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Biomarkers of Meat and Seafood Intake: an Extensive Literature Review Cătălina Cuparencu1*† , Giulia Praticó1†, Lieselot Y

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Biomarkers of Meat and Seafood Intake: an Extensive Literature Review Cătălina Cuparencu1*† , Giulia Praticó1†, Lieselot Y Cuparencu et al. Genes & Nutrition (2019) 14:35 https://doi.org/10.1186/s12263-019-0656-4 REVIEW Open Access Biomarkers of meat and seafood intake: an extensive literature review Cătălina Cuparencu1*† , Giulia Praticó1†, Lieselot Y. Hemeryck2†, Pedapati S. C. Sri Harsha3†, Stefania Noerman4, Caroline Rombouts2, Muyao Xi1, Lynn Vanhaecke2, Kati Hanhineva4, Lorraine Brennan3 and Lars O. Dragsted1 Abstract Meat, including fish and shellfish, represents a valuable constituent of most balanced diets. Consumption of different types of meat and fish has been associated with both beneficial and adverse health effects. While white meats and fish are generally associated with positive health outcomes, red and especially processed meats have been associated with colorectal cancer and other diseases. The contribution of these foods to the development or prevention of chronic diseases is still not fully elucidated. One of the main problems is the difficulty in properly evaluating meat intake, as the existing self-reporting tools for dietary assessment may be imprecise and therefore affected by systematic and random errors. Dietary biomarkers measured in biological fluids have been proposed as possible objective measurements of the actual intake of specific foods and as a support for classical assessment methods. Good biomarkers for meat intake should reflect total dietary intake of meat, independent of source or processing and should be able to differentiate meat consumption from that of other protein-rich foods; alternatively, meat intake biomarkers should be specific to each of the different meat sources (e.g., red vs. white; fish, bird, or mammal) and/or cooking methods. In this paper, we present a systematic investigation of the scientific literature while providing a comprehensive overview of the possible biomarker(s) for the intake of different types of meat, including fish and shellfish, and processed and heated meats according to published guidelines for biomarker reviews (BFIrev). The most promising biomarkers are further validated for their usefulness for dietary assessment by published validation criteria. Keywords: Biomarkers of food intake, Protein sources, Red meat, Processed meat, Poultry, Fish, Seafood Background other hand, high consumption of processed meat and Meat, including fish and shellfish, represents a valuable possibly red meat has been associated with a series of constituent of a balanced omnivorous diet. The import- adverse health outcomes, including cardiovascular dis- ance of meat from a nutritional point of view is related ease (CVD) [4], overall mortality [5], and certain types of to its high-quality protein content, as it comprises a bal- cancer, especially colorectal cancer [6–8]. However, re- anced source of all essential amino acids for muscle cent large, prospective investigation including almost maintenance [1]. Minerals and vitamins, such as iron half a million subjects from ten European countries [9], and B12 vitamin, and other micronutrients that are es- only found significant associations with processed meat sential for growth and development, are additionally intake. Poultry was not related to all-cause mortality, highly bioavailable from meat compared to other sources whereas red meat was related to higher all-cause mortal- [2]. Meat processing, such as curing, smoking, or heat- ity only before correcting for potential confounding [9]. ing, further improves its organoleptic properties, as well Additionally, high intake of red and processed meat has as its microbiological safety and shelf life [3]. On the also been associated with an increased risk of developing type 2 diabetes, although major inconsistencies regard- * Correspondence: [email protected] ing consumption levels exist between studies [10–12]. †Cătălina Cuparencu, Giulia Praticó, Lieselot Y. Hemeryck, and Pedapati S.C. Sri Harsha shared first co-authorship. Fish and shellfish intake has been associated with posi- 1Department of Nutrition, Exercise and Sports, University of Copenhagen, tive health outcomes, such as decreasing CVD risk [13] Rolighedsvej 30, 1958 Frederiksberg C, Denmark and possibly colorectal cancer [14, 15], while its role in Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Cuparencu et al. Genes & Nutrition (2019) 14:35 Page 2 of 30 preventing type 2 diabetes development is still unclear Primary literature search [16, 17]. Different outcomes in the studies may also as- The reviewing process, including article search and se- sociate with the type of fish consumed and the cooking lection, reviewing and reporting of the results, follows methods [17]. Moreover, aquatic meat has proven to be the