TY - JOUR
T1 - Relative validity of habitual sugar and low/no-calorie sweetener consumption assessed by food frequency questionnaire, multiple 24-h dietary recalls and urinary biomarkers
T2 - an observational study within the SWEET project
AU - Buso, Marion EC
AU - Boshuizen, Hendriek C.
AU - Naomi, Novita D.
AU - Maho, Walid
AU - Diepeveen-de Bruin, Marlies
AU - Balvers, Michiel GJ
AU - de Vries, Jeanne HM
AU - Harrold, Joanne A.
AU - Halford, Jason CG
AU - Raben, Anne
AU - Feskens, Edith JM
AU - Brouwer-Brolsma, Elske M.
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
KW - dietary intake
KW - fructose
KW - low/no-calorie sweetened beverages
KW - measurement error models
KW - non-nutritive sweeteners
KW - sucrose
KW - sugar-sweetened beverages
KW - urine biomarkers
U2 - 10.1016/j.ajcnut.2023.11.019
DO - 10.1016/j.ajcnut.2023.11.019
M3 - Journal article
C2 - 38043866
AN - SCOPUS:85181832258
VL - 119
SP - 546
EP - 559
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 2
ER -