Epidemiologic assessment of sugars consumption using biomarkers: Comparisons of obese and nonobese individuals in the European Prospective Investigation of Cancer Norfolk

Abstract

We have previously shown that urinary sugars excretion in 24 h urine collections can serve as an independent biomarker of sugars consumption. In the European Prospective Investigation of Cancer (EPIC) Norfolk study of nutrition and cancer, this biomarker in spot urines has been assessedin a cross-sectional comparison of 404 obese individuals aged 45 to 75 years with a body mass index (BMI) of >30 kg/m2 and 471 normal weight individuals aged 45 to 75 years with a BMI of <25 kg/m2. In individuals of normal weight, sucrose, protein, andvitamin C intake were positively and highly significantly relatedto biomarkers in spot urine or plasma (P < 0.001), but there were no significant associations between biomarkers and food intake reports in the obese. Odds ratios for a BMI of >30 were significantly elevated for urinary sucrose [trendper milligram per liter quintile, 1.13; 95% confidence interval (95% CI), 1.02-1.25; P = 0.016], and the odds ratio for urinary sucrose/fructose ratio was highly significant (trendper quintile, 1.264; 95% CI, 1.142-1.401; P < 0.001). No associations for sugars intake andobesity were foundusing a food frequency questionnaire, andd ietary vitamin C was apparently associatedwith increased risk (P < 0.001) despite an inverse association for plasma vitamin C. Nutritional biomarkers of consumption can complement existing methods for assessing cancer risk from diet in epidemiologic studies. Copyright © 2007 American Association for Cancer Research.