Urinary 3-(3,5-dihydroxyphenyl)-1-propanoic acid, an alkylresorcinol metabolite, is a potential biomarker of whole-grain intake in a U.S. population

Exhaustive Search of Dietary Intake Biomarkers as Objective Tools for Personalized Nutrimetabolomics and Precision Nutrition Implementation

OBJECTIVE

To conduct an exhaustive scoping search of existing literature, incorporating diverse bibliographic sources to elucidate the relationships between metabolite biomarkers in human fluids and dietary intake.

BACKGROUND

The search for biomarkers linked to specific dietary food intake holds immense significance for precision health and nutrition research. Using objective methods to track food consumption through metabolites offers a more accurate way to provide dietary advice and prescriptions on healthy dietary patterns by healthcare professionals. An extensive investigation was conducted on biomarkers associated with the consumption of several food groups and consumption patterns. Evidence is integrated from observational studies, systematic reviews, and meta-analyses to achieve precision nutrition and metabolism personalization.

METHODS

Tailored search strategies were applied across databases and gray literature, yielding 158 primary research articles that met strict inclusion criteria. The collected data underwent rigorous analysis using STATA and Python tools. Biomarker-food associations were categorized into 5 groups: cereals and grains, dairy products, protein-rich foods, plant-based foods, and a miscellaneous group. Specific cutoff points (≥3 or ≥4 bibliographic appearances) were established to identify reliable biomarkers indicative of dietary consumption.

RESULTS

Key metabolites in plasma, serum, and urine revealed intake from different food groups. For cereals and grains, 3-(3,5-dihydroxyphenyl) propanoic acid glucuronide and 3,5-dihydroxybenzoic acid were significant. Omega-3 fatty acids and specific amino acids showcased dairy and protein foods consumption. Nuts and seafood were linked to hypaphorine and trimethylamine N-oxide. The miscellaneous group featured compounds like theobromine, 7-methylxanthine, caffeine, quinic acid, paraxanthine, and theophylline associated with coffee intake.

CONCLUSIONS

Data collected from this research demonstrate potential for incorporating precision nutrition into clinical settings and nutritional advice based on accurate estimation of food intake. By customizing dietary recommendations based on individualized metabolic profiles, this approach could significantly improve personalized food consumption health prescriptions and support integrating multiple nutritional data.This article is part of a Nutrition Reviews special collection on Precision Nutrition.

Investigation of Potential Food Intake Biomarkers by LC-MS/MS: Suitability Under Conditions Close to Everyday Live

SCOPE

Food intake biomarkers are proposed to be a more reliable tool for investigating the nutritional status compared to food diaries or food frequency questionnaires. Nevertheless, biomarkers have some disadvantages such as the influence of the individual lifestyle, different metabolism, nutrient-nutrient interaction or the specificity of the used biomarkers. To evaluate the suitability of several biomarkers, a study under conditions close to everyday life was conducted.

METHODS AND RESULTS

Ten healthy volunteers were divided into three groups who followed different meal plans for 24 h and collected their entire urine. Afterward, several potential biomarkers were quantified using an LC-MS/MS approach. To further investigate the suitability of those biomarkers, the results were investigated with the main goal of grouping the participants according to their provided diet, while the first author did not have any knowledge of the meal plans or other specific knowledge about the study design.

CONCLUSION

The use of different biomarkers enables the evaluation of different eating habits without any prior wash out period or bigger than usual portion sizes. Especially long-term biomarkers seem to have a good suitability. Very high intakes and very low intakes are easier to distinguish than a moderate intake. Food intake biomarkers are proposed as a more reliable tool than food diaries or food frequency questionnaires. Nevertheless, data under realistic conditions are rarely available. In this study, ten volunteers were divided into three groups with different meal plans. An LC-MS/MS approach was performed and the data were further investigated with the main goal of grouping the participants according their provided diet, while the first author did not have any knowledge about the meal plans.

Human Intervention Study: Alkylresorcinol Metabolites as Potential Biomarkers for Grain Intake and the Occurrence of Alkylresorcinols in Commonly Consumed Foods in the German Retail Sector

Grains are one of the primary nutrients and are associated with many health benefits. To reflect the intake of grain-based products, two promising potential biomarkers are alkylresorcinol (AR) metabolites 3,5-dihydroxybenzoic acid (3,5-DHBA) and 3-(3,5-dihydroxyphenyl)-propanoic acid (3,5-DHPPA). The aim of this study was to validate the occurrence of AR in food samples and investigate the suitability of their metabolites as potential biomarkers in human intervention studies. In the first step, the AR content in different grain products from the German retail sector was analyzed by GC-MS. ARs were found in higher concentrations in whole grain products and in moderate contents in refined grains and quinoa. Based on these results, human intervention studies were performed in the next step, and the AR metabolites 3,5-DHBA and 3,5-DHPPA were analyzed by LC-MS/MS in urine samples. The intake of only whole grain products leads to an increasing level of both potential biomarkers, while a refined grain diet shows decreasing levels of the AR metabolites. The excretion of 3,5-DHBA after a whole grain-rich diet differs significantly (p = 0.043) from no grain intake.

