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Assessing potential biomarkers of micronutrient status by using a systematic review methodology: methods^1,2,3,4,5

¹ From the School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom (LH, KA, LJH, SF-T); the PenTAG, Peninsula Medical School, Universities of Plymouth and Exeter, Exeter, United Kingdom (KA); the Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom (LJH); and the Department of Pediatrics, University of Pécs, Pécs, Hungary (TD).

² This manuscript does not necessarily reflect the views of the Commission of the European Communities and in no way anticipates the future policy in this area.

³ Presented at the EURRECA workshop "Biomarkers of Micronutrient Status," held in Sveti Stefan, Montenegro, 9 June 2008.

⁴ Supported in part by the Commission of the European Communities, specific RTD Programme, "Quality of Life and Management of Living Resources," within the 6th Framework Programme (contract no. FP6-036196-2 EURRECA: EURopean micronutrient RECommendations Aligned).

⁵ Address correspondence to L Hooper, School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, United Kingdom. E-mail: l.hooper{at}uea.ac.uk.

Background: To explore the relation between micronutrient status and health, it is important to understand which markers of micronutrient status can be relied on and under what circumstances.

Objective: The objective of this article was to develop a common systematic review methodology for use in the assessment of micronutrient status for selenium, iodine, copper, zinc, riboflavin, vitamin B-12, vitamin D, and omega-3 (n–3) long-chain polyunsaturated fatty acids.

Design: We developed a methodology on the basis of defining studies that clearly altered micronutrient status and then pooled data on the effects of this intervention on each specific biomarker to assess objectively the response of various status markers to changes in intake.

Results: The generic methodology included defining, and systematically searching for, studies that resulted in a change in micronutrient status. Study inclusion, data extraction, and assessment of validity were conducted with a minimum of 10% independent duplication. For each study and each potential biomarker, the highest dose and longest duration intervention data were selected to assess the statistical significance of any change in intake on the status biomarker. The consistency of biomarker response was explored by subgrouping the studies according to baseline micronutrient status, sex, population group, supplementation type, dose, duration, and analytic method.

Conclusion: This methodology allows systematic assessment of the usefulness of a number of biomarkers for a selection of micronutrients.

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