You Are What You Eat: Application of Metabolomics Approaches to Advance Nutrition Research

Metabolomics-based analysis of the diatom Cheatoceros tenuissimus combining NMR and GC-MS techniques

Metabolomics, a recent addition to omics sciences, studies small molecules across plants, animals, humans, and marine organisms. Nuclear magnetic resonance (NMR) and gas chromatography-mass spectrometry (GC-MS) are widely used in those studies, including microalgae metabolomics. NMR is non-destructive and highly reproducible but has limited sensitivity, which could be supplemented by joining GC-MS analysis. Extracting metabolites from macromolecules requires optimization for trustworthy results. Different extraction methods yield distinct profiles, emphasizing the need for optimization. The results indicated that the optimized extraction procedure successfully identified NMR and GC-MS-based metabolites in MeOH, CHCl3, and H2O extraction solvents. The findings represented the spectral information related to carbohydrates, organic molecules, and amino acids from the water-soluble metabolites fraction and a series of fatty acid chains, lipids, and sterols from the lipid fraction. Our study underscores the benefit of combining NMR and GC-MS techniques to comprehensively understand microalgae metabolomes, including high and low metabolite concentrations and abundances.•In this study, we focused on optimizing the extraction procedure and combining NMR and GC-MS techniques to overcome the low NMR sensitivity and the different detected range limits of NMR and GC-MS.•We explored metabolome diversity in a tropical strain of the small cells' diatom Cheatoceros tenuissimus.

Metabolome-wide Mendelian randomization for age at menarche and age at natural menopause

BACKGROUND

The role of metabolism in the variation of age at menarche (AAM) and age at natural menopause (ANM) in the female population is not entirely known. We aimed to investigate the causal role of circulating metabolites in AAM and ANM using Mendelian randomization (MR).

METHODS

We combined MR with genetic colocalization to investigate potential causal associations between 658 metabolites and AAM and between 684 metabolites and ANM. We extracted genetic instruments for our exposures from four genome-wide association studies (GWAS) on circulating metabolites and queried the effects of these variants on the outcomes in two large GWAS from the ReproGen consortium. Additionally, we assessed the mediating role of the body mass index (BMI) in these associations, identified metabolic pathways implicated in AAM and ANM, and sought validation for selected metabolites in the Avon Longitudinal Study of Parents and Children (ALSPAC).

RESULTS

Our analysis identified 10 candidate metabolites for AAM, but none of them colocalized with AAM. For ANM, 76 metabolites were prioritized (FDR-adjusted MR P-value ≤ 0.05), with 17 colocalizing, primarily in the glycerophosphocholines class, including the omega-3 fatty acid and phosphatidylcholine (PC) categories. Pathway analyses and validation in ALSPAC mothers also highlighted the role of omega and polyunsaturated fatty acids levels in delaying age at menopause.

CONCLUSIONS

Our study suggests that metabolites from the glycerophosphocholine and fatty acid families play a causal role in the timing of both menarche and menopause. This underscores the significance of specific metabolic pathways in the biology of female reproductive longevity.

Phytochemical reduces toxicity of PM2.5: a review of research progress

Studies have shown that exposure to fine particulate matter (PM2.5) affects various cells, systems, and organs in vivo and in vitro. PM2.5 adversely affects human health through mechanisms such as oxidative stress, inflammatory response, autophagy, ferroptosis, and endoplasmic reticulum stress. Phytochemicals are of interest for their broad range of physiological activities and few side effects, and, in recent years, they have been widely used to mitigate the adverse effects caused by PM2.5 exposure. In this review, the roles of various phytochemicals are summarized, including those of polyphenols, carotenoids, organic sulfur compounds, and saponin compounds, in mitigating PM2.5-induced adverse reactions through different molecular mechanisms, including anti-inflammatory and antioxidant mechanisms, inhibition of endoplasmic reticulum stress and ferroptosis, and regulation of autophagy. These are useful as a scientific basis for the prevention and treatment of disease caused by PM2.5.

