Abstract
Studies on sugar intake and its link to cardiometabolic risk show inconsistent results, partly due to dietary misreporting. Cost-effective and easily measured nutritional biomarkers that can complement dietary data are warranted. Measurement of 24-h urinary sugars is a biomarker of sugar intake, but there are knowledge gaps regarding the use of overnight urine samples. We aim to compare (1) overnight urinary sucrose and fructose measured with liquid chromatography-tandem mass spectrometry, (2) self-reported sugar intake measured with web-based 4-day food records, (3) their composite measure, and (4) these different measures' (1–3) cross-sectional associations with cardiometabolic risk factors in 991 adults in the Malmö Offspring Study (18–69 years, 54% women). The correlations between the reported intakes of total sugar, added sugar and sucrose was higher for urinary sucrose than fructose, and the correlations for the sum or urinary sucrose and fructose (U-sugars) varied between r≈0.2–0.3 (P < 0.01) in men and women. Differences in the direction of associations were observed for some cardiometabolic risk factors between U-sugars and reported added sugar intake, as well as between the sexes. In women, U-sugars, but not reported added sugar intake, were positively associated with systolic and diastolic blood pressure and fasting glucose. Both U-sugars and added sugar were positively associated with BMI and waist circumference in women, whereas among men, U-sugars were negatively associated with BMI and waist circumference, and no association was observed for added sugar. The composite measure of added sugars and U-sugars was positively associated with BMI, waist circumference and systolic blood pressure and negatively associated with HDL cholesterol in women (P < 0.05). Conclusively, we demonstrate statistically significant, but not very high, correlations between reported sugar intakes and U-sugars. Results indicate that overnight urinary sugars may be used as a complement to self-reported dietary data when investigating associations between sugar exposure and cardiometabolic risk. However, future studies are highly needed to validate the overnight urinary sugars as a biomarker because its use, instead of 24-h urine, facilitates data collection.
Highlights
Sugars have received increasing attention in recent decades and have been linked to metabolic syndrome and related conditions and diseases [1,2,3]
We showed statistically significant correlations of r≈0.20–0.30 between reported sugar intakes and overnight urinary sugars after adjusting for age, sex, energy intake, and body mass index (BMI)
The relatively low coefficients of these correlations and the modest agreement observed in the alluvial plot may reflect that both these measures of sugar intake are subject to random variation and measurement error
Summary
Sugars have received increasing attention in recent decades and have been linked to metabolic syndrome and related conditions and diseases (obesity, type 2 diabetes and cardiovascular disease) [1,2,3]. The measurement of 24-h urinary sucrose and fructose as a predictive biomarker for sugar intake was first recognized after its dose-response relationship was demonstrated through controlled sugar intake and its validity to estimate sugar intake (after ad libitum intake) was confirmed [6]. Thereon, this biomarker has been compared against several different dietary assessment methods [7, 8], e.g., correlation of r = 0.21 with a 4-day food record [8]. Higher urinary sucrose levels (from any time spot urine samples) were associated with an increased risk of being overweight, whereas higher self-reported sugar intake was associated with a decreased risk [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
