Abstract
Background: Studies investigating associations between sweeteners and health yield inconsistent results, possibly due to subjective self-report dietary assessment methods. Objectives: We compared the performance of a food frequency questionnaire (FFQ), multiple 24-h dietary recalls (24hRs), and urinary biomarkers to estimate intake of sugars and low/no-calorie sweeteners (LNCSs). Methods: Participants (n = 848, age 54 ± 12 y) from a 2-y observational study completed 1 semiquantitative FFQ and ≥ 3 nonconsecutive 24hRs. Both methods assessed intake of sugars (mono- and disaccharides, sucrose, fructose, free and added sugars) and sweetened foods and beverages (sugary foods, fruit juice, and sugar or LNCS-containing beverages [sugar-sweetened beverages and low/no-calorie sweetened beverages (LNCSBs)]); 24hRs also included LNCS-containing foods and tabletop sweeteners (low/no-calorie sweetened foods [LNCSFs]). Urinary excretion of sugars (fructose+sucrose) and LNCSs (acesulfame K+sucralose+steviol glucuronide+cyclamate+saccharin) were simultaneously assessed using ultrapressure liquid chromatography coupled to tandem mass spectrometry in 288 participants with 3 annual 24-h urine samples. Methods were compared using, amongst others, validity coefficients (correlations corrected for measurement error). Results: Median (interquartile range) FFQ intakes ranged from 0 (0–7) g/d for LNCSBs to 94 (73–117) g/d for mono- and disaccharides. LNCSB use was reported by 32% of participants. Median LNCSB+LNCSF intake using 24hRs was 1 (0–50) g/d and reported by 58%. Total sugar excretions were detected in 100% of samples [56 (37–85) mg/d] and LNCSs in 99% of urine samples [3 (1–10) mg/d]. Comparing FFQ against 24hRs showed VCs ranging from 0.38 (fruit juice) to 0.74 (LNCSB). VCs for comparing FFQ with urinary excretions were 0.25 to 0.29 for sugars and 0.39 for LNCSBs; for 24hR they amounted to 0.31–0.38 for sugars, 0.37 for LNCSBs, and 0.45 for LNCSFs. Conclusions: The validity of the FFQ against 24hRs for the assessment of sugars and LNCSBs ranged from moderate to good. Comparing self-reports and urine excretions showed moderate agreement but highlighted an important underestimation of LNCS exposure using self-reports.
Originalsprog | Engelsk |
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Bogserie | American Journal of Clinical Nutrition |
Vol/bind | 119 |
Udgave nummer | 2 |
Sider (fra-til) | 546-559 |
ISSN | 0002-9165 |
DOI | |
Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:This EU project under the acronym “SWEET” has received funding from the European Union’s Horizon 2020 research and innovation programme, grant agreement No. 774293. The NQplus study was core funded by ZonMW (Zon MW, grant 91110030). The funders had no role in the study design, data collection, data analysis, and interpretation, writing the report, or the decision to submit the article for publication.
Funding Information:
EJMF reports financial support from the Knowledge Center Sugar and Health (NL). JCGH reports financial support from the American Beverage Association , board membership with DuPont and Mars, and speaking and lecture fees from the International Sweeteners Association . AR reports speaking and lecture fees from Nestlé SA and the International Sweeteners Association; travel reimbursement from the International Sweeteners Association; and consulting or advisory fees from Unilever Plc. JAH reports financial support from the American Beverage Association . All other authors report no conflicts of interest.
Funding Information:
EJMF reports financial support from the Knowledge Center Sugar and Health (NL). JCGH reports financial support from the American Beverage Association, board membership with DuPont and Mars, and speaking and lecture fees from the International Sweeteners Association. AR reports speaking and lecture fees from Nestlé SA and the International Sweeteners Association; travel reimbursement from the International Sweeteners Association; and consulting or advisory fees from Unilever Plc. JAH reports financial support from the American Beverage Association. All other authors report no conflicts of interest.This EU project under the acronym “SWEET” has received funding from the European Union's Horizon 2020 research and innovation programme, grant agreement No. 774293. The NQplus study was core funded by ZonMW (Zon MW, grant 91110030). The funders had no role in the study design, data collection, data analysis, and interpretation, writing the report, or the decision to submit the article for publication.
Publisher Copyright:
© 2023 The Author(s)