Pregnant women avoiding extra calories by drinking beverages with artificial sweeteners may be placing their offspring at greater risk of being overweight or obese by the age of seven according to research published in the International Journal of Epidemiology.
Approximately half of women reported consuming artificially sweetened beverages (ASBs) during pregnancy and 9% consumed daily.
In a prospective study of 918 mother-singleton child dyads from the Danish National Birth Cohort, maternal dietary intake was assessed by a food frequency questionnaire during pregnancy.
With findings showing a positive association between intrauterine exposure to artificially sweetened beverages, the researchers suggest their findings are biologically plausible.
“The high-intensity artificial sweeteners compared with glucose or sucrose may exacerbate glucose intolerance at a greater magnitude via alteration of gut microbiota, increasing intestinal glucose absorption through the apical glucose transporter and promoting excessive intake and weight gain via dysregulation of sweet taste and caloric reward,” the authors explained.
After adjusting for major maternal and offspring covariates, daily ASB consumption during pregnancy compared with never consuming ASB was positively associated with offspring risk of large-for-age gestational age (LGA). This LGA is defined as birthweight greater than the sex- and gestational age-specific 90th percentile based on the entire Danish National Birth Cohort population (n= 101402).
“Daily ASB consumption during pregnancy compared with never, was positively associated with offspring risk of LGA, (aRR, 1.57; 95%CI, 1.05-2.35) and overweight/obesity at 7 years (aRR 1.93; 95%CI, 1.24 -3.01 but during infancy,” the authors said.
Per-serving-per-day substitution of ASBs with water during pregnancy was related to a lower overweight and obesity risk at 7 years (aRR 0.83; 95% CI: 0.76, 0.91).
The study also asserts that unfavourable early life factors, such as sub-optimal breast feeding duration may exacerbate the potential adverse effects of intrauterine ASB exposure on childhood risk of overweight and obesity.
“Further, our findings suggest that pregnancy is an important window of susceptibility to ASBs in relation to risk of offspring diabetes. The shifting beverage landscape with an overall increasing trend of ASB consumption during the past decades necessitates further investigation.
“Our study further raises the question ability of promoting ASBs as ‘healthier’ alternatives for sugar-sweetened beverages, particularly among high-risk pregnant women. Future studies among other populations with longer follow-up beyond early childhood are warranted,” the authors concluded.
International Journal of Epidemiology 2017, 1-10. DOI: 10.1093/ice/dxy095