guidelines previously proposed by the FoodBAll con- one of the major dietary sources of contaminants that sortium to carry out an extensive literature search and are potentially harmful to human health, such as methyl- evaluation of biomarkers for food intake (BFIs) [23]. mercury and arsenic [18, 19]. In brief, original research papers and reviews were Since associations are always debatable in terms of searched in at least two databases, among which cause and effect and weak associations like those be- PubMed, Scopus, and ISI Web of Knowledge, using tween meat and chronic disease are always at a high risk combinations of the grouped search terms (biomarker* of being affected by bias or confounding, it is important OR marker* OR metabolite* OR biokinetics OR bio- to find biomarkers able to objectively discriminate be- transformation) AND (trial OR experiment OR study tween different classes of meat, particularly red meat, OR intervention OR cohort) AND (human* OR men OR white meat from poultry, white meat from fish or shell- women OR patient* OR volunteer* OR participant*) fish, and processed meats [20]. The existing self- AND (urine OR plasma OR serum OR blood OR excre- reporting tools for dietary assessment, such as food tion) AND (intake OR meal OR diet OR ingestion OR frequency questionnaires (FFQ) and dietary records, are consumption OR eating OR drink* OR administration), imprecise and can be affected by systematic and random as reported in Additional file 1: Table S1, together with errors, especially when a certain food is perceived as specific keywords related to each animal-derived food healthy or unhealthy [21]. Dietary biomarkers have been group (Additional file 1: Table S2). The fields used as proposed as possible objective measurements of the ac- default for each of the databases were [All Fields] for tual specific food intakes or at least as a support for the PubMed, [Article Title/ Abstract/ Keywords] for Scopus, classical assessment methods [22]. A good marker of and [Topic] for ISI Web of Science, respectively. For al- overall meat intake should reflect total dietary meat in- most all food groups, the three databases were con- take differentiating any meat consumption from that of sulted. For “processed meat” and “offal meat,” the search other protein-rich foods; additional markers should dis- was carried out only in PubMed and ISI Web of Know- criminate between different meat sources (e.g., red vs. ledge. The literature search process was carried out be- white or between different species, e.g., pork vs. beef) tween November and December 2015 and updated at and identify cooking methods. In this paper, we present the end of December 2018 for all food groups. the results of a systematic search of the scientific litera- The search was limited to papers written in English, while ture according to the BFIrev methodology [23] providing no restriction was applied regarding publication date. The a comprehensive overview of the possible marker(s) for research papers identifying or using potential biomarkers of the intake of different meat types, including fish and intake for the different kinds of meat were selected from shellfish. The most promising biomarkers are further the list of retrieved references by one or more skilled re- validated according to a validation scheme previously searchers in a process outlined in Additional file 1:Figure proposed for biomarkers of food intake [24]. This review S1. The papers obtained from the search in different data- represents the continuation of the reviewing process for bases were merged and filtered for duplicates. Subse- candidate intake biomarkers for various foods of animal quently, papers were screened based on title and abstract. origin initiated in a previous paper on dairy and egg bio- The selected papers were then retrieved and assessed for markers, as part of the FoodBAll project [25]. eligibility based on the contents of the whole manuscript. Additional papers were identified from reference lists in Methods these papers and from reviews or book chapters identified Selection of food groups through the search. The result was a list of compounds po- In order to obtain a good coverage of the different meat tentially relevant as biomarkers for the food group and cor- sources, meat was subdivided into fresh meat (e.g., over- responding references. all meat intake, red meat, white meat), fish and fish oil, and other aquatic meat, e.g., various shellfish, processed Secondary search, marker identification, and classification meat products (cured and smoked), and offal or organ A second search step was used to evaluate the apparent meats. Two particular groups, strongly heated (e.g., specificity of the markers in the list. The compound da- grilled) meat products and biomarkers for fish contami- tabases HMDB [26] and FooDB (http://foodb.ca/)) were nants, were also investigated. A total of nine food groups used for a first evaluation of marker specificity.
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