Concurrent validity of skin carotenoid status as a concentration biomarker of vegetable and fruit intake compared to multiple 24-h recalls and plasma carotenoid concentrations across one year: a cohort study

Lisa Jahns, LuAnn K Johnson, Zach Conrad, Michael Bukowski, Susan K Raatz, Stephanie Jilcott Pitts, Youfa Wang, Igor V Ermakov, Werner Gellermann, Lisa Jahns, LuAnn K Johnson, Zach Conrad, Michael Bukowski, Susan K Raatz, Stephanie Jilcott Pitts, Youfa Wang, Igor V Ermakov, Werner Gellermann

Abstract

Background: Biological markers of vegetable and fruit (VF) intake are needed both for nutrition surveillance and for the evaluation of nutrition interventions. Optically assessed skin carotenoid status (SCS) has been proposed as a marker of intake but there are few published validity studies to date. Therefore, the objective of the study was to examine the concurrent validity of multiple methods of assessing VF intake cross-sectionally and seasonally over one year and to discuss the relative merits and limitations of each method.

Methods: Fifty-two 40-60 y old women completed a 1-year longitudinal study that included 1) SCS assessment using resonance Raman spectroscopy (RRS) and using pressure-mediated reflection spectroscopy (RS) at 12 timepoints, 2) thirty-six 24-h recalls using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24; total 1866 recalls), and 3) plasma carotenoid concentrations measured every 3 months. Pearson correlation coefficients and mixed linear models were used to estimate pairwise correlations between RRS, RS, ASA24, and plasma carotenoids.

Results: RS and RRS were strongly correlated at baseline and over the year (r = 0.86 and 0.76; respectively, P < 0.001). RS was strongly correlated with plasma carotenoids at baseline (r = 0.70) and moderately across the year (r = 0.65), as was RRS (r = 0.77 and 0.69, respectively, all P < 0.001). At baseline, self-reported VF was weakly correlated with RRS (r = 0.33; P = 0.016), but not with RS or plasma carotenoids. Across the year, self-reported VF intake was weakly correlated with both RS (r = 0.37; P = 0.008), RRS (r = 0.37; P = 0.007), and with plasma carotenoids (r = 0.36; P < 0.008).

Conclusions: SCS as measured by RS and RRS is moderately to strongly correlated with plasma carotenoid concentrations both cross-sectionally and longitudinally, indicating that it can be a powerful tool to assess carotenoid-rich VF intake in populations.

Clinical trial registry: This trial was registered at ClinicalTrials.gov as NCT01674296.

Keywords: ASA24 Dietary Assessment Tool; Biomarkers; Cohort study; Dietary intake; Fruits; Reflection spectroscopy; Resonance Raman spectroscopy; Skin carotenoids; Vegetables; Women.

Conflict of interest statement

WG and IE hold patents on the reflection technology and are with Longevity Link Corporation, the maker of the instrumentation used in this study The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
RS compared with RRS intensities for 52 women over 12 time points. Colored lines represent the slope for each person over the year. Per maximum likelihood, the overall between-person correlation between the two skin carotenoid scores was 0.76 (P < 0.001) and the overall within-person correlation coefficient was 0.30 (P < 0.03). RS, reflection spectroscopy; RRS, resonance Raman spectroscopy

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