ASB intake during pregnancy influences infant birth size, obesity risk in childhood
Intrauterine exposure to artificially sweetened beverage (ASB) contributes to an increase in birth size and in the risk of overweight or obesity at 7 years of age, a study has found.
The prospective study included 918 mother-singleton child pairs from the Danish National Birth Cohort. Maternal dietary intake during pregnancy was evaluated using a food frequency questionnaire. Offspring body mass index z-scores (BMIz) and overweight/obesity status were assessed using weight and length/height at the following time points: birth, 5 and 12 months, and 7 years.
Consumption of ASBs during pregnancy was reported by approximately half of the mothers, whereas daily consumption was reported by 9 percent. Linear and Poisson regression analyses found that compared with never consumption, daily ASB intake during pregnancy was positively associated with infant large-for-gestational age (adjusted relative risk [aRR], 1.57; 95 percent CI, 1.05 to 2.35), BMIz (adjusted β 0.59; 0.23 to 0.96), and overweight/obesity status at 7 years (aRR, 1.93; 1.24 to 3.01).
Per-serving-per-day replacement of ASBs with water during pregnancy was associated with a nearly 20-percent reduction in the risk of overweight/obesity at 7 years (aRR, 0.83; 0.76 to 0.91), whereas replacing sugar-sweetened beverages with ASBs did not afford such a benefit (aRR, 1.14; 1.00 to 1.31).
Sugar replacements or nonnutritive sweeteners have become increasingly popular as a result of population-wide recommendations. It is said that sweet taste is usually accompanied by energy intake, with previous experiments suggesting that when oral or gut receptors are exposed to artificial sweeteners, hormonal signals between the gut and the brain could stimulate appetite and result in weight gain. However, identifying the mechanisms underlying the effect of intrauterine ASB exposure on infant weight and BMI might depend on the chemical structure of the sweetener. [JAMA Pediatr 2016;170:642-3; Diabetes Care 2009;32:2184-2186; 2012;35:959-964]