Life-history stage determines the diet of ectoparasitic mites on their honey bee hosts

Ectoparasitic mites of the genera Varroa and Tropilaelaps have evolved to exclusively exploit honey bees as food sources during alternating dispersal and reproductive life history stages. Here we show that the primary food source utilized by Varroa destructor depends on the host life history stage. While feeding on adult bees, dispersing V. destructor feed on the abdominal membranes to access to the fat body as reported previously. However, when V. destructor feed on honey bee pupae during their reproductive stage, they primarily consume hemolymph, indicated by wound analysis, preferential transfer of biostains, and a proteomic comparison between parasite and host tissues. Biostaining and proteomic results were paralleled by corresponding findings in Tropilaelaps mercedesae, a mite that only feeds on brood and has a strongly reduced dispersal stage. Metabolomic profiling of V. destructor corroborates differences between the diet of the dispersing adults and reproductive foundresses. The proteome and metabolome differences between reproductive and dispersing V. destructor suggest that the hemolymph diet coincides with amino acid metabolism and protein synthesis in the foundresses while the metabolism of non-reproductive adults is tuned to lipid metabolism. Thus, we demonstrate within-host dietary specialization of ectoparasitic mites that coincides with life history of hosts and parasites.

Metabolomics Changes in Meat and Subcutaneous Fat of Male Cattle Submitted to Fetal Programming

This study investigated changes in meat and subcutaneous fat metabolomes and possible metabolic pathways related to prenatal nutrition in beef cattle. For this purpose, 18 Nellore bulls were used for meat sampling and 15 for fat sampling. The nutritional treatments during the gestation were: NP-not programmed or control, without protein-energy supplementation; PP-partially programmed, with protein-energy supplementation (0.3% of body weight (BW)) only in the final third of pregnancy; and FP-full programming, with protein-energy supplementation (0.3% of BW) during the entire pregnancy. The meat and fat samples were collected individually 24 h after slaughter, and the metabolites were extracted using a combination of chemical reagents and mechanical processes and subsequently quantified using liquid chromatography or flow injection coupled to mass spectrometry. The data obtained were submitted to principal component analysis (PCA), analysis of variance (ANOVA), and functional enrichment analysis, with a significance level of 5%. The PCA showed an overlap between the treatments for both meat and fat. In meat, 25 metabolites were statistically different between treatments (p ≤ 0.05), belonging to four classes (glycerophospholipids, amino acids, sphingolipids, and biogenic amine). In fat, 10 significant metabolites (p ≤ 0.05) were obtained in two classes (phosphatidylcholine and lysophosphatidylcholine). The functional enrichment analysis showed alterations in the aminoacyl-tRNA pathway in meat (p = 0.030); however, there was no pathway enriched for fat. Fetal programming influenced the meat and fat metabolomes and the aminoacyl-tRNA metabolic pathway, which is an important candidate for the biological process linked to meat quality and related to fetal programming in beef cattle.

Improving quality of analysis by suppression of unwanted signals through band-selective excitation in NMR spectroscopy for metabolomics studies

INTRODUCTION

Nuclear Magnetic Resonance (NMR) spectroscopy stands as a preeminent analytical tool in the field of metabolomics. Nevertheless, when it comes to identifying metabolites present in scant amounts within various types of complex mixtures such as plants, honey, milk, and biological fluids and tissues, NMR-based metabolomics presents a formidable challenge. This predicament arises primarily from the fact that the signals emanating from metabolites existing in low concentrations tend to be overshadowed by the signals of highly concentrated metabolites within NMR spectra.

OBJECTIVES

The aim of this study is to tackle the issue of intense sugar signals overshadowing the desired metabolite signals, an optimal pulse sequence with band-selective excitation has been proposed for the suppression of sugar's moiety signals (SSMS). This sequence serves the crucial purpose of suppressing unwanted signals, with a particular emphasis on mitigating the interference caused by sugar moieties' signals.

METHODS

We have implemented this comprehensive approach to various NMR techniques, including 1D 1H presaturation (presat), 2D J-resolved (RES), 2D 1H-1H Total Correlation Spectroscopy (TOCSY), and 2D 1H-13C Heteronuclear Single Quantum Coherence (HSQC) for the samples of dates-flesh, honey, a standard stock solution of glucose, and nine amino acids, and commercial fetal bovine serum (FBS).

RESULTS

The outcomes of this approach were significant. The suppression of the high-intensity sugar signals has considerably enhanced the visibility and sensitivity of the signals emanating from the desired metabolites.

CONCLUSION

This, in turn, enables the identification of a greater number of metabolites. Additionally, it streamlines the experimental process, reducing the time required for the comparative quantification of metabolites in statistical studies in the field of metabolomics.

Influences of dietary supplementation of ginger powder and frankincense oil on productive performance, blood biochemical parameters, oxidative status and tissues histomorphology of laying Japanese quail

The objective of the current study was to ascertain the effect of using ginger powder or frankincense oil at different levels on the production rate, biochemical properties of blood, and immune response of laying Japanese quail housed from 12 to 21 wk of age. Three hundred sexually mature quail (200 females and 100 males) were distributed among 5 groups at 12 wk of age in a completely randomized design. Group 1: received basal diet not including additives and acted as a control group. Groups 2 and 3: received a basal diet with 250 and 500 mg ginger/kg feed, respectively. Groups 4 and 5: received a basal diet with 200 and 400 mg frankincense oil/kg feed, respectively. Results revealed that egg production parameters of laying Japanese quail were not influenced by ginger or frankincense oil added in all groups tested during experimental periods except at the time (15-18 wks.). Moreover, egg weight was significantly increased only during the period (15-18 wks.) and total period (12-21 wk of age), and group 5 recorded the highest weight during the 2 periods studied. Feed additives did not impact feed consumption or feed conversion ratio (FCR). Except for WBCs, Hb, and monocytes, treatments impacted blood hematological parameters. Also, blood serum parameters were influenced by feed additives, except total protein, albumin, globulin, and creatinine were not influenced. Moreover, histological examination of the spleen was influenced by feed additives. It is concluded that utilizing frankincense oil or ginger powder in diets of laying Japanese quails enhanced blood serum properties and improved reproductive and productive performance.

Untargeted metabolomics analysis of four date palm (Phoenix dactylifera L.) cultivars using MS and NMR

Since ancient times, the inhabitants of dry areas have depended on the date palm (Phoenix dactylifera L.) as a staple food and means of economic security. For example, dates have been a staple diet for the inhabitants of the Arabian Peninsula and Sahara Desert in North Africa for millennia and the local culture is rich in knowledge and experience with the benefits of dates, suggesting that dates contain many substances essential for the human body. Madinah dates are considered one of the most important types of dates in the Arabian Peninsula, with Ajwa being one of the most famous types and grown only in Madinah, Saudi Arabia. Date seeds are traditionally used for animal feed, seed oil production, cosmetics, and as a coffee substitute. Phytochemical compounds that have been detected in date fruits and date seeds include phenolic acids, carotenoids, and flavonoids. Phenolic acids are the most prevalent bioactive constituents that contribute to the antioxidant activity of date fruits. The bioactive properties of these phytochemicals are believed to promote human health by reducing the risk of diseases such as chronic inflammation. Ajwa dates especially are thought to have superior bioactivity properties. To investigate these claims, in this study, we compare the metabolic profiles of Ajwa with different types of dates collected from Saudi Arabia and Tunisia. We show by UHPLC-MS that date seeds contain several classes of flavonoids, phenolic acids, and amino acid derivatives, including citric acid, malic acid, lactic acid, and hydroxyadipic acid. Additionally, GC-MS profiling showed that date seeds are richer in metabolite classes, such as hydrocinnamic acids (caffeic, ferulic and sinapic acids), than flesh samples. Deglet N fruit extract (minimum inhibitory concentration: 27 MIC/μM) and Sukkari fruit extract (IC50: 479 ± 0.58μg /mL) have higher levels of antibacterial and antioxidative activity than Ajwa fruits. However, the seed analysis showed that seed extracts have better bioactivity effects than fruit extracts. Specifically, Ajwa extract showed the best MIC and strongest ABTS radical-scavenging activity among examined seed extracts (minimum inhibitory concentration: 20 μM; IC50: 54 ± 3.61μg /mL). Our assays are a starting point for more advanced in vitro antibacterial models and investigation into the specific molecules that are responsible for the antioxidative and anti-bacterial activities of dates.

