|KIM, HYUNJU - Johns Hopkins University|
|LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|WONG, KERI - Metabolon, Inc|
|APPEL, LAWRENCE - Johns Hopkins University|
|CORESH, JOSEF - Johns Hopkins University|
|REBHOLZ, CASEY - Johns Hopkins University|
Submitted to: Molecular Nutrition and Food Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/9/2020
Publication Date: 12/9/2020
Citation: Kim, H., Lichtenstein, A.H., Wong, K.E., Appel, L.J., Coresh, J., Rebholz, C.M. 2020. Urine metabolites associated with the Dietary Approaches to Stop Hypertension (DASH) diet: results from the DASH-sodium trial. Molecular Nutrition and Food Research. 65(3):2000695. https://doi.org/10.1002/mnfr.202000695.
Interpretive Summary: The Dietary Approaches to Stop Hypertension (DASH) diet has been recommended to reduce risk of hypertension and heart disease. It is challenging to determine from subjective dietary data commonly collected in large groups of individuals how closely subjects adhere to the DASH or other dietary patterns. Urine is a biological sample that can be collected non-invasively. The level of selected urinary metabolites may serve as biomarkers of habitual dietary intake. To address this issue our prior work measured potential biomarkers of dietary intake in urine samples of individuals fed both a DASH diet and control diet. Discrete urinary biomarkers were identified that differed between the two feeding periods. The objective of this study was to determine whether these data could be replicated in an independent controlled dietary intervention. Assessed were candidate urinary biomarkers of the original DASH feeding trial in the DASH-Sodium trial. The results indicated that urinary biomarkers during the period when the participants were fed the DASH diet, whether relatively high or low in sodium diet, were significantly different from they were fed the control diet. Most urinary candidate biomarkers from the original DASH feeding study were replicated in the DASH-Sodium trial. The results of this work indicate that urinary biomarkers of the DASH diet were replicated in an independent study and are strong candidates for objective biomarkers of the DASH dietary pattern. These metabolites may be used to improve dietary assessment in large cohorts.
Technical Abstract: Scope: Serum metabolomic markers of the Dietary Approaches to Stop Hypertension (DASH) diet are previously reported. In an independent study, the similarity of urine metabolomic markers are investigated. Methods and Results: In the DASH-Sodium trial, participants are randomly assigned to the DASH diet or control diet, and received three sodium interventions (high, intermediate, low) within each randomized diet group in random order for 30 days each. Urine samples are collected at the end of each intervention period and analyzed for 938 metabolites. Two comparisons are conducted: 1) DASH-high sodium (n = 199) versus control-high sodium (n = 193), and 2) DASH-low sodium (n = 196) versus control-high sodium. Significant metabolites identified using multivariable linear regression are compared and the top 10 influential metabolites identified using partial least-squares discriminant analysis to the results from the DASH trial. Nine out of 10 predictive metabolites of the DASH-high sodium and DASH-low sodium diets are identical. Most candidate biomarkers from the DASH trial replicated. N-methylproline, chiro-inositol, stachydrine, and theobromine replicated as influential metabolites of DASH diets. Conclusions: Candidate biomarkers of the DASH diet identified in serum replicated in urine. Replicated influential metabolites are likely to be objective biomarkers of the DASH diet.