Benzoic acid and hippuric acid are formed from the bacterial metabolism of polyphenols. Urinary benzoic acid may also come from ingestion of food preservatives such as sodium benzoate. Hippuric acid is made when sodium benzoate is conjugated with glycine.
Common Dietary Sources:
Orange juice, elderberry, huckleberry, food preservative, berries, other flavonoids
- Badenhorst CP, Erasmus E, van der Sluis R, Nortje C, van Dijk AA. A new perspective on the importance of glycine conjugation in the metabolism of aromatic acids. Drug Metab Rev. 2014;46(3):343- 361.
- Lees HJ, Swann JR, Wilson ID, Nicholson JK, Holmes E. Hippurate: the natural history of a mammalian-microbial cometabolite. J Proteome Res. 2013;12(4):1527-1546.
- Loo RL, Zou X, Appel LJ, Nicholson JK, Holmes E. Characterization of metabolic responses to healthy diets and association with blood pressure: application to the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), a randomized controlled study. Am J Clin Nutr. 2018;107(3):323-334.
- Williams HR, Cox IJ, Walker DG, et al. Differences in gut microbial metabolism are responsible for reduced hippurate synthesis in Crohn’s disease. BMC Gastroenterol. 2010;10:108.
Increased metabolism by imbalanced gut flora may increase levels. Additionally, dietary intake of polyphenols or food preservatives can also increase levels of these organic acids.
Clinical Associations: Elevated levels of urinary hippuric acid have been associated with several clinical conditions that may be linked to dysbiosis. For example, elevated urinary hippurate was associated with an increase in blood pressure, likely due to the direct effect of gut-microbial products on blood pressure. However, in other studies low hippuric acid excretion has also been attributed to dysbiosis, which supports its use as a biomarker for general microbial alterations.
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