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Biomarkers of Seaweed Intake Muyao Xi* and Lars O Xi and Dragsted Genes & Nutrition (2019) 14:24 https://doi.org/10.1186/s12263-019-0648-4 REVIEW Open Access Biomarkers of seaweed intake Muyao Xi* and Lars O. Dragsted Abstract Seaweeds are marine macroalgae, some of which are edible. They are rich in specific dietary fibers and also contain other characteristic biological constituents. Biological activities have been investigated mainly in animal studies, while very few results are available from human studies. Biomarkers of food intake (BFIs) specific to seaweed could play an important role as objective measurements in observational studies and dietary intervention studies. Thus, the health effects of seaweeds can be explored and understood by discovering and applying BFIs. This review summarizes studies to identify candidate BFIs of seaweed intake. These BFIs are evaluated by a structured validation scheme. Hydroxytrifuhalol A, 7-hydroxyeckol, C-O-C dimer of phloroglucinol, diphloroethol, fucophloroethol, dioxinodehydroeckol, and/or their glucuronides or sulfate esters which all belong to the phlorotannins are considered candidate biomarkers for brown seaweed. Fucoxanthinol, the main metabolite of fucoxanthin, is also regarded as a candidate biomarker for brown seaweed. Further validation will be needed due to the very limited number of human studies. Further studies are also needed to identify additional candidate biomarkers, relevant specifically for the red and green seaweeds, for which no candidate biomarkers emerged from the literature search. Reliable BFIs should also ideally be found for the whole seaweed food group. Keywords: Biomarkers of food intake, Food exposure marker, Dietary assessment, Seaweed, Macroalgae Introduction originate from a variety of seaweed compounds, such as Seaweeds or macroalgae, including species of brown, soluble fiber and carotenoids [6, 11–15]. Only one study red, and green seaweeds, have been consumed as food in has so far shown which compounds can be used as bio- East Asia for a long time, but with more limited use in markers of seaweed intake in overweight or obese sub- Europe and North America, except for the use of certain jects. In addition, no study has so far firmly documented constituents as additives [1]. Recent interest in manufac- longer-term effects of seaweed intake in human trials. turing and consuming high-value food products derived In order to explore the relationship of seaweed intake from seaweeds in Western countries is fueled by their with human health, it is important to measure intake ac- proposed health benefits as well as by the introduction curately and it is therefore of importance to find specific of Asian foods. Seaweeds may supply several nutrients compounds related to seaweed intake in general or to and have been proposed to promote health and counter- intake of any certain type of seaweed. Intake assessments act a wide range of conditions and diseases, such as in human studies to date largely depend on dietary as- obesity, oxidative stress, hypertension, digestive prob- sessment instruments such as food frequency question- lems, thrombosis, and even cancer [2–5]. However, this naires (FFQ) or 24-h recalls (R24h). These instruments builds largely on very limited evidence from animal and are prone to recall bias and systematic errors [16]. Lack in vitro studies. There are also a few trials with seaweeds of compliance is also common in dietary intervention or seaweed preparations in humans investigating effects studies. Thus, it is difficult to evaluate the relationship on blood pressure [5, 6], appetite [7, 8], inflammation between health effects and seaweed intake. Well- [9], and insulin response [10]. These health effects may validated biomarkers of food intake (BFIs) may provide more objective estimates of actual intake. The objectives of this review are (1) to summarize in- * Correspondence: [email protected] Department of Nutrition, Exercise and Sports, University of Copenhagen, formation from the scientific literature related to Copenhagen, Denmark © 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. Xi and Dragsted Genes & Nutrition (2019) 14:24 Page 2 of 13 compounds that may be currently used as, or considered unless they contain information on unique seaweed- as, candidate biomarkers for seaweed consumption [16] derived compounds. Papers on contaminants and min- and (2) to provide systematic validation of the candidate eral contents of seaweed were also excluded from the BFIs based on recent methodology [17]. search. Materials and methods Secondary search—evaluation of putative BFIs Defining the food group After identification of potential candidate BFIs from Seaweeds are not well-defined in biological terms but the primary literature search, a second search step cover largely the macroalgae. The macroalgae contain was performed to evaluate the specificity of each pu- species belonging to several different phyla consisting of tative BFI for seaweed intake. The second search was red, green, or brown algae and in some cases are consid- carried out by replacing (seaweed OR macroalgae) ered to include also the prokaryotic photosynthetic with (“the name and synonyms of the potential candi- cyanobacteria. Within the food group of seaweeds, there date biomarker” OR “thenameandsynonymsofpo- is a corresponding subdivision into three food sub- tential candidate biomarker class”). In addition to the groups, the red, brown, and green seaweeds, each with a online databases listed above, hmdb [18]andfoodb large number of species. Although there are differences [19] were searched for each putative BFI in order to within and between these 3 subgroups of seaweed, it is ascertain that they have not been measured previously considered of interest to find candidate biomarkers of in other foods. The full list of putative BFIs is shown the overall seaweed group as well as for each subgroup. in Table 1. Plausibility of the BFIs, i.e., the evaluation Within each subgroup, there are many species that are of whether the putative marker compound is likely to likely to vary considerably in composition; however, the be uniquely present in seaweeds, was decided based present review will not emphasize the detail of species on the secondary search; the final list of plausible or of varieties within species because little is known at BFIs are shown as the top 7 items of Table 2. this level of detail. Validation criteria of candidate BFIs Primary literature search for relevant BFIs for seaweed The candidate BFIs were validated according to a set of intake criteria published recently [17]. There are 8 topics in this Original research papers were searched within three da- validation system (Additional file 1: Text S1) relating to tabases (Scopus, PubMed, and the ISI Web of Know- aspects of analytical performance, applicability in nutri- ledge). The search made use of combinations of several tion research, and various aspects of biological validity, search terms with inclusion and exclusion criteria as which were answered for each candidate BFI in Table 3. keywords, as described for the BFIRev literature search procedure [16]: (biomarker* OR marker* OR metabolite* Results OR biokinetics OR biotransformation OR pharmacokin- The original search process retrieved 364 research pa- etics OR bioavailability OR ADME) AND (intake OR pers, of which 290 remained after excluding duplicates. meal OR diet OR ingestion OR consumption OR eating Subsequently, the number decreased to 21 eligible pa- OR drink* OR administration) AND (human* OR men pers after screening titles and abstracts. The other 269 OR women OR patient* OR volunteer* OR participant*) papers were eliminated because they were not relevant AND (urine OR plasma OR blood OR serum OR excre- in relation to seaweed BFIs, mainly because they were tion OR hair OR toenail OR feces OR fecal water) AND not concerned with seaweed constituents or mentioned (seaweed OR macroalgae). The field of each database only contents of common nutrients in seaweeds. The used as default is [Article Title/ Abstract/ Keywords] for twenty-one remaining eligible full-text articles were eval- Scopus, [All Fields] for PubMed, and [Topic] for ISI uated for relevant content about BFIs. The reference lists Web of Science. The search for papers on seaweed in- were additionally checked to acquire more relevant pa- take biomarkers was covering all papers published up pers. As a result of this selection process, 8 papers were until March 2019 but was restricted to papers in the identified from the database search and 1 paper from English or Chinese language. Additional papers were ac- reference lists for further review (Fig. 1 and Additional quired from reference lists of included papers after filter- file 1: Table S1). The relevant information from the se- ing and from reviews, books, or online databases lected 9 papers is extracted into Table 1. The studies in- (Google Scholar). Exclusion criteria avoided papers deal- cluded four single oral dose intervention studies,
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