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Establishing Urinary Biomarkers as Objective Indicators of Dietary Intake In Adolescents

Obesity is a public health concern and cardiometabolic consequences are severe when obesity develops during youth and continues into adulthood. Treatment prior to adulthood confers health benefits, but adolescent obesity rates have continually increased, reaching 20.6% in 2013-2014. Quality and quantity of dietary intake contribute to the development of obesity, but limitations of self-reported dietary intake are evident in overweight or obese adolescents, who frequently misreport nutrients of concern. Added sugar, sodium, and protein intake may indicate diet quality in this population. The 2015-2020 Dietary Guidelines recommend decreasing consumption of added sugars, sodium, and processed protein due to their known contributions to overweight and obesity. Objective dietary intake assessment measures are necessary for investigating the association between dietary intake and health outcomes. Added sugar, sodium, and protein intake could be assessed objectively with a panel of urinary biomarkers. Prior research indicates the potential of these urinary biomarkers to reflect dietary intake, but to date, no controlled feeding study has been conducted in adolescents. Using a controlled feeding design, the current study aims to evaluate the validity of urinary sucrose, fructose, sodium, and nitrogen as objective indicators of dietary intake. It is hypothesized that urinary sucrose and fructose will reflect dietary added sugar intake, while urinary sodium and nitrogen will correspond to dietary sodium and protein intake, respectively, in a healthy adolescent population. These biomarkers, if valid, could be used in clinical and epidemiological research to improve understanding of the associations between dietary intake and health outcomes. / Master of Science / An increasing percentage of adolescents are becoming overweight or obese as a result of lifestyle changes that have decreased physical activity and increased access to foods with more calories and less nutrients. Overweight or obese adolescents are typically less heatlhy than their normal weight peers, and they are more likely to become overweight or obese adults, increasing the liklihood that they will develop diabetes and heart disease. It is important to prevent adolescents from becoming overweight or obese to preserve their health, and to treat adolescents who are overweight or obese to improve their health. Eating certain foods in excess contributes to negative health outcomes, including increased weight gain, so dietary change is an important aspect of overweight and obesity prevention and treatment. Current dietary guidelines recommend eating less added sugars, sodium, and processed protein. Quantifying dietary intake of these food components is essential for fully understanding their impact on health. However, self-reporting food intake is a flawed measure, because individuals may not accurately report all of the foods they consume. An objective method is needed to determine dietary intake of specific food components. Fortunately, urinary biomarkers can objectively assess dietary intake of added sugar, sodium, and protein. Controlling consumption of each food component and measuring urinary excretion of each biomarker is necessary to establish how intake corresponds to excretion, but this type of study has not been conducted in adolescents. The current study aims to use a controlled feeding approach to establish relationships between dietary intake of added sugars, sodium, and protein, and urinary excretion of sucrose/fructose, sodium, and nitrogen, in an adolescent population. These biomarkers could be used in future research to advance understanding of the relationships between food intake and overall health.

Identiferoai:union.ndltd.org:VTETD/oai:vtechworks.lib.vt.edu:10919/77962
Date08 June 2017
CreatorsMoore, Lori Beth
ContributorsHuman Nutrition, Foods, and Exercise, Davy, Brenda M., Neilson, Andrew P., Hedrick, Valisa E.
PublisherVirginia Tech
Source SetsVirginia Tech Theses and Dissertation
Detected LanguageEnglish
TypeThesis
FormatETD, application/pdf
RightsIn Copyright, http://rightsstatements.org/vocab/InC/1.0/

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