A recent study from Denmark has raised concerns about the effects of drinking diet beverages during pregnancy, particularly regarding the risk of obesity in children. The study suggests that artificial sweeteners (ASBs), commonly found in diet drinks, may contribute to higher body weight in children years after birth. The findings have prompted experts to reconsider the safety of such beverages for expectant mothers.
Study Overview
Published in the British Journal of Nutrition, the study explores the long-term effects of maternal consumption of artificially sweetened and sugar-sweetened beverages (ASBs and SSBs) during pregnancy. It examines their potential links to overweight and obesity in children from birth through adolescence.
Background
Childhood obesity rates have more than doubled over the past three decades, with excess weight early in life raising the risk of diabetes, heart disease, and other chronic conditions. Many pregnant women turn to ASBs, believing they are a safer alternative to sugary drinks to prevent weight gain. However, growing evidence indicates that artificial sweeteners may disrupt metabolism, affect gut bacteria, or increase sugar cravings—even during pregnancy.
Though studies on this topic show mixed results, some have linked the consumption of artificial sweeteners to obesity in offspring. Given the widespread use of ASBs during pregnancy, further research is critical to better understand their long-term impact on children’s health.
Details of the Study
The research, a nationwide cohort study, used data from the Danish National Birth Cohort (DNBC). The cohort involved 101,042 pregnant women who were enrolled between 1996 and 2002, and their children were followed up to the age of 18. The study tracked maternal ASB and SSB intake through interviews conducted at different stages of pregnancy and early childhood. A food frequency questionnaire was used to measure beverage consumption at 25 weeks of pregnancy, with intake categorized by frequency: none, less than one serving per week, 1-6 servings per week, or more than one serving per day.
Researchers examined outcomes like birth weight, overweight status at various ages (5, 12 months, and 7, 11, 14, and 18 years), using body mass index (BMI) measurements collected by doctors, parents, or adolescents.
Study Results
Out of the original cohort, 66,668 women had valid data on ASB intake, and 66,568 had data on SSB intake. Women who consumed one or more ASBs per day tended to be younger, have a higher pre-pregnancy BMI, and more frequently smoked, compared to women who consumed fewer ASBs.
In the early stages of life, maternal ASB consumption was not associated with an increased risk of overweight or large for gestational age (LGA) babies. However, a clear pattern emerged by age 7, where children of mothers who consumed ASBs were significantly more likely to be overweight at ages 7, 11, 14, and 18 years. This risk remained significant even after accounting for factors such as maternal age, physical activity, and socioeconomic status. Specifically, children whose mothers consumed one or more ASBs per day had an adjusted odds ratio (OR) of 1.26 for being overweight at age 18, indicating a moderate increase in risk.
In contrast, maternal SSB consumption showed a protective effect, with children of mothers who consumed one or more sugary drinks per day being less likely to be overweight at 11 and 18 years. The study noted that mothers who consumed SSBs were generally healthier, with lower pre-pregnancy BMI and higher socioeconomic status, which could partially explain this result.
Further analysis suggested that the association between ASBs and higher BMI z-scores in children was not merely a result of higher calorie consumption. Substituting ASBs with SSBs indicated a lower risk of overweight, hinting that artificial sweeteners themselves might play a role.
Timing of ASB Effects
The effects of ASB intake were not evident in infancy, suggesting that weight differences might emerge as children begin to make their own food choices. This could imply that prenatal exposure to ASBs may influence long-term preferences or metabolic responses. However, the study could not fully rule out unmeasured factors, such as dietary habits after birth, that may also influence outcomes.
Concerns were also raised about the potential for continued ASB consumption after childbirth, possibly exposing infants through breastfeeding. A significant data gap between 12 months and 7 years also limited insights into when the effects of ASBs might first appear.
Conclusion
The Danish study suggests that daily consumption of ASBs during pregnancy is linked to a modest but consistent increase in the risk of overweight in children, particularly from age 7 onward. Interestingly, maternal SSB consumption was associated with a lower risk of overweight, although this finding may be influenced by socioeconomic or lifestyle factors rather than a direct protective effect of sugary drinks.
These results challenge current recommendations for pregnant women, particularly those with overweight or diabetes, who are often advised to substitute sugar with artificial sweeteners. Although the increase in risk is modest, even small effects at the population level could have significant public health implications.
The study’s findings underline the need for further research on the long-term effects of ASBs and the safety of these products during pregnancy. It also calls for a reevaluation of dietary guidelines and exploration of safer alternatives for managing weight gain during pregnancy.
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