Use of the predictive sugars biomarker to evaluate self-reported total sugars intake in the Observing Protein and Energy Nutrition (OPEN) study.

BACKGROUND A predictive biomarker for intake of total sugars was recently developed under controlled conditions. We used this biomarker to assess measurement error (ME) structure in self-reported intake of total sugars in free-living individuals. METHODS The Observing Protein and Energy Nutrition (OPEN) study involved 484 participants aged 40 to 69 years. Diet was assessed using two administrations of a food frequency questionnaire (FFQ) and two nonconsecutive 24-hour dietary recalls (24HDR). Two 24-hour urine samples checked for completeness were analyzed on sucrose and fructose. We applied the biomarker calibrated in a feeding study to OPEN data to assess the ME structure and the attenuation factors (AF) for intakes of absolute total sugars and sugars density for the FFQ and 24HDR. RESULTS The AFs for absolute sugars were similar for a single FFQ and 24HDR, but attenuation decreased with repeated 24HDRs. For sugars density, the AFs for FFQ (men: 0.39; women: 0.33) were greater than for single 24HDR (men: 0.30; women: 0.24), and similar to two 24HDRs (men: 0.41; women: 0.35). The attenuation associated with both instruments was greater in women than in men. CONCLUSIONS Both the FFQ and 24HDR were found to be biased; hence, incorporation of the sugars biomarker in calibration studies within the cohorts may be necessary to more reliably estimate associations of sugars and disease. IMPACT In this article, we propose a new dietary reference instrument based on the recently defined class of predictive biomarkers. Using sugars biomarker, we quantify ME in the FFQ- and 24HDR-reported absolute total sugars and total sugars density.