Urinary sugars as biomarker for dietary sugar intake; a prospective population study

Lead Research Organisation: University of Cambridge
Department Name: Clinical Gerontology


Though it is commonly believed that a high dietary intake of sugar is bad for health, there is surprisingly little scientific evidence to support this. This may relate to our difficulty in measuring dietary sugar intake given its widespread presence and variable amounts in foods. Our work suggests that sugar excretion (sucrose and fructose) in the urine (as opposed to glucose, which is may indicate diabetes) is a good reflection of dietary sugar intake. We propose to examine whether dietary sugar intake, as assessed using urine sugar excretion is related to long term risk of chronic diseases associated with ageing such as heart disease, stroke and diabetes in 25,000 men and women aged 40-79 who have been followed up between 1993 to the present for health. This may help us understand better how to prevent chronic diseases associated with ageing.

Technical Summary

We propose to assess urinary sugars (sucrose and fructose) as a biomarker of dietary sugars intake and the risk of chronic disease in a prospective population study. Despite widely held beliefs that a high dietary sugar intake has adverse consequences for health, in particular for obesity, diabetes and cardiovascular disease risk, there has been a surprising dearth of good evidence relating sugar intake to health from epidemiologic studies. This may relate to the difficulty in assessing dietary sugar intake. Our previous work has demonstrated that urinary sugars sucrose and fructose can be used as a biomarker of sugar intake, that high through put methods such as mass spectrometry can be used for measurement of urinary sugars, and that a casual urine sample can be used to assess sugars intake in large population studies. We propose therefore in a large prospective population study EPIC-Norfolk) of 25,000 men and women aged 40-79 years in 1993-1997 who had a urine sample collected at baseline in 1993-1997 and stored frozen, who have been followed up to the present to examine the relationship between urinary sugars as a biomarker of dietary sugar intake and subsequent health endpoints, including cardiovascular disease incidence (estimated 3000 incident cases), diabetes incidence (estimated 1000 incident cases) as well as prospective measured weight change over 4 years.
Description Sugars Biomarkers
Amount £150,000 (GBP)
Organisation World Cancer Research Fund 
Sector Charity/Non Profit
Country Global
Start 01/2009 
End 12/2011
Title Analysis of urinary sugars 
Description Method for analysis of urinary sugars suitable for large epidemiologic studies 
Type Of Material Technology assay or reagent 
Year Produced 2009 
Provided To Others? Yes  
Impact Using methods now in epidemiologic studies 
Title UK Dietary Cohort Consortium 
Description Pooled dataset prepared for colorectal and breast cancer, analysis under way. 
Type Of Material Biological samples 
Year Produced 2008 
Provided To Others? Yes  
Impact A number of manuscripts have been prepared and are in various stages of submission. 
Description Dr. Jules Griffin Dept of Biochemistry Cambridge 
Organisation University of Cambridge
Department Department of Biochemistry
Country United Kingdom 
Sector Academic/University 
PI Contribution Provision of samples and epidemiologic data
Collaborator Contribution Scientific expertise and collaborative use of specialised equipment and methods and joint training
Impact Currently working together on analysis of samples and data which will result in joint publications
Start Year 2009
Description Unnary sugars analysis 
Organisation University of Reading
Department Department of Food and Nutritional Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Collection of data and samples
Collaborator Contribution Analysis of biological samples
Impact In progress
Start Year 2009
Title Urinary sugar biomarker 
Description Urinary sugars biomarker 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2010
Development Status Under active development/distribution
Impact Interest in use of this biomarker for large epidemiologic studies 
Title Dietary assessment tool: FFQ 
Description This is a freely available downloadable programme for analysis of dietary intake using food frequency questionnaires. 
Type Of Technology Software 
Year Produced 2014 
Open Source License? Yes  
Impact This is now being used by researchers. As far as we know, this is the only freely available analytic programme for dietary intake assessment 
URL http://www.srl.cam.ac.uk/epic/epicffq/websitedocumentation.html
Description 2nd Metabolomics Sardinian Scientific School 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact 2nd Metabolomics Sardinian Scientific School was aimed at post-grad students new to the field of metabolomics. We gave seminars and workshops in various tools and techniques in metabolomics.
Year(s) Of Engagement Activity 2016
Description Cambridge Science Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Talks to and activities in the Cambridge Science Festival which stimulated interest in the topics e.g. healthy ageing, use of supplements, dietary recommendations
Year(s) Of Engagement Activity 2013,2014,2015,2016
Description Presented work at meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Health professionals
Results and Impact Talk about the methods and study at scientific meeting

Interest in use of method in future epidemiologic studies
Year(s) Of Engagement Activity 2009