Drinking Diet Beverages During Pregnancy Linked to Child Obesity: NIH Study

07 Jun 2017 --- Children born to women who had gestational diabetes and drank at least one artificially sweetened beverage per day during pregnancy were more likely to be overweight or obese at age 7, compared to children born to women who had gestational diabetes and drank water instead of artificially sweetened beverages, according to a study by the US National Institutes of Health (NIH). The study is published online in the International Journal of Epidemiology.

According to the study authors, as the volume of amniotic fluid increases, pregnant women tend to increase their consumption of fluids. To avoid extra calories, many pregnant women replace sugar-sweetened soft drinks and juices with beverages containing artificial sweeteners. Citing prior research implicating artificially sweetened beverages in weight gain, the study authors sought to determine if diet beverage consumption during pregnancy could influence the weight of children.

“Our findings suggest that artificially sweetened beverages during pregnancy are not likely to be any better at reducing the risk for later childhood obesity than sugar-sweetened beverages,” said the study’s senior author, Cuilin Zhang, Ph.D., in the Epidemiology Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “Not surprisingly, we also observed that children born to women who drank water instead of sweetened beverages were less likely to be obese by age 7.”

The researchers analyzed data collected from 1996 to 2002 by the Danish National Birth Cohort, a long-term study of pregnancies among more than 91,000 women in Denmark. At the 25th week of pregnancy, the women completed a detailed questionnaire on the foods they ate. The study also collected data on the children’s weight at birth and at 7 years old.
In the current study, the NICHD team limited their analysis to data from more than 900 pregnancies that were complicated by gestational diabetes, a type of diabetes that occurs only during pregnancy.

Approximately 9 percent of these women reported consuming at least one artificially sweetened beverage each day. Their children were 60 percent more likely to have a high birth weight, compared to children born to women who never drank sweetened beverages. At age 7, children born to mothers who drank an artificially sweetened beverage daily were nearly twice as likely to be overweight or obese.

Consuming a daily artificially sweetened beverage appeared to offer no advantages over consuming a daily sugar-sweetened beverage. At age 7, children born to both groups were equally likely to be overweight or obese. However, women who substituted water for sweetened beverages reduced their children’s obesity risk at age 7 by 17 percent.

Childhood obesity is known to increase the risk for certain health problems later in life, such as diabetes, heart disease, stroke and some cancers. According to a new study in the journal Obesity Reviews, childhood obesity predicts the risk of adult adiposity, which is associated with the earlier onset of cardiovascular disease. 

It is not well understood why drinking artificially sweetened beverages compared to drinking water may increase obesity risk. The authors cited an animal study that associated weight gain with changes in the types of bacteria and other microbes in the digestive tract. Another animal study suggested that artificial sweeteners may increase the ability of the intestines to absorb the blood sugar glucose. Other researchers found evidence in rodents that, by stimulating taste receptors, artificial sweeteners desensitized the animals’ digestive tracts, so that they felt less full after they ate and were more likely to overeat. 

The authors caution that more research is necessary to confirm and expand on their current findings. Although they could account for many other factors that might influence children’s weight gain, such as breastfeeding, diet and physical activity levels, their study couldn’t definitively prove that maternal artificially sweetened beverage consumption caused the children to gain weight. The authors mention specifically the need for studies that use more contemporary data, given recent upward trends in the consumption of artificially sweetened beverages. They also call for additional investigation on the effects of drinking artificially sweetened beverages among high-risk racial/ethnic groups.

In response to the study, Ailbhe Fallon, a consultant to the food industry, stressed that the epidemiological study does not bear scrutiny in terms of plausible mechanism of action.

“It is widely acknowledged that babies born to mothers with gestational diabetes have a higher risk of being heavy at birth, and a higher risk of developing obesity and type 2 diabetes later in life. Recent work at Imperial College London also points to the babies having higher levels of fat,” she notes.

“While the reasons for these outcomes is yet to be completely understood, pointing to low calorie beverages as a factor risks frightening mothers unnecessarily and may cause them to avoid consuming drinks which, if replacing caloric beverages, may help them to manage their blood sugar levels.”

“All of the low calorie sweeteners are rapidly metabolized; some do not enter the blood-stream at all. It would, therefore, be impossible that they have the effect suggested. Furthermore, the clinical studies required before any low calorie sweetener is approved for use in food and drinks ensures that there is no risk to health, including to people with diabetes, or to expectant mothers and their babies.”

“At a time when overweight, and its consequences, is a major public health concern, speculation based on observation and without reference to the wider scientific context is irresponsible and potentially damaging to helping people maintain a healthy weight,” she concludes.

NutritionInsight currently features an overview of a number of new products with diabetic positioning. Growth continues to be sporadic for new product launches tracked with a diabetic positioning, according to data provided by Innova Market Insights. However, there was a +16% increase in product launch activity in 2016 from 2015.