Comparison of plasma biomarkers with dietary assessment methods for fruit and vegetable intake

Objective: To assess the variability and validity of plasma-based biomarkers of antioxidant vitamin, and fruit and vegetable intake.Setting: Leeds, Wakefield, Huddersfield and Bradford, England.Subjects: A total of 54 free-living, nonsmoking women recruited from participants of the UK Women's Cohort Study (UKWCS).Methods: Two fasting blood samples were taken at two time points, 18 months apart. A 4-day food diary was completed prior to the first blood sample and a 24-h recall was conducted at the time of the second blood collection. All blood samples were analysed for ascorbic acid and four carotenoids. Associations between antioxidant vitamin intake from all food sources and supplements, as well as fruit and vegetable intake, and plasma levels of the antioxidant vitamins were assessed.Results: Using the 4-day diary, positive associations were found between micronutrient intake from all food sources and plasma concentrations of ascorbic acid (P<0.01) and β-carotene (P<0.01). No associations were seen between plasma micronutrient levels and specifically fruit and vegetable intakes. In general, associations between plasma levels and intakes assessed by the 24-h recall were less marked than those based on the 4-day diary.Conclusions: Plasma ascorbic acid and β-carotene are good indicators of previous vitamin C and β-carotene intake, from all food sources. However, caution is required in extrapolating these results to include individual food groups, rich in these vitamins. The results imply that the practice of using plasma biomarkers simply as a proxy measure of dietary intake is not valid and emphasise that plasma biomarkers are not simply a reflection of dietary intake, but also of a number of physiological processes. Biomarkers in nutrition epidemiological studies are however useful to measure nutrient status at the tissue level.