{"id":{"repo_id":"vt","oai_identifier":"oai:vtechworks.lib.vt.edu:10919/85835"},"canonical_url":"https://search.dev.ndltd.org/etd/vt/oai:vtechworks.lib.vt.edu:10919/85835","repository":{"repo_id":"vt","name":"Virginia Tech","base_url":"https://vtechworks.lib.vt.edu/oai/request"},"display":{"title":"Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach","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","abstract_html":"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 &lt; 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","abstract_has_math":false,"creators":["Liu, Sarah Victoria"],"institution":"Virginia Tech","degree_name":"Master of Science","degree_level":"masters","degree_discipline":"Human Nutrition, Foods, and Exercise","degree_department":"Human Nutrition, Foods, and Exercise","school":null,"contributors":[],"advisors":[],"committee_chairs":["Davy, Brenda M."],"committee_members":["Hedrick, Valisa E.","Savla, Jyoti S."],"year":2017,"date_issued":"2017-05-22","date_published":"2017-05-22","updated_at":"2026-07-22T22:20:21Z","subjects":["overweight and obesity","added sugars","dietary recall and assessment","δ¹³C biomarker","urinary sucrose/fructose biomarker","children and adolescents"],"languages":[],"rights":["In Copyright"],"rights_urls":["http://rightsstatements.org/vocab/InC/1.0/"],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:10163"],"render_values":[{"text":"vt_gsexam:10163","href":null,"code":true}]}]},"links":{"outbound_url":"http://hdl.handle.net/10919/85835","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.committeechair","label":"Committee Chair","values":["Davy, Brenda M."]},{"key":"dc:contributor.committeemember","label":"Committee Member","values":["Hedrick, Valisa E.","Savla, Jyoti S."]},{"key":"dc:contributor.department","label":"Department","values":["Human Nutrition, Foods, and Exercise"]},{"key":"dc:creator","label":"Author","values":["Liu, Sarah Victoria"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2018-11-14T07:01:03Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2018-11-14T07:01:03Z"]},{"key":"dc:date.issued","label":"Date","values":["2017-05-22"]},{"key":"dc:publisher","label":"Institution","values":["Virginia Tech"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Human Nutrition, Foods, and Exercise"]},{"key":"thesis:degree_level","label":"Degree Level","values":["masters"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Science"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["Virginia Polytechnic Institute and State University"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["overweight and obesity","added sugars","dietary recall and assessment","δ¹³C biomarker","urinary sucrose/fructose biomarker","children and adolescents"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["In Copyright"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://rightsstatements.org/vocab/InC/1.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:10163"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/10919/85835"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["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"]},{"key":"dc:description.abstractgeneral","label":"General Abstract","values":["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."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Master of Science"]},{"key":"dc:format.medium","label":"Dc Format Medium","values":["ETD"]},{"key":"dc:title","label":"Title","values":["Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach"]}]}],"canonical_facts":{"dc:contributor.committeechair":["Davy, Brenda M."],"dc:contributor.committeemember":["Hedrick, Valisa E.","Savla, Jyoti S."],"dc:contributor.department":["Human Nutrition, Foods, and Exercise"],"dc:creator":["Liu, Sarah Victoria"],"dc:date.accessioned":["2018-11-14T07:01:03Z"],"dc:date.available":["2018-11-14T07:01:03Z"],"dc:date.issued":["2017-05-22"],"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"],"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."],"dc:description.degree":["Master of Science"],"dc:format.medium":["ETD"],"dc:identifier.other":["vt_gsexam:10163"],"dc:identifier.uri":["http://hdl.handle.net/10919/85835"],"dc:publisher":["Virginia Tech"],"dc:rights":["In Copyright"],"dc:rights.uri":["http://rightsstatements.org/vocab/InC/1.0/"],"dc:subject":["overweight and obesity","added sugars","dietary recall and assessment","δ¹³C biomarker","urinary sucrose/fructose biomarker","children and adolescents"],"dc:title":["Assessment of the Validity, Reliability, and Sensitivity of Fingerstick δ¹³C as an Added Sugar Biomarker in Adolescents: A Controlled Feeding Study Approach"],"dc:type":["Thesis"],"thesis:degree_discipline":["Human Nutrition, Foods, and Exercise"],"thesis:degree_level":["masters"],"thesis:degree_name":["Master of Science"],"thesis:institution_name":["Virginia Polytechnic Institute and State University"]},"updated_at":"2026-07-22T22:20:21Z"}