Flavonoids in human urine as biomarkers for intake of fruits and vegetables.

Flavonoids are polyphenolic compounds ubiquitously found in human diets. We have studied the association between urinary excretion of flavonoids and the intake of fruits and vegetables to evaluate the usefulness of flavonoids as a biomarker for fruit and vegetable intake. Levels of 12 dietary relevant flavonoids were determined by LC-MS in urine samples collected prior to an intervention study, when the subjects were on their habitual diet (n = 94), and after they had participated in an intervention study with diets either high or low in fruits, berries, and vegetables (n = 77). Both flavonoid glycosides and aglycones were included in the assay, but only the flavonoid aglycones were detectable. Thus, the flavonols quercetin, kaempferol, isorhamnetin, and tamarixetin, the dihydrochalcone phloretin, and the flavanones naringenin and hesperetin were quantified in the enzymatically hydrolyzed urine samples. The habitual intake of fruits and vegetables, determined by 3-day dietary records before the intervention study, correlated significantly with the total excretion of urinary flavonoids, with a coefficient of correlation of 0.35, P < 0.005 (n = 94). In addition, highly significant differences in the urinary excretion of all flavonoids were observed in the human intervention study between subjects on diets high or low in fruits, berries, and vegetables. Also, at the individual level a significant positive correlation between changes in fruit and vegetable intake and changes in urinary flavonoid excretion was observed. We conclude that urinary flavonoids may be useful as a new biomarker for fruit, berry, and vegetable intakes and may prove useful when the possible health protective effects of flavonoids are studied.