CPS-3 Researchers Don’t Just Ask People What They Eat—They Check Urine Samples

Grantee: Ying Wang, PhD 
Institution: American Cancer Society
Area of Focus: Epidemiology Research, Population Science

The Challenge: Many scientific studies use questionnaires or interviews to gather information from people about what they usually eat and drink, how often, and in what amounts. These self-reported methods are only as reliable as a person’s memory, and regardless of a study participant’s diligence and intentions, their accuracy is questionable. Likely errors in data about a person’s eating habits makes it harder to study the role of diet in cancer prevention and survival.

To overcome these problems, nutritional epidemiologists examine dietary biomarkers found in blood or urine to measure the biological effects of specific dietary components and to identify foods that influence the risk for certain metabolic diseases, like obesity.

Dietary biomarkers have great potential because they are objective and not subject to the types of errors with self-reported diet, such as relying on memory. New, robust laboratory methods allow for the investigation of biological markers of foods, beverages, and other dietary components.  Dietary biomarkers include natural food constituents, like vitamins and flavonoids (nutrients in plants), food additives, as well as food contaminants. Small molecules derived from food components are called food metabolites.

“Dietary biomarkers found in the blood and urine are considered objective
measures of diet. The problem is reliable dietary biomarkers are sparse and
most are nutrient-based, not food-based. Our study used metabolomics technology,
which measures thousands of small molecules in blood and urine, to identify new
food-based biomarkers for a large group of men and women.”--Ying Wang, PhD

Nutritional epidemiologic studies have significantly advanced the understanding of the relationships between diet and chronic diseases and have led to dietary guidelines for disease prevention in recent decades. However, the field has been limited by inconsistent findings from many studies. Confirmed, validated dietary biomarkers do not exist for most foods and dietary patterns.

The Research: Ying Wang, PhD, along with colleagues from the American Cancer Society (ACS) and Emory University, use a high-throughput technology called metabolomics to measure thousands of small molecules in blood and urine and other body tissues—to identify metabolites related to the food have eaten.

They used responses to questionnaires and biospecimens from about 700 men and women in the Cancer Prevention Study-3, Diet Assessment Sub-Study to identify hundreds of metabolites that are related to what people frequently eat and drink, such as with oranges, broccoli, whole grains, fish, coffee, and tea.

With repeated measurements collected about 6 months apart, Wang and her team were also able to assess the reproducibility of the biomarkers.

They compared: 

  • 101 food groups/items by a food frequency questionnaire
  • 105 food groups/items by repeated 24-hr diet recalls
  • With 1,391 metabolites measured in 2 different 24-hour urine samples (urine collected in a special container for a full day, 24 hours)

They identified 513 unique metabolites correlated with 79 food groups/items. Many of these replicated metabolites found in earlier studies, adding a step towards their validity. They published their results in the journal Metabolites.

Why Does It Matter? Objective dietary biomarkers help validate, or add to, self-reported questionnaires and are important in diet assessment in large population studies to move the field forward. Wang’s findings about identified food-related metabolic biomarkers contribute to the evidence from the limited studies and will need to be confirmed and evaluated in future studies.

Identifying and learning more about dietary biomarkers may help researchers and health care professionals:

  • Shed light on physiological or pathological responses people have to certain food behaviors.
  • Help predict the risk for certain diseases.
  • Improve screening and diagnosis.
  • Monitor the progression of a disease and its responses to treatment.
  • Have information on the kinds of individual differences people have in response to diet.

In the future, knowledge about dietary biomarkers may help researchers and other experts develop personalized dietary recommendations, also called precision nutrition.