Health & Medicinearticle2026-09-17

Urinary Hypaphorine as a Candidate Marker of FFQ-Derived Legume Intake Within the EAT-Lancet Framework in Free-Living Adults

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Abstract

Dietary assessment is affected by recall, reporting, portion-size error, and food-composition inconsistencies. Hypaphorine, a tryptophan-derived betaine alkaloid found in pulses and other foods, has been proposed as a marker of legume exposure, but its performance in free-living populations remains uncertain. In this cross-sectional study of 138 adults, dietary intake was assessed by food-frequency questionnaire, and legume intake was represented by an FFQ-derived variable within the EAT-Lancet food-group framework. Urinary hypaphorine was quantified by targeted hydrophilic-interaction liquid chromatography-mass spectrometry. Associations were examined using Spearman correlations and multivariable linear models with HC3 robust standard errors. Predictive performance was assessed using repeated 10-fold cross-validation. Hypaphorine correlated with legume intake (ρ = 0.240; p = 0.0047). After adjustment for age, sex, BMI, energy intake, and log10-transformed urinary creatinine signal, each 10 g/day increment in legume intake was associated with 19.1% higher hypaphorine (95% CI, 7.2–32.2%; p = 0.0014). Estimation of the FFQ-derived legume-intake variable was limited (cross-validated R2 = 0.061), whereas discrimination between intake above and at or below the sample median was modest (AUC = 0.653). In the exploratory clinical screen, the inverse correlation with leukocyte count did not remain below the 0.05 FDR threshold (q = 0.090). A focused adjusted model yielded an inverse association (β = −1.38 × 103/µL; p = 0.030), but exclusion of the most influential observation attenuated statistical support (p = 0.061). Urinary hypaphorine may provide modest information for ranking FFQ-derived legume exposure but should not be considered a quantitative measure of individual intake without further validation.

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Authors: Teresa Cepeda-Vidal, João Tomé‐Carneiro, Alberto Valdés, Nieves R. Colás‐Ruiz, Edwin Fernández‐Cruz, Isabel Espinosa‐Salinas, Pilar Matía‐Martín, Ana Barabash, Angélica Larrad-Sáinz, Miguel Ángel Rubio, Alfonso L. Calle‐Pascual, Alberto Cepeda, J. Alfredo Martínéz

Institutions: Universidad Complutense de Madrid, Instituto de Salud Carlos III, Universidad Autónoma de Madrid, Universidad de Valladolid, Madrid Institute for Advanced Studies, Universidade de Santiago de Compostela, Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Universidad Nebrija, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Instituto de Investigación en Ciencias de la Alimentación, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas