dc.contributor.author	Liu, Sarah Victoria	en
dc.contributor.committeechair	Davy, Brenda M.	en
dc.contributor.committeemember	Hedrick, Valisa E.	en
dc.contributor.committeemember	Savla, Jyoti S.	en
dc.contributor.department	Human Nutrition, Foods, and Exercise	en
dc.date.accessioned	2018-11-14T07:01:03Z	en
dc.date.available	2018-11-14T07:01:03Z	en
dc.date.issued	2017-05-22	en
dc.description.abstract	An estimated 20.5% of adolescents ages 12 – 19 years were obese (≥95th percentile of BMI-for-age) in 2011 – 2014. Consumption of added sugars (AS) has been linked with adverse effects on weight and cardiovascular disease risk factors. Approximately 16% of adolescents’ calories come from AS, of which sugar-sweetened beverages (SSB) are a major contributor. However, the relationship between AS/SSB intake and obesity is controversial, partly due to limitations in self-reported dietary data. Objective dietary intake biomarkers may circumvent this problem. The δ13C biomarker for AS intake is based upon the fact that C4 plants– major source for sugar production in the United States – have elevated δ¹³C values compared to C3 plants, which includes most fruits and vegetables. The δ¹³C value of blood, which is influenced by diet, has been established as a valid, reliable, and sensitive biomarker, but when compared to selfreported AS intake. This investigation evaluated the sensitivity and reliability of the δ13C biomarker, assessed with fingerstick blood samples, in adolescents using a controlled feeding, crossover design. Fingerstick δ¹³C values significantly changed by -0.05‰ and +0.03‰ after subjects completed the 5% and 25% AS diets, respectively (F(1, 30) = 18.828, p < 0.001). High reliability was found between two consecutive fingerstick δ¹³C values on the low (ICC = 0.996) and high (ICC = 0.997) AS diets. Thus, fingerstick δ¹³C may be a sensitive and reliable indicator of AS intake in adolescents. Future investigations should develop an equation to estimate AS intake based on fingerstick δ¹³C	en
dc.description.abstractgeneral	Approximately one-fifth of adolescents 12 – 19 years old were obese in 2011 – 2014. A diet high in added sugars (AS), which are sugars that do not naturally occur in a food product, is associated with increased weight and higher risk for cardiovascular, or heart, disease. About 16% of adolescents’ calories come from AS, and a major source of AS intake is sugary beverages. Because people tend to inaccurately report what they eat and drink, researchers are interested in biomarkers to objectively estimate dietary intake. The δ<sup>13</sup>C biomarker measures carbon isotope ratios. Since most of the sugar produced in the United States comes from corn, sugarcane, and sorghum – which have a higher δ <sup>13</sup>C content compared to most fruits and vegetables – δ <sup>13</sup>C could indicate AS intake. Studies have reported that the δ <sup>13</sup>C value of whole blood, which is influenced by diet, is valid, reliable, and sensitive, but when compared to self-reported AS intake. This investigation evaluated the sensitivity and reliability of whole blood δ <sup>13</sup>C, sample using fingersticks, in adolescents consuming controlled diets so that AS intake was known. Fingerstick δ <sup>13</sup>C values significantly changed after subjects completed the low and high AS diets (<i>F</i>(1, 30) = 18.828, <i>p</i> < 0.001). High reliability was found between two consecutive fingerstick δ <sup>13</sup>C values on the low (ICC = 0.996) and high (ICC = 0.997) AS diets. Thus, fingerstick δ <sup>13</sup>C may be a sensitive, reliable indicator of AS intake in adolescents. Future studies should develop an equation to estimate AS intake based on fingerstick δ <sup>13</sup>C.	en
dc.description.degree	Master of Science	en
dc.format.medium	ETD	en
dc.identifier.other	vt_gsexam:10163	en
dc.identifier.uri	http://hdl.handle.net/10919/85835	en
dc.publisher	Virginia Tech	en
dc.rights	In Copyright	en
dc.rights.uri	http://rightsstatements.org/vocab/InC/1.0/	en
dc.subject	overweight and obesity	en
dc.subject	added sugars	en
dc.subject	dietary recall and assessment	en
dc.subject	δ¹³C biomarker	en
dc.subject	urinary sucrose/fructose biomarker	en
dc.subject	children and adolescents	en
dc.title	Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach	en
dc.type	Thesis	en
thesis.degree.discipline	Human Nutrition, Foods, and Exercise	en
thesis.degree.grantor	Virginia Polytechnic Institute and State University	en
thesis.degree.level	masters	en
thesis.degree.name	Master of Science	en

Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach

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