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Evaluation of (-)-epicatechin metabolites as recovery biomarker of dietary flavan-3-ol intake.

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Ottaviani, Javier I 
Fong, Reedmond 
Kimball, Jennifer 
Ensunsa, Jodi L 
Gray, Nicola 


Data from dietary intervention studies suggest that intake of (-)-epicatechin mediates beneficial vascular effects in humans. However, population-based investigations are required to evaluate associations between habitual intake and health and these studies rely on accurate estimates of intake, which nutritional biomarkers can provide. Here, we evaluate a series of structurally related (-)-epicatechin metabolites (SREM), particularly (-)-epicatechin-3'-glucuronide, (-)-epicatechin-3'-sulfate and 3'-O-methyl-(-)-epicatechin-5-sulfate (SREMB), as flavan-3-ol and (-)-epicatechin intake. SREMB in urine proved to be a specific indicator of (-)-epicatechin intake, showing also a strong correlation with the amount of (-)-epicatechin ingested (R2: 0.86 (95% CI 0.8l; 0.92). The median recovery of (-)-epicatechin as SREMB in 24 h urine was 10% (IQR 7-13%) and we found SREMB in the majority of participants of EPIC Norfolk (83% of 24,341) with a mean concentration of 2.4 ± 3.2 µmol/L. Our results show that SREMB are suitable as biomarker of (-)-epicatechin intake. According to evaluation criteria from IARC and the Institute of Medicine, the results obtained support use of SREMB as a recovery biomarker to estimate actual intake of (-)-epicatechin.



Adult, Biomarkers, Catechin, Cohort Studies, Diet, Female, Flavonoids, Healthy Volunteers, Humans, Male, Middle Aged

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Springer Science and Business Media LLC


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Medical Research Council (MC_UU_12015/5)
Cambridge University Hospitals NHS Foundation Trust (CUH) (146281)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0617-10149)
Medical Research Council (MR/N003284/1)
Medical Research Council (G0401527)
Medical Research Council (G1000143)
National Institute for Health and Care Research (IS-BRC-1215-20014)
Medical Research Council (G0401527/1)
We thank all EPIC-Norfolk study participants and staff for their contribution to the study. We thank all volunteers at UC Davis. NGF acknowledges MRC Epidemiology Unit core support [MC_UU_12015/5] and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet and Lifestyle Research Theme [IS-BRC-1215-20014].