- The study evaluated the relationship between biomarkers of fruit and vegetable intake and reported intake in 4th grade children using a health fair model. - Resonance Raman Spectroscopy (RRS) was used to non-invasively measure dermal carotenoids and correlated strongly with plasma carotenoid levels and reported intake of oranges and leafy vegetables. - This validates RRS as an objective, non-invasive method to assess fruit and vegetable intake in children and supports its potential use in larger nutrition intervention studies.

1. • Nutritional status is difficult to assess in young children because reported dietary
intake is not always accurate and there is a lack of support for blood sampling in
children due to its invasive nature.
• A Health Fair Model is used because it brings together the school and community
members in a supportive healthy environment.
• Carotenoids are used as biomarkers for fruit and vegetable intake because they
are unique compounds found in high concentrations in those foods. Previous
studies have shown a dose-dependent relationship between intake and
carotenoids found in blood and skin.
• High Performance Liquid Chromatography (HPLC) is considered the gold
standard for measuring plasma carotenoids.
• Carotenoids are lipophilic and serve a protective role in the skin’s antioxidants
defense system and can be measured by Resonance Raman Spectroscopy (RRS),
a validated method to quantify dermal carotenoids in adults.
The objective of this study is to evaluate the relationship between biomarkers of fruit
and vegetable intake comparing plasma and dermal carotenoids to reported intake. It
is important to have a valid, objective, and non-invasive method to assess nutritional
status in children and a feasible data collection method. As part of the multi-
component nutrition education intervention Shaping Healthy Choices, a health fair
was hosted to collect biochemical data from 4th graders. Dermal carotenoids were
measured using Resonance Raman Spectroscopy (RRS). Plasma carotenoids were
quantified using High Performance Liquid Chromatography. Dietary intake was
assessed using the Block Food Frequency Questionnaire. Total plasma carotenoids
strongly correlated with RRS values when corrected for BMI (R2=.80; P<.01; n=10).
RRS values strongly correlated with FFQ orange and leafy vegetable servings (R2=.
80; P<.03 and R2=.83; P<.02, respectively). This study shows that a health fair is a
feasible model to collect valid biomarker data assessing fruit and vegetable intake.
RRS is a valid, non-invasive method for determining carotenoids and correlates with
reported intake. This validation work serves as justification for larger sample sizes in
future studies. This model will be used to gather biomarker data at post-evaluation
and in future nutrition intervention studies.
Departments of 1Nutrition, 2Center for Nutrition in Schools, 3Population Health and Reproduction, 4Human Ecology, and 5Betty Irene Moore School of Nursing, University of California, Davis; 6UC Cooperative Extension Sacramento County, 7UC Cooperative Extension
Stanislaus and Merced Counties, UC Agriculture and Natural Resources; 8Department of Physics and Astronomy, University of Utah
• The Health Fair Model is a feasible method to collect biomarker data in
children.
• RRS is a valid, non-invasive method for determining carotenoid levels in
fourth-grade children and correlates with plasma values and reported intake
in this population.
• RRS can be a useful tool to objectively assess fruit and vegetable intake and
monitor changes in patterns of fruit and vegetable consumption.
• Pilot the Health Fair Model as method to collect biomarker data
• Evaluate the relationship between reported dietary intake and biomarkers of
fruit and vegetable intake
• Validate RRS as a method to objectively assess fruit and vegetable intake in
school-aged children
• This project is part of the Shaping Healthy Choices Program
(SHCP), a multi-component nutrition education intervention.
• SHCP goals are to: (1) increase nutrition knowledge and use of science
processing skills; (2) promote availability, consumption, and enjoyment of
fruits and vegetables; (3) improve dietary patterns and encourage physical
activity; (4) foster positive changes in the school environment; and
(5) facilitate development of an infrastructure to sustain the program.
• A non-invasive method to objectively measure fruit and vegetable intake is
needed to evaluate nutrition intervention programs.
UCANR 11-1018 and USDA 2011-38420-20082
Charles (Rocky) Carlson; UC Davis Nurses: Anita
Depatie, Patricia Gonzalves, and Tracy Nord; Health Fair
volunteers: Michael Beccarelli, Jacqueline Bergman,
Dawn Dillman, Samuel Gaona, Anna Jones, Sung Tin
Derek Kan, Lenna Ontai, Alejandro Pena, Linda Pena,
Carolyn Sutter, Allyson Sy, Amy Vu, and Noel Zeng,
Household Income (n)
$0-19,999
$20,000-39,999
$40,000-59,000
$60,000-79,999
$80,000-$99,999
$100,000 or more
Number of Students
Ethnic Diversity
Index†
Age ( x
±
s.e.) 9.5
years
±
0.3
months
Sex 9
males,
13
females
Average BMI percentile 85.7
Ethnicity*
African Am./Black, not of
Hispanic origin
Am. Indian/Alaska native
Asian/Pacific Islander
Caucasian/White, not of
Hispanic origin
Latino/Hispanic
Other
r = 0.80* P = 0.01
n = 11
r = 0.60 P = 0.04
n = 12
• Stronger correlations with plasma carotenoids were observed after
controlling for BMI.
• Moderate correlations are expected due to possible misreporting on the
FFQ as well as intra- and inter-individual variation in bioavailability,
efficiency of absorption, metabolism, uptake, utilization, and rate of
catabolism.
• Limitations include the small sample size, lack of variation in sex, weight,
and ethnicity.
r = 0.46 P = 0.05
n = 18
r = 0.45 P = 0.05
n = 18
r = 0.49
P = 0.05
n = 18
• Ermakov, I., et al. Resonance Raman detection of carotenoid antioxidants in
living human tissue. J Biomed Opt. 2005; 10(6): 064028.
r = 0.46
P = 0.05
n = 18
* Controlling for BMI
†From Ed-Data, The Ethnic Diversity Index of a school reflects how evenly distributed students are among
the race/ethnicity categories reported to the California Department of Education. The more evenly
distributed the student body, the higher the number. Schools where all students are of the same ethnicity
would have an index of 0.
*Some parents declined to report ethnicity, so those participants are not included in this table.
Reported Intake: Total
Veg
Total Veg
(no potato)
Orange
Veg
Leafy
Veg
Other
Veg
Total
Fruit
Citrus/
Melon/
Bberry
Other
Fruit
Total
Carotenoids
Dermal
Carotenoids
r
=
0.46
r
=
0.49
r
=
0.46
r
=
0.26
r
=
0.38
r
=
0.03
r
=
-­‐0.13
r
=
0.10
r
=
0.45
P
=
0.05
P
=
0.04
P
=
0.05
P
=
0.29
P
=
0.12
P
=
0.92
P
=
0.60
P
=
0.68
P
=
0.05
Plasma
Carotenoids
r
=
0.25
r
=
0.27
r
=
0.17
r
=
0.11
r
=
0.60
r
=
-­‐0.23
r
=
-­‐0.55
r
=
0.03
r
=
-­‐0.01
P
=
0.26
P
=
0.04
P
=
0.60
P
=
0.72
P
=
0.04
P
=
0.47
P
=
0.06
P
=
0.93
P
=
0.96
Total Plasma
Carotenoids
Total
Dermal
Carotenoids
r
=
0.80
P
=
0.01