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Prediction of fruit and vegetable intake from biomarkers using individual participant data of diet-controlled intervention studies

Author: Souverein, O.W. · Vries, J.H.M. de · Freese, R. · Watzl, B. · Bub, A. · Miller, E.R., III · Castenmiller, J.J.M. · Pasman, W.J. · Hof, K. van het · Chopra, M. · Karlsen, A. · Dragsted, L.O. · Winkels, R. · Itsiopoulos, C. · Brazionis, L. · O'Dea, K. · Loo-Bouwman, C.A. van · Naber, T.H.J. · Voet, H. van der · Boshuizen, H.C.
Source:British Journal of Nutrition, 9, 113, 1396-1409
Identifier: 526107
doi: doi:10.1017/S0007114515000355
Keywords: Health · Carotenoids · Folate · Fruits and vegetables · Prediction models · Vitamin C · Ascorbic acid · Beta carotene · Beta cryptoxanthin · Biological marker · Folic acid · Lycopene · Xanthophyll · Zeaxanthin · Age distribution · Body mass · Food intake · Fruit juice · Fruitarian diet · Prediction · Questionnaire · Sex difference · Smoking · Validation process · Vegetarian diet · Vitamin blood level · Biomedical Innovation · Healthy Living · Life · MSB - Microbiology and Systems Biology · ELSS - Earth, Life and Social Sciences


Fruit and vegetable consumption produces changes in several biomarkers in blood. The present study aimed to examine the dose-response curve between fruit and vegetable consumption and carotenoid (α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin), folate and vitamin C concentrations. Furthermore, a prediction model of fruit and vegetable intake based on these biomarkers and subject characteristics (i.e. age, sex, BMI and smoking status) was established. Data from twelve diet-controlled intervention studies were obtained to develop a prediction model for fruit and vegetable intake (including and excluding fruit and vegetable juices). The study population in the present individual participant data meta-analysis consisted of 526 men and women. Carotenoid, folate and vitamin C concentrations showed a positive relationship with fruit and vegetable intake. Measures of performance for the prediction model were calculated using cross-validation. For the prediction model of fruit, vegetable and juice intake, the root mean squared error (RMSE) was 258.0 g, the correlation between observed and predicted intake was 0.78 and the mean difference between observed and predicted intake was -1.7 g (limits of agreement: -466.3, 462.8 g). For the prediction of fruit and vegetable intake (excluding juices), the RMSE was 201.1 g, the correlation was 0.65 and the mean bias was 2.4 g (limits of agreement: -368.2, 373.0 g). The prediction models which include the biomarkers and subject characteristics may be used to estimate average intake at the group level and to investigate the ranking of individuals with regard to their intake of fruit and vegetables when validating questionnaires that measure intake. Copyright © The Authors 2015.