title: Evaluation of a novel biomarker of added sugar intake (δ 13C) compared with self-reported added sugar intake and the Healthy Eating Index-2010 in a community-based, rural U.S. sample.
abstract: OBJECTIVE
  The δ 13C value of human blood is an emerging novel biomarker of added sugar (AS) intake for adults. However, no free-living, community-based assessments of comparative validity of this biomarker have been conducted. The purpose of the present investigation was to determine if Healthy Eating Index-2010 (HEI-2010) score, SoFAAS score (HEI-2010 sub-component for solid fat, alcohol and AS), AS and sugar-sweetened beverage (SSB) intakes were associated with δ 13C value of fingerstick blood in a community-based sample of adults, while controlling for relevant demographics.
  
  
  METHODS
  A cross-sectional analysis of data obtained from assessments of BMI, dietary intake using 24 h recalls and a fingerstick blood sample was completed. Statistical analyses included descriptive statistics, multiple linear regression and one-way ANOVA.
  
  
  METHODS
  Rural Southwest Virginia, U.S.A.
  
  
  METHODS
  Adults (n 216) aged >18 years who consumed at least 837 kJ/d (200 kcal/d) from SSB.
  
  
  RESULTS
  This sample of adult participants with low socio-economic status demonstrated a mean HEI-2010 score of 43.4 (sd 12.2), mean SoFAAS score of 10.2 (sd 5.7), mean AS intake of 93 (sd 65) g/d and mean blood δ 13C value of -18.88 (sd 0.7) ‰. In four separate regression models, HEI-2010 (R 2=0.16), SoFAAS (R 2=0.19), AS (R 2=0.15) and SSB (R 2=0.14) predicted δ 13C value (all P≤0.001). Age was also predictive of δ 13C value, but not sex or race.
  
  
  CONCLUSIONS
  These findings suggest that fingerstick δ 13C value has the potential to be a minimally invasive method for assessing AS and SSB intake and overall dietary quality in community-based settings. Strengths, limitations and future areas of research for using an objective δ 13C biomarker in diet-related public health studies are discussed.
authors.affiliation: 1Department of Human Nutrition,Foods and Exercise,Virginia Tech,295 West Campus Drive,335A Wallace Hall (0430),Blacksburg,VA 24061,USA.
authors.forename: Valisa E
authors.initials: VE
authors.lastname: Hedrick
authors.affiliation: 1Department of Human Nutrition,Foods and Exercise,Virginia Tech,295 West Campus Drive,335A Wallace Hall (0430),Blacksburg,VA 24061,USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Davy
authors.affiliation: 1Department of Human Nutrition,Foods and Exercise,Virginia Tech,295 West Campus Drive,335A Wallace Hall (0430),Blacksburg,VA 24061,USA.
authors.forename: Grace A
authors.initials: GA
authors.lastname: Wilburn
authors.affiliation: 2Department of Geology and Geophysics,University of Hawaii at Manoa,Honolulu,HI,USA.
authors.forename: A Hope
authors.initials: AH
authors.lastname: Jahren
authors.affiliation: 1Department of Human Nutrition,Foods and Exercise,Virginia Tech,295 West Campus Drive,335A Wallace Hall (0430),Blacksburg,VA 24061,USA.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Zoellner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001628:Beverages / Q000032:analysis*; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D002247:Carbon Isotopes; D003430:Cross-Sectional Studies; D019422:Dietary Sucrose / Q000008:administration & dosage / Q000097:blood*; D002149:Energy Intake; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D011634:Public Health; D012424:Rural Population; D057566:Self Report; D012959:Socioeconomic Factors; D014768:Virginia; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002247:Carbon Isotopes; D019422:Dietary Sucrose
keywords: Added sugar; Biomarker; Dietary assessment; Dietary quality