Metabolomics: A suitable foodomics approach to the geographical origin traceability of Ethiopian Arabica specialty coffees

Coffee arabica, originated in Ethiopia, is considered a quality bean for its high sensory qualities, and has a special price in the world coffee market. The country is a pool of genetic diversity for Arabica coffee, and coffee from different regions has a distinct flavor profile. Their exceptional quality is attributed to their genetic diversity, favorable environmental conditions, and agroforestry-based production system. However, the country still needs to benefit from its single-origin product due to a lack of appropriate traceability information to register for its geographical indication. Certification of certain plants or plant-derived products emerged to inform consumers about their exceptional qualities due to their geographical origin and protect the product from fraud. The recently emerging foodomics approaches, namely proteomics, genomics, and metabolomics, are reported as suitable means of regional agri-food product authentication and traceability. Particularly, the metabolomics approach provides truthful information on product traceability. Despite efforts by some researchers to trace the geographical origin of Ethiopian Arabica coffees through stable isotope and phenolic compound profiling and elemental analysis, foodomics approaches are not used to trace the geographical origin of Arabica specialty coffees from various parts of the country. A metabolomics-based traceability system that demonstrates the connection between the exceptional attributes of Ethiopian Arabica specialty coffees and their geographic origin is recommended to maximize the benefit of single-origin coffees.

Research Progress of Natural Matrine Compounds and Synthetic Matrine Derivatives

Matrine is a quinoline alkaloid extracted and separated from the dried root, fruit, and other parts of the plant Sophora flavescens using an organic solvent. Matrine exhibits a variety of biological activities and is widely used in pharmacy, agronomy, and other fields. Due to its low bioavailability, poor chemical stability, and toxicity to the central nervous system, a large number of researchers have searched for matrine derivatives with higher biological activity and safety by modifying its structure. In this review article, the research progress of matrine derivatives obtained using two methods (extraction from Sophora flavescens and structural modifications) from 2018 to 2022 in terms of pharmacological activity, mechanism of action, and structure-activity relationship are presented. The modification of matrine over the past five years has been mainly on the D-ring. Many new matrine alkaloids have been extracted from natural products, some of which have good pharmacological activity, which broadens the strategy for matrine structural modification in the future.

Dietary Flavonoid Intake and Carotid Calcification in Patients with Ischemic Stroke

INTRODUCTION

Owing to the antioxidant and anti-inflammatory effects, flavonoids can influence the initiation and development of atherosclerosis, but the underlying mechanisms remain largely undetermined. This study aimed to evaluate the associations between dietary flavonoids and carotid calcification in patients with ischemic stroke.

METHODS

This study screened consecutive patients with ischemic stroke via Nanjing Stroke Registry Program from February 2016 to April 2021. A semiquantitative food frequency questionnaire was used to evaluate dietary consumption of flavonoids and other nutritional components. Presence and degree of carotid calcification were determined according to Agatston scores on computer tomography angiography. Logistic regression was performed to evaluate the association between dietary flavonoids (total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, and isoflavones) and carotid calcification.

RESULTS

Of the 601 enrolled patients, 368 (61.2%) were detected with carotid calcification. Patients with high intake of total flavonoids (the fifth quintile) had a 52% lower carotid calcification risk than those with low intake (the first quintile; odds ratio [OR] = 0.48; 95% confidence interval [CI], 0.26-0.90; p = 0.007 for trends) after adjusting for major confounders. Patients with high intake of flavan-3-ols (the fifth quintile) had a 51% lower carotid calcification risk than those with low intake (the first quintile; OR = 0.49; 95% CI, 0.25-0.97; p = 0.016 for trends).

CONCLUSION

Dietary flavonoid intake is associated with carotid calcification, and, therefore, may influence the risk of stroke occurrence and recurrence.

Metabolomics signatures of plant protein intake: effects of amino acids and compounds associated with plant protein on cardiometabolic health

PURPOSE OF REVIEW

An increase in the plant-based characteristics of the diet is now recommended for human and planetary health. There is growing evidence that plant protein (PP) intake has beneficial effects on cardiometabolic risk. However, proteins are not consumed isolated and the protein package (lipid species, fiber, vitamins, phytochemicals, etc) may contribute, besides the protein effects per se, to explain the beneficial effects associated with PP-rich diets.

RECENT FINDINGS

Recent studies have shown the potential of nutrimetabolomics to apprehend the complexity of both the human metabolism and the dietary habits, by providing signatures associated to the consumption of PP-rich diets. Those signatures comprised an important proportion of metabolites that were representative of the protein package, including specific amino acids (branched-chain amino acids and their derivates, glycine, lysine), but also lipid species (lysophosphatidylcholine, phosphatidylcholine, plasmalogens) and polyphenol metabolites (catechin sulfate, conjugated valerolactones and phenolic acids).