Impact of wheat aleurone on biomarkers of cardiovascular disease, gut microbiota and metabolites in adults with high body mass index: a double-blind, placebo-controlled, randomized clinical trial

Purpose

Aleurone is a cereal bran fraction containing a variety of beneficial nutrients including polyphenols, fibers, minerals and vitamins. Animal and human studies support the beneficial role of aleurone consumption in reducing cardiovascular disease (CVD) risk. Gut microbiota fiber fermentation, polyphenol metabolism and betaine/choline metabolism may in part contribute to the physiological effects of aleurone. As primary objective, this study evaluated whether wheat aleurone supplemented foods could modify plasma homocysteine. Secondary objectives included changes in CVD biomarkers, fecal microbiota composition and plasma/urine metabolite profiles.

Methods

A parallel double-blind, placebo-controlled and randomized trial was carried out in two groups of obese/overweight subjects, matched for age, BMI and gender, consuming foods supplemented with either aleurone (27 g/day) (AL, n = 34) or cellulose (placebo treatment, PL, n = 33) for 4 weeks.

Results

No significant changes in plasma homocysteine or other clinical markers were observed with either treatment. Dietary fiber intake increased after AL and PL, animal protein intake increased after PL treatment. We observed a significant increase in fecal Bifidobacterium spp with AL and Lactobacillus spp with both AL and PL, but overall fecal microbiota community structure changed little according to 16S rRNA metataxonomics. Metabolomics implicated microbial metabolism of aleurone polyphenols and revealed distinctive biomarkers of AL treatment, including alkylresorcinol, cinnamic, benzoic and ferulic acids, folic acid, fatty acids, benzoxazinoid and roasted aroma related metabolites. Correlation analysis highlighted bacterial genera potentially linked to urinary compounds derived from aleurone metabolism and clinical parameters.

Conclusions

Aleurone has potential to modulate the gut microbial metabolic output and increase fecal bifidobacterial abundance. However, in this study, aleurone did not impact on plasma homocysteine or other CVD biomarkers.

Trial Registration

The study was registered at ClinicalTrials.gov (NCT02067026) on the 17th February 2014.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00394-022-02836-9.

Urinary biomarkers of dietary intake: a review

Dietary intakes are commonly assessed by established methods including food frequency questionnaires, food records, or recalls. These self-report methods have limitations impacting validity and reliability. Dietary biomarkers provide objective verification of self-reported food intakes, and represent a rapidly evolving area. This review aims to summarize the urinary biomarkers of individual foods, food groups, dietary patterns, or nutritional supplements that have been evaluated to date. Six electronic databases were searched. Included studies involved healthy populations, were published from 2000, and compared measured dietary intake with urinary markers. The initial search identified 9985 studies; of these, 616 full texts were retrieved and 109 full texts were included. Of the included studies, 67 foods and food components were studied, and 347 unique urinary biomarkers were identified. The most reliable biomarkers identified were whole grains (alkylresorcinols), soy (isoflavones), and sugar (sucrose and fructose). While numerous novel urinary biomarkers have been identified, further validation studies are warranted to verify the accuracy of self-reported intakes and utility within practice.

Biomarkers of Whole-Grain and Cereal-Fiber Intake in Human Studies: A Systematic Review of the Available Evidence and Perspectives

High whole-grain consumption is related to better health outcomes. The specific physiological effect of these compounds is still unrevealed, partly because the accurate estimation of the intake of whole grains from dietary assessments is difficult and prone to bias, due to the complexity of the estimation of the intake by the consumer. A biomarker of whole-grain intake and type of whole-grain intake would be useful for quantifying the exposure to whole-grain intake. In this review, we aim to review the evidence on the potential biomarkers for whole-grain intake in the literature. We conducted a systematic search in Medline, Embase, Web of Science, and the Cochrane database. In total, 39 papers met the inclusion criteria following the PRISMA guidelines and were included. The relative validity, responsiveness, and reproducibility of these markers were assessed for short-, medium-, and long-term exposure as important criteria for the potential use of these biomarkers from a clinical and research perspective. We found three major groups of biomarkers: (1) alkylresorcinol, as well as its homologs and metabolites, assessed in plasma, adipose tissue biopsies, erythrocyte membranes, and urine; (2) avenacosides, assessed in urine samples; and (3) benzoxazinoid-derived phenylacetamide sulfates, assessed in blood and urine samples. The reviewed biomarkers may be used for improved assessment of associations between whole-grain intake and health outcomes.

