Urinary flavanone concentrations as biomarkers of dietary flavanone intakes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Br J Nutr. 2020 Mar 28;123(6):691-698. doi: 10.1017/S0007114519003131. Epub 2019 Dec 3.


In the present study, the aim was to investigate the correlation between the acute and habitual dietary intake of flavanones, their main food sources and the concentrations of aglycones naringenin and hesperetin in 24 h urine in a European population. A 24-h dietary recall (24-HDR) and a 24-h urine sample were collected the same day from a subsample of 475 people from four different countries of the European Prospective Investigation into Cancer and Nutrition study. Acute and habitual dietary data were captured through a standardised 24-HDR and a country/centre-specific validated dietary questionnaire (DQ). The intake of dietary flavanones was estimated using the Phenol-Explorer database. Urinary flavanones (naringenin and hesperetin) were analysed using tandem MS with a previous enzymatic hydrolysis. Weak partial correlation coefficients were found between urinary flavanone concentrations and both acute and habitual dietary flavanone intakes (Rpartial = 0·14-0·17). Partial correlations were stronger between urinary excretions and acute intakes of citrus fruit and juices (Rpartial ∼ 0·6) than with habitual intakes of citrus fruit and juices (Rpartial ∼ 0·24). In conclusion, according to our results, urinary excretion of flavanones can be considered a good biomarker of acute citrus intake. However, low associations between habitual flavanone intake and urinary excretion suggest a possible inaccurate estimation of their intake or a too sporadic intake. For assessing habitual exposures, multiple urinary collections may be needed. These results show that none of the approaches tested is ideal, and the use of both DQ and biomarkers can be recommended.

Keywords: Biomarkers; European Prospective Investigation into Cancer and Nutrition study; Flavanones; Intake; Urine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / urine
  • Citrus sinensis
  • Diet*
  • Europe
  • Female
  • Flavanones / administration & dosage*
  • Flavanones / chemistry
  • Flavanones / urine*
  • Hesperidin / chemistry
  • Hesperidin / urine
  • Humans
  • Male
  • Middle Aged
  • Nutrition Assessment
  • Nutrition Surveys


  • Biomarkers
  • Flavanones
  • Hesperidin
  • naringenin
  • hesperetin
  • flavanone