SUMMARY

Further studies are needed to go deeper in the identification of all metabolites making part of the specific metabolomic signatures, associated to the large range of protein package constituents and their effects on the endogenous metabolism, rather than to the protein fraction itself. The objective is to determine the bioactive metabolites, as well as the modulated metabolic pathways and the mechanisms responsible for the observed effects on cardiometabolic health.

Acute enteric-coated sodium bicarbonate has negligible effect on anaerobic performance but affects metabolomics and attenuates the gastrointestinal response

Sodium bicarbonate ingestion before exercise has a performance-enhancing effect on high-intensity exercise. However, gastrointestinal symptoms can be a problematic side-effect. Enteric-coated sodium bicarbonate can attenuate gastrointestinal symptoms following acute bicarbonate loading. In addition, the subsequent effects on exercise performance and metabolomics have not been investigated. The purpose of this study was to investigate the acute effect of enteric-coated sodium bicarbonate supplementation on the anaerobic performance, physiological profile, and symptoms of gastrointestinal discomfort after severe-intensity intermittent exercise. At the same time, targeted metabolomics was used to study the changes in urine metabolism after ingestion of enteric-coated sodium bicarbonate and to explore the characteristics of biological metabolism. In a randomized crossover design, twelve male college students completed four Wingate anaerobic 30-s cycling tests (WACT) after consuming a placebo (PL) and two experimental conditions: 0.2 g/kg body mass in enteric-coated sodium bicarbonate pills (ES) or general sodium bicarbonate pills (GS). Blood lactate (BLA), heart rate (HR), ratings of perceived exertion (RPE), and gastrointestinal–symptoms assessment questionnaire (GSAQ) were measured pre-exercise and post-exercise. In contrast, mean power (MP) and peak power (PP) were recorded immediately post-exercise. Urine samples were collected before formal tests and 50 min after the third WACT. Our findings indicate the following: 1) mean power and peak power showed no significant difference among conditions (MP: F_{2.0, 33} = 0.541, p = 0.587, η² = 0.032; PP: F_{2.0, 33} = 0.526, p = 0.596, η² = 0.031). The PP decline of the ES and GS after the third WACT was lower than that of the PL; 2) There were no significant differences in physiological responses, such as BLA (F_{2.0, 33.0}= 0.191, p = 0.827, η² = 0.011) and heart rate (F_{2, 33} = 0.418, p = 0.662, η² = 0.025), between the three conditions. Although blood lactate concentration after 10 min of the third WACT was lower with ES and GS than with placebo; 3) Fewer participants experienced gastrointestinal symptoms with enteric-coated than with general sodium bicarbonate; 4) The metabolites with differences among the three conditions 50 min after exercise were 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, cis-aconitate, oxaloacetate, and citrate. ES had higher levels of 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, and cis-aconitate than GS. The 3-phospho-d-glycerate, d-Glucose 6-phosphate, pyruvate, and cis-aconitate levels in GS were significantly lower than in PL. In contrast, the citrate level in GS was significantly higher than that in other experimental conditions. Compared to PL, the level of oxaloacetate was higher after exercise in ES. This data suggests that supplementation of enteric-coated and general sodium bicarbonate before exercise can alter energy metabolism following anaerobic exercise, involving the metabolism of 3-phospho-d-glycerate, D-Glucose 6-phosphate, pyruvate, cis-aconitate, oxaloacetate, citrate, and lactate. However, they do not affect anaerobic performance and blood lactate. The supplementation of acute enteric-coated sodium bicarbonate and general sodium bicarbonate can enhance some of the weak effects of blood lactate clearance during anaerobic exercise, which may be beneficial for glycolytic energy supply. In addition, enteric-coated sodium bicarbonate intake mitigates gastrointestinal symptoms compared to general sodium bicarbonate.