Biomarkers of cereal food intake

Background/objectives

Cereal foods are major contributors to the daily energy, protein, and dietary fiber intake all over the world. The role of cereals in human health is dependent on whether they are consumed as refined or whole grain and on cereal species. To unravel the underlying mechanisms of health effects attributed to specific cereal foods and to provide more precise dietary advice, there is a need for improved dietary assessment of whole-grain intake. Dietary biomarkers of specific cereals, different fractions or cereal-containing foods could offer such a possibility. The aim of this review was to summarize the current status on biomarkers of different cereals, fractions, and specific cereal foods.

Subjects and methods

A literature review was conducted and putative biomarkers of different cereals and pseudo-cereals (wheat, oats, rye, barley, rice, and quinoa) as well as for different grain fractions (whole grain, refined grain, bran) and foods were summarized and discussed.

Results

Several putative biomarkers have been suggested for different cereals, due to their unique presence in these grains. Among the biomarkers, odd-numbered alkylresorcinols are the most well-studied and -evaluated biomarkers and reflect whole-grain wheat and rye intake. Even-numbered alkylresorcinols have been suggested to reflect quinoa intake. Recent studies have also highlighted the potential of avenanthramides and avenacosides as specific biomarkers of oat intake, and a set of biomarkers have been suggested to reflect rice bran intake. However, there are yet no specific biomarkers of refined grains. Most biomarker candidates remain to be evaluated in controlled interventions and free-living populations before applied as biomarkers of intake in food and health studies.

Conclusion

Several putative biomarkers of different cereals have been suggested and should be validated in human studies using recently developed food intake biomarker validation criteria.

Long-Term Whole Grain Wheat and Rye Intake Reflected by Adipose Tissue Alkylresorcinols and Breast Cancer: A Case-Cohort Study

Whole grain rye (WGR) and whole grain wheat (WGW) have been suggested to protect against the development of breast cancer. In this study, we estimated long-term intake of WGR and WGW, using both a food frequency questionnaire (FFQ) and alkylresorcinol concentrations in adipose tissue biopsies, in relation to the risk of developing invasive breast cancer in a case-cohort study (n = 414 in the case group, n = 933 in the subcohort group) on the Danish “Diet, Cancer and Health” cohort. The median follow-up time of the subcohort was 5.3 years. Total WGR and WGW intake estimated with FFQ or reflected by total alkylresorcinol concentration in adipose tissue was not significantly associated with risk of breast cancer. However, after adjustment for total WGR and WGW intake, women in the highest quartile of relative WGR intake, reflected by the alkylresorcinol C17:0/C21:0 ratio, had a higher risk of overall breast cancer and estrogen-receptor-positive (ER+) breast cancer than women in the lowest quartile of relative WGR intake, while the risk of estrogen-receptor-negative (ER-) breast cancer incidence was unaffected. Similar results were obtained with the FFQ data. Based on these data, further investigation of the role of specific grain types in reducing or increasing breast cancer risk, and their overall impact on health, is warranted.

Metabolomics and Microbiomes as Potential Tools to Evaluate the Effects of the Mediterranean Diet

The approach to studying diet–health relationships has progressively shifted from individual dietary components to overall dietary patterns that affect the interaction and balance of low-molecular-weight metabolites (metabolome) and host-enteric microbial ecology (microbiome). Even though the Mediterranean diet (MedDiet) has been recognized as a powerful strategy to improve health, the accurate assessment of exposure to the MedDiet has been a major challenge in epidemiological and clinical studies. Interestingly, while the effects of individual dietary components on the metabolome have been described, studies investigating metabolomic profiles in response to overall dietary patterns (including the MedDiet), although limited, have been gaining attention. Similarly, the beneficial effects of the MedDiet on cardiometabolic outcomes may be mediated through gut microbial changes. Accumulating evidence linking food ingestion and enteric microbiome alterations merits the evaluation of the microbiome-mediated effects of the MedDiet on metabolic pathways implicated in disease. In this narrative review, we aimed to summarize the current evidence from observational and clinical trials involving the MedDiet by (1) assessing changes in the metabolome and microbiome for the measurement of diet pattern adherence and (2) assessing health outcomes related to the MedDiet through alterations to human metabolomics and/or the microbiome.

Comparison of plasma alkylresorcinols (AR) and urinary AR metabolites as biomarkers of compliance in a short-term, whole-grain intervention study

PURPOSE

Alkylresorcinols (AR) are phenolic lipids present in the bran of wheat and rye. Plasma AR and their urinary metabolites may be suitable biomarkers of whole-grain (WG) wheat and rye consumption. The objective of this study was to examine plasma AR and urinary AR metabolites in response to WG wheat consumption.

