Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health
Nikos Stratakis, Alexandros Siskos, Eleni Papadopoulou, Anh N. Nguyen, Yinqi Zhao, Katerina Margetaki, Chung‐Ho E. Lau, Muireann Coen, Léa Maître, Sílvia Fernández‐Barrés, Lydiane Agier, Sandra Andrušaitytė, Xavier Basagaña, Anne Lise Brantsæter, Maribel Casas, Serena Fossati, Regina Gražulevičienė, Barbara Heude, Rosemary McEachan, Helle Margrete Meltzer, Christopher Millett, Fernanda Rauber, Oliver Robinson, Theano Roumeliotaki, Eva Borràs, Eduard Sabidó, José Urquiza, Marina Vafeiadi, Paolo Vineis, Trudy Voortman, John Wright, David V. Conti, Martine Vrijheid, Hector C. Keun, Leda Chatzi
Abstract
Urinary metabolic profiling is a promising powerful tool to reflect dietary intake and can help understand metabolic alterations in response to diet quality. Here, we used 1 H NMR spectroscopy in a multicountry study in European children (1147 children from 6 different cohorts) and identified a common panel of 4 urinary metabolites (hippurate, N -methylnicotinic acid, urea, and sucrose) that was predictive of Mediterranean diet adherence (KIDMED) and ultra-processed food consumption and also had higher capacity in discriminating children’s diet quality than that of established sociodemographic determinants. Further, we showed that the identified metabolite panel also reflected the associations of these diet quality indicators with C-peptide, a stable and accurate marker of insulin resistance and future risk of metabolic disease. This methodology enables objective assessment of dietary patterns in European child populations, complementary to traditional questionary methods, and can be used in future studies to evaluate diet quality. Moreover, this knowledge can provide mechanistic evidence of common biological pathways that characterize healthy and unhealthy dietary patterns, and diet-related molecular alterations that could associate to metabolic disease.