Canadian researchers have found that daily maternal artificial sweetener consumption during pregnancy is associated with higher infant BMI and an increased risk of an infant being overweight at 1 year of age.
One third of children in the developed world are overweight or obese with a higher risk for developing metabolic, cardiovascular and mental diseases later on. Research has shown that childhood obesity starts in early life and it seems that prenatal maternal diet has a key role in its development. Almost one third of pregnant women consume artificially sweetened beverages (ASB) regularly. The American Dietetic Association states that ASB are safe to be consumed during pregnancy and early childhood, while the US Institute of Medicine warns that non-nutritive sweeteners (NNS) have adverse long-term effects when consumed in childhood. Animal studies indicate that NNS consumption during pregnancy may predispose offspring to developing obesity and metabolic syndrome.
In a new article published in JAMA Pediatrics as part of the CHILD (Canadian Healthy Infant Longitudinal Development) Study, researchers investigated the association between ASB consumption during pregnancy and obesity in infancy. 3033 mothers completed a food frequency questionnaire in the second or third trimester of their pregnancy. They were asked about their diet or normal soft drink/pop consumption and their usage of artificial sweetener or sugar/honey in their coffee or tea. 2413 out of 3033 cases had complete data for infant BMI at 1 year of age and all covariates (infant sex, birthweight, gestational age, maternal age, maternal pre-pregnancy BMI, maternal education, prenatal smoking, maternal diabetes, breastfeeding, timing of introduction of solid foods).
The mean maternal age was 32.5 years, mean maternal BMI was 24.8. 78.2% of mothers had post-secondary education, 7.9% smoked during pregnancy and 5.8% had diabetes. The mean infant BMI z-score was 0.19 at 1 year of age, and 5.1% of infants were overweight. 29.5% of mothers consumed ASB during pregnancy and 5.1% reported daily consumption, while 77.2% of mothers consumed sugar-sweetened beverages (SSB), 23.4% of which consumed SSB daily. ASB and SSB consumption were associated with maternal smoking, higher maternal BMI, lower maternal diet quality, and shorter breastfeeding duration. Consumption of ASBs was further associated with earlier introduction of solid foods, while SSB consumption was associated with lower maternal education and higher total energy intake.
The highest BMI z-scores were found in infants born to mothers who consumed ASBs daily. The significant association between daily ASB consumption and increased infant BMI z-score was independent from the other covariates. However, drinking SSBs was not associated with infant BMI z-scores. The highest incidence of overweight was observed among the infants born to mothers who consumed ASBs every day. The study also revealed that ASB consumption only affected male infants.
This was the first human study that provided evidence that artificial sweetener consumption during pregnancy may increase the risk for childhood obesity. Further studies are needed to investigate the underlying biological mechanisms, evaluate specific NNS and determine longer-term outcomes.
Written By: Dr. Fanni R. Eros