METHODS

In a randomized crossover study, 19 subjects (10 males, 9 females; BMI 22.0 kg/m(2); age 26 years) incorporated either 3 servings (48 g) or 6 servings (96 g) of WG wheat daily into their regular diet for 1 week. Subjects completed a 2-week washout period, abstaining from all WG consumption, before each intervention. Fasting blood and 24-h urine were collected before and after each intervention. Plasma AR homologues (C19:0, C21:0, C23:0) were quantified by GC-MS after diethyl ether and solid phase extraction and derivatization. Urinary AR metabolites [3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-propanoic acid] were determined using HPLC with electrochemical detection after enzymatic deconjugation and ethyl acetate extraction.

RESULTS

Urinary total AR metabolites were significantly higher after 6 compared with 3 servings of WG wheat (56 vs. 32 μmol/day, P < 0.001). This dose-response relationship was independent of age, sex, energy intake, and baseline urinary AR metabolite concentration. Plasma total AR tended to be higher after 6 compared with 3 servings of WG wheat (103.0 vs. 86.9 nmol/L), but this difference was not significant (P = 0.42).

CONCLUSION

The results suggest that urinary AR metabolites from 24-h urine collections may be useful as biomarkers of compliance in intervention studies of WG wheat.

Identification and pharmacokinetics of novel alkylresorcinol metabolites in human urine, new candidate biomarkers for whole-grain wheat and rye intake

Biomarkers of dietary intake are prominent tools in nutritional research. The alkylresorcinol metabolites 3,5-dihydroxybenzoic acid (3,5-DHBA) and 3-(3,5-dihydroxyphenyl)propanoic acid (3,5-DHPPA) have been proposed as exposure biomarkers of whole-grain (WG) wheat and rye intake. However, the profile of alkylresorcinol metabolites is not fully understood. The aim of this study was to investigate the metabolism of alkylresorcinols in mice and in humans, while further determining urinary pharmacokinetics of the novel alkylresorcinol metabolites to explore their potential as biomarkers of WG wheat intake. Utilization of the liquid chromatography-mass spectrometry approach resulted in 10 alkylresorcinol metabolites identified in mice and in humans, including 3 phenolic acids and 7 of their phase II conjugates. Among them, 2 novel metabolites were discovered: 5-(3,5-dihydroxyphenyl)pentanoic acid (3,5-DHPPTA) and 2-(3,5-dihydroxybenzamido)acetic acid (3,5-DHBA glycine). The structures of these 2 metabolites were confirmed by comparing with authentic standards synthesized in-house. In the pharmacokinetic study, a group of 12 volunteers consumed a polyphenolic-restricted diet for 4 d before ingesting WG wheat bread containing 61 mg of alkylresorcinols. Urine samples were collected for 32 h, and alkylresorcinol metabolites were quantified with HPLC-coulometric electrode array detection. The mean urinary excretion rates and mean apparent half-life of 3,5-DHPPTA, 3,5-DHBA glycine, 3,5-DHBA, and 3,5-DHPPA at each time point were determined. Our results suggest that 3,5-DHPPTA and 3,5-DHBA glycine may be used in combination with 3,5-DHBA and 3,5-DHPPA as potential biomarkers to increase the accuracy of recording WG wheat and rye intake in epidemiologic studies. Further validation of 3,5-DHPPTA and 3,5-DHBA glycine as potential biomarkers is warranted.

Hydroxylated phenylacetamides derived from bioactive benzoxazinoids are bioavailable in humans after habitual consumption of whole grain sourdough rye bread

SCOPE

Understanding relationships between dietary whole grain and health is hindered by incomplete knowledge of potentially bioactive metabolites derived from these foods. We aimed to discover compounds in urine correlated with changes in amounts of whole grain rye consumption.

METHODS AND RESULTS

After a wash-out period, volunteers consumed 48-g whole grain rye foods per day for 4 wk and then doubled their intake for a further 4 wk. Samples of 24-h urines were analyzed by flow infusion electrospray MS followed by supervised multivariate data analysis. Urine samples from participants who reported high intakes of rye flakes, rye pasta, or total whole grain rye products could not be discriminated adequately from their wash-out samples. However, discrimination was seen in urine samples from participants who reported high whole grain sourdough rye bread consumption. Accurate mass analysis of explanatory signals followed by fragmentation identified conjugates of the benzoxazinoid lactam 2-hydroxy-1,4-benzoxazin-3-one and hydroxylated phenyl acetamide derivatives. Statistical validation showed sensitivities of 84-96% and specificities of 70-81% (p values < 0·05) for elevated concentrations of these signals after preferential whole grain sourdough rye bread consumption.

CONCLUSION

Several potentially bioactive alkaloids have been identified in humans consuming fermented whole grain sourdough rye bread.

