Table 1.
Summary: Recent research* investigating the δ13C sugar intake biomarker
| Study | Substrate Assessed | Population | Design | Results | Comments |
|---|---|---|---|---|---|
| Chi et al., [22] | Hair | US children aged 6–17 years, Yup’ik Alaska Natives, 50% female (n=51) | Cross-sectional | 40g/d increase in AS intake (determined by hair δ13C analysis) was associated with 6.4% absolute increase in the proportion of carious tooth surfaces (p=0.02). No associations of self-reported sugary foods/beverage intake with tooth decay. | 49% of children reported consuming SSB 2–3 times/day. Weight status was not reported. Equation used to estimate AS intake from δ13C hair analysis was developed using prior data from 14–79 year old Yup’ik. |
| Davy et al., [23] | Finger-stick blood | US children aged 6–18 years, 92% white, 46% female (n=140) | Cross-sectional | δ 13C test-retest reliability, r=0.99 (p<0.0001). δ13C value was associated (P<0.0001) with self-reported SSB kcal, r=0.35. | Mean reported SSB intake was 116+11 kcal/d. 20% of sample was overweight/obese. |
| Fakhouri et al., [24] | Blood serum | US adults aged 25–79 years, 81% black, 66% female (n=144) | 18-month trial, subset of PREMIER | A 12 fl oz/d reduction in self-reported SSB intake was associated with 0.17‰ reduction in serum δ13C value (p<0.0001) over 18 months. | Results remained significant after controlling for multiple confounders, including corn consumption and δ 15N. Mean BMI=34kg/m2 |
| Hedrick et al., [19] | Finger-stick blood | US adults aged ≥18 years, 91% white, 77% female (n=257) | Cross-sectional | δ13C value was associated (p≤0.01) with AS (r=0.32) and SSB (r=0.39). Including δ15N resulted in minimal changes to the model’s ability to predict AS/SSB intake. | 74% of sample was overweight/obese. Mean reported SSB intake was 359±347 kcal/d. Non-sweetener corn intake was not associated with δ13C value. |
| Hedrick et al., [18] | Finger-stick blood | US adults aged ≥18 years, 94% white, 83% female (n=216) | Cross-sectional | Regression models demonstrated that HEI-2010 (i.e., overall diet quality)(R2=0.16), AS (R2=0.15) and SSB (R2=0.14) were all significant predictors of fingerstick δ13C value. HEI-2010 was significantly different across δ13C tertiles. | High habitual SSB consumers according to self-report (>200 kcal/d). Mean BMI=33kg/m2 |
| Nash et al., [25] | Red blood cells | US adults aged 19–94 years, 55% female, Yup’ik Alaska Natives (n=1076) | Cross-sectional | Total sugar intake was estimated via prediction equation using RBC δ13C and δ15N values; positive associations of sugar intake noted with BP and triglyceride concentrations; inverse associations noted with total-, HDL-and LDL-cholesterol concentrations. | 68% were overweight or obese; BMI and waist circumference were not associated with estimated sugar intake. |
| Nash et al., [26] | Plasma, plasma glucose, RBC, hair | US adults aged 14–79 years, Yup’ik Alaska Natives Two sets of participants (n=52 with complete data; n=68 with partial data; ~50% female overall) | Cross-sectional | RBC and hair dual isotope (δ13C and δ15N) models predicated self-reported total sugar (R2=0.52–0.53), AS (R2=0.47–0.48) and SSB intake (R2=0.34). Plasma dual isotope models predicted SSB (R2=0.28) but not total sugars or AS. Fasting plasma glucose was not associated with any of the self-reported sugar intake variables. | 55–56% in each sample were overweight or obese; most were >21 years or older (84–90% of sample). |
| Patel et al., [27] | Blood serum | UK adults aged 40–79 years, 59% female (total n=1178; 476 T2D cases and 718 in subcohort) | Case-cohort study, longitudinal | δ13C values were lower in cases than in the subcohort (p=0.009), and inversely associated with T2D (HR per tertile 0.74, p<0.001). No associations between δ13C values and sugar intake determined by FFQ. | European population with different primary sources of sugar intake than US samples. Mean BMI=26 kg/m2 |
*
Published in 2014–2015.
Abbreviations used: US = United States; AS = Added Sugar; SSB = Sugar-sweetened Beverage; PA = physical activity; BMI = body mass index; HEI-2010 = Healthy Eating Index – 2010; BP = blood pressure; HDL = high-density lipoprotein; LDL-low-density lipoprotein; UK = United Kingdom; T2D = type 2 diabetes; HR = hazard ratio; FFQ = food frequency questionnaire.