Objective assessment of dietary patterns using metabolic phenotyping: a randomized, controlled, crossover trial

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Title: Objective assessment of dietary patterns using metabolic phenotyping: a randomized, controlled, crossover trial
Authors: Garcia Perez, I
Posma, JM
Gibson, R
Chambers, ES
Hansen, TH
Vestergaard, H
Hansen, T
Beckmann, M
Pedersen, O
Elliott, P
Stamler, J
Nicholson, JK
Draper, J
Mathers, JC
Holmes, E
Frost, G
Item Type: Journal Article
Abstract: Background: The burden of non-communicable diseases, such as obesity, diabetes, coronary heart disease and cancer, can be reduced by the consumption of healthy diets. Accurate monitoring of changes in dietary patterns in response to food policy implementation is challenging. Metabolic profiling allows simultaneous measurement of hundreds of metabolites in urine, many of them influenced by food intake. We aim to classify people according to dietary behaviour and enhance dietary reporting using metabolic profiling of urine. Methods: To develop metabolite models from 19 healthy volunteers who attended a clinical research unit for four day periods on four occasions. We used the World Health Organisation’s healthy eating guidelines (increase fruits, vegetables, wholegrains, dietary fibre and decrease fats, sugars, and salt) to develop four dietary interventions lasting for four days each that ranged from a diet associated with a low to high risk of developing non-communicable disease. Urine samples were measured by 1H-NMR spectroscopy. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN 43087333. INTERMAP U.K. (n=225) and a healthy-eating Danish cohort (n=66) were used as free-living validation datasets. Findings: There was clear separation between the urinary metabolite profiles of the four diets. We also demonstrated significant stepwise differences in metabolite levels between the lowest and highest metabolic risk diets and developed metabolite models for each diet. Application of the derived metabolite models to independent cohorts confirmed the association between urinary metabolic and dietary profiles in INTERMAP (P<0•001) and the Danish cohort (P<0•001). Interpretation: Urinary metabolite models, developed in a highly controlled environment, can classify groups of free-living people into consumers of dietary profiles associated with lower or higher non-communicable disease risk based on multivariate metabolite patterns. This approach enables objective monitoring of dietary patterns in population settings and enhances validity of dietary reporting. Funding: National Institute for Health Research (NIHR) and Medical Research Council (MRC).
Editors: Van Epps, H
Issue Date: 12-Jan-2017
Date of Acceptance: 9-Nov-2016
ISSN: 2213-8587
Publisher: Elsevier: Lancet
Start Page: 184
End Page: 195
Journal / Book Title: The Lancet Diabetes & Endocrinology
Volume: 5
Issue: 3
Copyright Statement: © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access Article under the CC BY license (
Sponsor/Funder: National Institutes of Health
National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
National Institutes of Health
Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
Medical Research Council (MRC)
National Institute for Health Research
Funder's Grant Number: 0600 370 D330 1362
RDC01 79560
60024563 ICL
Publication Status: Published
Appears in Collections:Division of Surgery
Department of Medicine
Faculty of Medicine
Epidemiology, Public Health and Primary Care

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