Purpose of review: This review compares fatty acid biomarkers to assess compliance in dietary intervention trials with their application in epidemiological studies.

Recent findings: Although many studies have used fatty acid biomarkers to assess compliance in short-term dietary intervention trials and habitual diets in observational studies, there is little information on the reliability and comparability of these measures. In this review, we summarize the usefulness and limitations of fatty acid biomarkers in clinical and epidemiological studies. As there are very few recent publications in this area, a complete literature review is provided.

Summary: Several options are available for the biological assessment of dietary fatty acids. The type of study (short or long-term), the metabolic characteristics and expected variability in the fatty acids of interest are major considerations when determining which tissues reflect a better measure of true intake. Certain fatty acids may not be suitable to assess differences in intake under non-isocaloric conditions and when trying to identify small differences. Serum cholesterol ester is the most suitable serum fraction to assess short-term dietary compliance, but given the multiple factors that affect response, the quantification of compliance should be interpreted with caution. Adipose tissue is the biomarker of choice for long-term intake, but a preferred blood constituent (plasma versus erythrocytes) is difficult to establish given the data available to date. Future studies should explore the use of whole blood as an alternative choice to measure fatty acid intake in epidemiological studies.