Hepatic biotransformation of alkylresorcinols is mediated via cytochrome P450 and β-oxidation: a proof of concept study

Alkylresorcinols (AR) are phenolic lipids present in the bran of some cereals. AR may serve as a biomarker for whole grain wheat and rye intake. While AR pharmacokinetics and two major metabolites have been reported, the metabolic pathways contributing to their relatively rapid elimination from the circulation remain to be speculative. In this study, we investigated if ω- and β-oxidation mediate catabolism of the AR homologue C19:0 to form 3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), using 3 in vitro platforms, human cytochrome P450 4F2 (CYP4F2), human liver S9, and HepG2 cells. One hydroxylated C19:0 metabolite was formed by CYP4F2 and one hydroxylated and one carboxylated C19:0 were tentatively identified after incubation of AR with S9. The formation of DHPPA was quantifiable when HepG2 cells were treated with C19:0 for 48 h. Our results are consistent with a metabolic pathway by which AR are degraded to phenolic acids via CYP4F2-mediated ω-oxidation and subsequent β-oxidation.

Long-term reproducibility of plasma alkylresorcinols as biomarkers of whole-grain wheat and rye intake within Northern Sweden Health and Disease Study Cohort

BACKGROUND/OBJECTIVES

Alkylresorcinols (AR) have been suggested as specific biomarkers of whole-grain (WG) and bran intake from wheat and rye. Before using plasma AR as biomarkers in prospective cohort studies, the long-term reproducibility needs to be determined in order to judge how well a single plasma sample reflects the long-term concentration. The objective was therefore to estimate the reproducibility of plasma AR concentrations over 0.1-3.9 years.

SUBJECTS/METHODS

The concentrations of AR homologues were analysed in plasma samples, drawn>8 h since last meal, 0.1-3.9 years apart (mean ≈ 2 years) in 74 participants in the Swedish prospective Västerbotten Intervention Project cohort. Reproducibility was estimated by calculating the intra class correlation coefficient (ICC).

RESULTS

Fasting plasma AR concentrations were similar between the first and second measurements. The ICC for total AR was 0.54 (95% confidence interval (CI)=0.38-0.69] overall, 0.34 (95% CI=0.13-0.64) for men and 0.73 (95% CI=0.56-0.85) for women, respectively. Somewhat higher ICCs were obtained for shorter AR homologues.

CONCLUSION

In summary, the reproducibility of plasma AR over 0.1-3.9 years was high for women and moderate for men within this population. Together with previous data showing high validity of plasma AR as biomarkers of wheat and rye in different populations, the current finding suggest that this biomarker is stable over a long-time period and is therefore probably useful for assessment of long-term WG intake in populations with a wide intake range and a frequent intake.

Plasma alkylresorcinols, biomarkers of whole-grain intake, are related to lower BMI in older adults

Alkylresorcinols (AR) are phenolic lipids found in the bran fraction of whole-grain wheat, rye, and barley. In intervention studies, plasma AR concentration increased in response to greater intakes of whole grain, wheat, and rye. This study examined the cross-sectional associations between plasma AR and habitual whole-grain intake, BMI, and metabolic risk factors in 407 free-living older adults (166 men and 241 women; aged 60-81y; median BMI: 27 kg/m(2)). Plasma AR were measured by liquid chromatography-tandem MS, and whole-grain intakes were estimated by using an FFQ. After adjustment for fasting TG concentrations, median plasma AR concentrations across quartile categories of AR were 5, 14, 27, and 62 nmol/L, respectively. Spearman correlation coefficients between plasma AR and whole-grain wheat-rich foods and total bran intake were 0.31 and 0.27, respectively (both P < 0.0001). After adjustment for multiple covariates, the geometric means of BMI in the lowest and highest quartile category of plasma AR were 27.6 and 26.7 kg/m(2), respectively (P-trend = 0.04). No associations were observed between plasma AR and glucose and insulin. Our study shows a dose-dependent relationship between whole-grain intake and plasma AR and confirms the previously observed inverse relationship between whole-grain intake and BMI using an independent biomarker of whole-grain wheat intake.

Alkylresorcinol metabolism in Swedish adults is affected by factors other than intake of whole-grain wheat and rye

The urinary alkylresorcinol (AR) metabolites, 3,5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-propanoic acid (DHPPA), could potentially serve as biomarkers for intake of whole-grain (WG) wheat and rye. Excretion of AR metabolites is largely dependent on the intake of AR but may also be influenced by other factors. This study aimed to investigate the validity of free and conjugated AR metabolites as biomarkers for WG intake of wheat and rye and to identify potential determinants of AR metabolites in urine. We quantified free aglycones and conjugates of AR metabolites in 24-h urine collections from 52 free-living Swedish adults and calculated correlation coefficients between urinary AR metabolite excretion and self-reported WG intake. We used partial least-squares regression to identify possible determinants of urinary AR metabolites. Approximately 50% of urinary AR metabolites were found as conjugates. Excretions of individually quantified free and conjugated AR metabolites and their sums were correlated to self-reported intake of WG rye and wheat (r = 0.50-0.68; P < 0.001). Excretion of urinary AR metabolites was mainly dependent on intake of 2 major dietary AR homologs, C19:0 and C21:0. Sex, BMI, and vitamin C intake were identified as determinants of the proportion of free and glucuronidated DHPPA in the present study. Urinary AR metabolites may be useful in reflecting short-term to medium-term intake of WG, but urine samples should be deconjugated prior to quantification. Anthropometric and dietary factors affecting the proportion of conjugated AR metabolites in urine may to some extent influence AR elimination and thereby the performance of urinary AR metabolites as biomarkers.

