Biomarkers of Sugar Intake in Nutritional Epidemiology
Summary
Biomarkers offer objective measures of sugar consumption that complement or replace self-report instruments. The most established biomarker is the urinary excretion of sucrose and fructose over 24 hours, which provides a quantitative proxy for total sugar intake. Advances in analytical chemistry have enhanced sensitivity and specificity, allowing simultaneous detection of multiple sweeteners and metabolites via liquid chromatography–tandem mass spectrometry. Beyond urinary measurements, stable isotope ratios of carbon and nitrogen in blood, hair or other tissues reflect long-term intake patterns, distinguishing sugar from other macronutrients. The application of biomarkers has illuminated the extent of underreporting in dietary surveys, refined estimates of sugar exposure in epidemiological cohorts and clarified the relationships between sugar intake and health outcomes such as obesity, type 2 diabetes and dental caries. While biomarkers reduce bias, challenges remain in calibration across diverse populations, accounting for individual variation in metabolism and ensuring feasibility in large-scale studies. Ongoing work seeks to integrate biomarker data with self-reported models and to develop novel metabolites that capture the intake of specific sugar sources, including sugar-sweetened beverages and low-calorie sweeteners.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Biomarkers of Sugar Intake in Nutritional Epidemiology publication trend
The graph below shows the total number of articles in biomarkers of sugar intake in nutritional epidemiology across all publications each year (not limited to Nature Index journals).
Technical terms
Biomarker: A biological measure, often a chemical compound or metabolite, used to assess exposure or intake.
24 h Urinary Sugars Biomarker: The total amount of sucrose and fructose excreted in a complete 24-hour urine collection, serving as an objective proxy for total sugar intake.
Food Frequency Questionnaire (FFQ): A self-administered dietary assessment tool that estimates usual food and nutrient intake over a specified period.
Stable Isotope Ratio: The ratio of heavy to light isotopes (e.g. 13C/12C) in biological tissues, reflecting dietary patterns and long-term intake of specific nutrients.
References
- Relative validity of habitual sugar and low/no-calorie sweetener consumption assessed by food frequency questionnaire, multiple 24-h dietary recalls and urinary biomarkers: an observational study within the SWEET project. American Journal of Clinical Nutrition (2023).
- The mediating role of obesity on the prospective association between urinary sucrose and diabetes incidence in a sub-cohort of the EPIC-Norfolk. Nutrition & Diabetes (2023).
- Twenty-Four-Hour Urinary Sugars Biomarker in a Vending Machine Intake Paradigm in a Diverse Population. Nutrients (2024).
- Associations of plasma, RBCs, and hair carbon and nitrogen isotope ratios with fish, meat, and sugar-sweetened beverage intake in a 12-wk inpatient feeding study. American Journal of Clinical Nutrition (2019).
- Urinary Sugars—A Biomarker of Total Sugars Intake. Nutrients (2015).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.