Metabolomics-Driven Mining of Metabolite Resources: Applications and Prospects for Improving Vegetable Crops

Vegetable crops possess a prominent nutri-metabolite pool that not only contributes to the crop performance in the fields, but also offers nutritional security for humans. In the pursuit of identifying, quantifying and functionally characterizing the cellular metabolome pool, biomolecule separation technologies, data acquisition platforms, chemical libraries, bioinformatics tools, databases and visualization techniques have come to play significant role. High-throughput metabolomics unravels structurally diverse nutrition-rich metabolites and their entangled interactions in vegetable plants. It has helped to link identified phytometabolites with unique phenotypic traits, nutri-functional characters, defense mechanisms and crop productivity. In this study, we explore mining diverse metabolites, localizing cellular metabolic pathways, classifying functional biomolecules and establishing linkages between metabolic fluxes and genomic regulations, using comprehensive metabolomics deciphers of the plant’s performance in the environment. We discuss exemplary reports covering the implications of metabolomics, addressing metabolic changes in vegetable plants during crop domestication, stage-dependent growth, fruit development, nutri-metabolic capabilities, climatic impacts, plant-microbe-pest interactions and anthropogenic activities. Efforts leading to identify biomarker metabolites, candidate proteins and the genes responsible for plant health, defense mechanisms and nutri-rich crop produce are documented. With the insights on metabolite-QTL (mQTL) driven genetic architecture, molecular breeding in vegetable crops can be revolutionized for developing better nutritional capabilities, improved tolerance against diseases/pests and enhanced climate resilience in plants.

The NMR added value to the green foodomics perspective: Advances by machine learning to the holistic view on food and nutrition

Food is a complex matter, literally. From production to functionalization, from nutritional quality engineering to predicting effects on health, the interest in finding an efficient physicochemical characterization of food has boomed in recent years. The sheer complexity of characterizing food and its interaction with the human organism has however made the use of data driven approaches in modeling a necessity. High-throughput techniques, such as nuclear magnetic resonance (NMR) spectroscopy, are well suited for omics data production and, coupled with machine learning, are paving a promising way of modeling food-human interaction. The foodomics approach sets the framework for omic data integration in food studies, in which NMR experiments play a key role. NMR data can be used to assess nutritional qualities of food, helping the design of functional and sustainable sources of nutrients; detect biomarkers of intake and study how they impact the metabolism of different individuals; study the kinetics of compounds in foods or their by-products to detect pathological conditions; and improve the efficiency of in silico models of the metabolic network.

Untargeted Metabolomic Profiling and Antioxidant Capacities of Different Solvent Crude Extracts of Ephedra foeminea

Ephedra foeminea is a traditional medicinal plant used in the Eastern Mediterranean region. This study aims to investigate the chemical profiles of different solvent extracts of E. foeminea via an untargeted metabolomics approach, alongside determining their antioxidant capacities. E. foeminea samples collected from Jordan were macerated in solvents of varying polarities; dichloromethane/methanol, methanol, ethanol, ethyl acetate, and acetone. The crude extracts were subjected to comprehensive chemical profiling and metabolomics study using Gas chromatography–Mass spectrometry (GC–MS), Liquid chromatography–Mass spectrometry (LC–MS), and Nuclear Magnetic Resonance (NMR). The obtained data were analyzed using Venn diagrams, Principle Component Analysis (PCA), and Metabolite Enrichment Set Analysis (MESA). ABTS assay was performed to measure the crude extracts’ antioxidant activity. MESA revealed the dominant chemical groups as amino acids, fatty acids, carboxylic acids, and carbohydrates. Results indicated that dichloromethane/methanol and methanolic extracts had the most distinct composition as well as the most unique compounds. The methanolic extract had the most potency (IC50 249.6 µg/mL) in the ABTS assay. However, no significant differences were found. In conclusion, solvents influenced the recovery of metabolites in E. foeminea and the antioxidant activity of the E. foeminea methanolic extract could be correlated to the abundant presence of diverse bioactive compounds.

Metabolomic Fingerprinting for the Detection of Early-Stage Lung Cancer: From the Genome to the Metabolome

The five-year survival rate of lung cancer patients is very low, mainly because most newly diagnosed patients present with locally advanced or metastatic disease. Therefore, early diagnosis is key to the successful treatment and management of lung cancer. Unfortunately, early detection methods of lung cancer are not ideal. In this brief review, we described early detection methods such as chest X-rays followed by bronchoscopy, sputum analysis followed by cytological analysis, and low-dose computed tomography (LDCT). In addition, we discussed the potential of metabolomic fingerprinting, compared to that of other biomarkers, including molecular targets, as a low-cost, high-throughput blood-based test that is both feasible and affordable for early-stage lung cancer screening of at-risk populations. Accordingly, we proposed a paradigm shift to metabolomics as an alternative to molecular and proteomic-based markers in lung cancer screening, which will enable blood-based routine testing and be accessible to those patients at the highest risk for lung cancer.