Alkylresorcinols in Latvian and Finnish breads

The alkylresorcinol (AR) content and relative homologue composition were determined in 9 Latvian and 11 Finnish soft breads. ARs were extracted with hot 1-propanol and quantified, using a gas chromatography-mass spectrometry method. The total AR content (μg/g dry matter) varied from 560 to 840 in rye breads, from 500 to 700 in Finnish mixed rye and wheat flour breads, from 200 to 300 in Latvian mixed rye and wheat flour breads and from 25 to 30 in white wheat breads. Rye and white wheat breads in the two countries varied only slightly in AR content, but there were wide variations in AR content in mixed flour breads. The AR contents in soft breads could be indicators of bran or fibre content, but not of whole-grain flour content.

Alkylresorcinol metabolite concentrations in spot urine samples correlated with whole grain and cereal fiber intake but showed low to modest reproducibility over one to three years in U.S. women

Two alkylresorcinol (AR) metabolites, 3, 5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), in urine have been suggested as biomarkers of whole grain (WG) and cereal fiber intake but the long-term reproducibility and correlation with habitual intake has not been determined. Therefore, we evaluated the long-term reproducibility of AR metabolites in spot urine samples and investigated their correlation with habitual WG and cereal fiber intake in U.S. women. AR metabolites were analyzed in 104 women participating in the Nurses' Health Study II and WG and fiber intakes were assessed using a FFQ. Long-term reproducibility was assessed by calculating the intra-class correlation coefficients (ICC) using samples taken 1-3 y (mean 1.8 y) apart. The observed Spearman correlation coefficients (r(s)) and r(s) adjusted for within-participant variation in the biomarker were calculated between WG and fiber intake and biomarkers. The long-term reproducibility was poor for DHBA [ICC = 0.17 (95% CI: 0.05, 0.43)] and modest for DHPPA [ICC = 0.31 (95% CI: 0.17, 0.51)]. The correlation between WG intake in 1995 and DHPPA measured 2 y later was 0.37 (P < 0.0001); the adjusted correlation was 0.60 (95% CI: 0.37, 0.76). Cereal fiber and WG intake were similarly correlated to the biomarkers. DHPPA in spot urine samples reflected WG intake despite relatively low intake of food sources of AR. The poor to modest reproducibility may limit the use of single measurements of these biomarkers in cohort studies in the US, where WG intake is relatively low and has changed over time. But DHPPA in repeated samples may be useful for validating WG intake and assessing compliance in WG intervention studies.

Alkylresorcinol metabolites in urine correlate with the intake of whole grains and cereal fibre in free-living Swedish adults

Alkylresorcinols (AR) have been established as short/medium-term biomarkers for whole grain (WG) wheat and rye intake; and AR metabolites, 3,5-dihydroxybenzoic acid and 3-(3,5-dihydroxyphenyl)-propanoic acid, have been suggested as complementary biomarkers to AR. The present study examined the medium-term reproducibility and relative validity of urinary AR metabolites as biomarkers for WG and cereal fibre intake. A total of sixty-six free-living Swedes completed 3 d weighed food records and provided single 24 h urine collections and morning urine spot samples on two occasions, 2-3 months apart. The medium-term reproducibility of urinary AR metabolites was moderate when assessed in 24 h collections and lower in creatinine (CR)-adjusted morning urine. Mean AR metabolite 24 h excretions correlated well with total WG (r(s) 0·31-0·52, P < 0·05) and cereal fibre (r(s) 0·46-0·58, P < 0·001) intake on both occasions. As expected, correlations with WG (r(s) 0·28-0·38, P < 0·05) and cereal fibre (r(s) 0·35-0·42, P < 0·01) were weaker for mean CR-adjusted AR metabolite concentrations in spot samples of morning urine, although the adjusted concentrations correlated well with 24 h urinary excretion (r(s) 0·69-0·73, P < 0·001). Adjustment for intra-individual variations substantially improved the correlations between intake and excretion. These findings suggest that urinary AR metabolites can successfully reflect the medium-term intake of WG and cereal fibre when adjusted for intra-individual variation in this population, where rye was the major contributor to high WG intake. The performance of urinary AR metabolites as medium-term biomarkers appears to be comparable to that of fasting plasma AR concentration in this population.

