samuelsen SO, Meltzer HM (2007) Urine flavonoids and plasma carotenoids in the validation of fruit, vegetable and tea intake during pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Public Health Nutr 10(8):838–847CrossRefGoogle Scholar
- 44.Nielsen SE, Freese R, Kleemola P, Mutanen M (2002) Flavonoids in human urine as biomarkers for intake of fruits and vegetables. Cancer Epidemiol Biomarkers Prev 11(5):459–466Google Scholar
- 47.Dériaz O, Fournier G, Tremblay A, Després JP, Bouchard C (1992) Lean-body-mass composition and resting energy expenditure before and after long-term overfeeding. Am J Clin Nutr 56(5):840–847Google Scholar
- 49.Ogata M, Kira S, Shimada Y, Ohsaki H, Sugihara R, Fujii T (1980) Comparison of several methods for the measurement of urinary hippuric acid as an index of toluene exposure. Acta Med Okayama 34(6):361–366Google Scholar