Present status and perspectives on the use of alkylresorcinols as biomarkers of wholegrain wheat and rye intake

Alkylresorcinols (ARs) were first proposed as potential biomarkers of wholegrain wheat and rye intake a decade ago. Since then there has been a considerable body of research which suggests that ARs do meet most criteria of a biomarker of these foods. Results from human studies on plasma AR and their plasma and urinary metabolites strongly indicate that these compounds are responsive to whole grain wheat and rye intake and are correlated with various measures of AR consumption. This review briefly summarises work on the bioactivities of AR and focuses on aspects related to their use as biomarkers of whole grain wheat and rye intake. Evidence suggests that they thus far broadly fulfil the criteria to act as biomarkers of these cereals. However, there are still gaps in the knowledge on factors relating to the wide interindividual variation, and application to different epidemiological cohorts. Overall, ARs are highly promising biomarkers of whole grain wheat and rye intake and add to our increasing understanding of whole grains and health.

Pharmacokinetics of alkylresorcinol metabolites in human urine

Wholegrain cereals are reported to promote beneficial health effects. Wholegrain wheat and rye are almost exclusive sources of alkylresorcinols, and intact alkylresorcinols together with their plasma and urinary metabolites, 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA) and 3,5-dihydroxybenzoic acid (DHBA), have been proposed as biomarkers of the intake of these foods in humans. The pharmacokinetics of alkylresorcinols and their metabolites in plasma have been determined but not that of the urinary metabolites. We aimed to characterise the urinary pharmacokinetics of alkylresorcinol metabolites in humans to evaluate their potential as biomarkers of wholegrain wheat and rye. A group of fifteen volunteers followed a low-alkylresorcinol diet for 2 d before ingesting a single dose of rye bread, containing 100 mg alkylresorcinols. Urine was collected between baseline (0 h) and 25 h after administration. Thereafter alkylresorcinol metabolites were quantified by HPLC with coulometric electrode array detection. Maximum excretion rates were observed at 5-6 h for both metabolites, DHPPA being predominant over DHBA and also possessing a greater area under the curve0-25 h. Total urinary recovery between 0 and 25 h yielded 43 % of ingested alkylresorcinols, and at 25 h significant amounts of metabolites were still retained in the body, suggesting that even a spot urine sample may be sufficient to indicate whether or not wholegrain wheat or rye is a daily dietary component. These results support the use of urinary DHPPA and DHBA as biomarkers of wholegrain wheat and rye and enable new potential for studying the association between wholegrain intake and diseases, even in the absence of dietary data.

Plasma and urinary alkylresorcinol metabolites as potential biomarkers of breast cancer risk in Finnish women: a pilot study

Alkylresorcinols (ARs) are shown to be good biomarkers of consumption of rye and whole-grain wheat products in man. The aim of this pilot study was to investigate AR metabolites as potential biomarkers of breast cancer (BC) risk in Finnish women since intake of cereal fiber and its components has been proposed to reduce this risk through an effect on the enterohepatic circulation of estrogens. This was a cross-sectional and observational pilot study. A total of 20 omnivores, 20 vegetarians, and 16 BC women (6-12 mo after operation) were investigated on 2 occasions 6 mo apart. Dietary intake (5-days record), plasma/urinary AR metabolites [3,5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA)] and plasma/urinary enterolactone were measured. The groups were compared using nonparametric tests. We observed that plasma DHBA (P = 0.007; P = 0.03), plasma DHPPA (P = 0.02; P = 0.01), urinary DHBA (P = 0.001; P = 0.003), urinary DHPPA (P = 0.001; P = 0.001), and cereal fiber intake (P = 0.007; P = 0.003) were significantly lower in the BC group compared to the vegetarian and omnivore groups, respectively. Based on measurements of AR metabolites in urine and in plasma, whole-grain rye and wheat cereal fiber intake is low in BC subjects. Thus, urinary and plasma AR metabolites may be used as potential biomarkers of BC risk in women. This novel approach will likely also facilitate studies of associations between rye and whole-grain wheat cereal fiber intake and other diseases. Our findings should, however, be confirmed with larger subject populations.

New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre?

Epidemiological studies have clearly shown that whole-grain cereals can protect against obesity, diabetes, CVD and cancers. The specific effects of food structure (increased satiety, reduced transit time and glycaemic response), fibre (improved faecal bulking and satiety, viscosity and SCFA production, and/or reduced glycaemic response) and Mg (better glycaemic homeostasis through increased insulin secretion), together with the antioxidant and anti-carcinogenic properties of numerous bioactive compounds, especially those in the bran and germ (minerals, trace elements, vitamins, carotenoids, polyphenols and alkylresorcinols), are today well-recognised mechanisms in this protection. Recent findings, the exhaustive listing of bioactive compounds found in whole-grain wheat, their content in whole-grain, bran and germ fractions and their estimated bioavailability, have led to new hypotheses. The involvement of polyphenols in cell signalling and gene regulation, and of sulfur compounds, lignin and phytic acid should be considered in antioxidant protection. Whole-grain wheat is also a rich source of methyl donors and lipotropes (methionine, betaine, choline, inositol and folates) that may be involved in cardiovascular and/or hepatic protection, lipid metabolism and DNA methylation. Potential protective effects of bound phenolic acids within the colon, of the B-complex vitamins on the nervous system and mental health, of oligosaccharides as prebiotics, of compounds associated with skeleton health, and of other compounds such as alpha-linolenic acid, policosanol, melatonin, phytosterols and para-aminobenzoic acid also deserve to be studied in more depth. Finally, benefits of nutrigenomics to study complex physiological effects of the 'whole-grain package', and the most promising ways for improving the nutritional quality of cereal products are discussed.

Responsiveness of urinary and plasma alkylresorcinol metabolites to rye intake in finnish women

Alkylresorcinols [ARs] have been proposed for use as biomarkers of whole-grain intake. The aim here was to examine the responsiveness of AR metabolites to rye intake. Sixty women were divided into three groups according to their rye consumption. We observed significant differences between groups in plasma 3-[3,5-dihydroxyphenyl]-1-propanoic acid [DHPPA] and in urinary DHPPA and 3,5-dihydroxybenzoic acid [DHBA]. In addition, these AR metabolites increased proportionally to rye fiber intake. We conclude that these ARs metabolites are accurate and useful biomarkers of rye fiber intake. Further studies are needed to confirm our results in larger and different populations.

Plasma pharmacokinetics of alkylresorcinol metabolites: new candidate biomarkers for whole-grain rye and wheat intake

BACKGROUND

Alkylresorcinols are phenolic compounds that are present almost exclusively in rye and wheat fiber. Alkylresorcinols are absorbed and thereafter metabolized to 3,5-dihydroxybenzoic acid (DHBA) and 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA), which have been detected in human urine and plasma.

OBJECTIVE

The objective was to determine the plasma pharmacokinetics of DHBA and DHPPA in human subjects to estimate whether they show potential as biomarkers for whole-grain rye and/or wheat intake.

DESIGN

Fifteen human volunteers followed a low-alkylresorcinol diet for 2 d before ingesting a single dose of high-fiber rye bread containing 100 mg alkylresorcinols [corrected]. Plasma samples were collected for 25 h, and the alkylresorcinol metabolites were quantified by HPLC with coulometric electrode array detection.

RESULTS

Maximum concentrations were reached at approximately 6 h for both metabolites, although interindividual variation was found. The half-life was significantly (P < 0.0002) longer for DHPPA (16.3 h) than for DHBA (10.1 h). No significant differences were discovered between women and men in the half-life of each metabolite, which, from a pharmacokinetic point of view, is the most important parameter. The area under the curve differed significantly between DHBA and DHPPA (P < 0.0001) and between women and men (P = 0.03 for DHBA and P = 0.01 for DHPPA). However, when corrected for body weight, the difference between sexes was no longer significant.

CONCLUSIONS

Our results suggest that DHBA and DHPPA are both good candidate biomarkers for whole-grain rye and/or wheat intake; however, DHPPA is the better indicator because of its longer half-life. This could provide a practical tool when investigating the association between diet and diseases.

Plasma alkylresorcinol metabolites as potential biomarkers of whole-grain wheat and rye cereal fibre intakes in women

It has been demonstrated that intact plasma alkylresorcinols (AR) and urinary AR metabolites could be used as biomarkers of whole-grain intake. Thereafter, we developed the method for the plasma AR metabolites, which is more convenient and requires less sample pretreatment than the analysis of intact plasma AR. The aim of the present study is to evaluate whether AR metabolites measured in plasma, in the same population, could also be considered as useful biomarkers of cereal fibre. Fifty-six women were recruited in a cross-sectional and observational study. Dietary intake (5-d record) and plasma AR metabolites (3,5-dihydroxybenzoic acid, DHBA; 3-(3,5-dihydroxyphenyl)-1-propanoic acid, DHPPA) were measured. The relationship between plasma AR metabolites and cereal fibre intake was examined using partial correlation and stepwise regression. Cereal fibre intake correlated significantly with plasma DHBA (r 0·411; P = 0·002) and DHPPA (r 0·463; P = 0·000) even after adjustment for BMI and age. Thus, plasma AR metabolites correlate with cereal fibre intake as noted with plasma intact AR and urinary AR metabolites. We observed that plasma DHPPA was the independent predictor of cereal fibre intake, explaining 18 % of the variance (adjusted r2 0·176; P = 0·002). In epidemiological screening, it might be easier to obtain and to collect plasma than urine samples. In addition, the plasma AR metabolites half-life seems longer than those of intact plasma AR, and their measurements are more convenient, and faster. Thus, sum of plasma AR metabolites and more specifically plasma DHPPA seems to be good and specific biomarkers of cereal fibre intake.