Non-sugar sweetener consumption could be linked to poor health in children, review flags

29 Jan 2024 --- Three researchers from the University of Washington, US, and the University of Chile propose that the US Food and Drug Administration (FDA) restrict the use of non-sugar sweeteners in food and beverage products marketed to children until there is conclusive evidence of the benefits and side effects. Their worries come in light of mounting concerns about the health impacts of non-sugar sweeteners.

“Consumption of some non-sugar sweeteners, such as sucralose and saccharin, have been shown to alter bacteria in the gastrointestinal tract and lead to the development of glucose intolerance,” Allison Sylvetsky, associate professor of exercise and nutrition sciences at George Washington University Milken Institute School of Public Health and lead author of the study, tells Nutrition Insight.

“In addition, analyses of dietary intake among children in the US demonstrate that those who consume beverages with non-sugar sweeteners consume more total calories than children who consume only unsweetened beverages and similarly added sugar intakes to children who consume sugary drinks.”

Several studies in adults have observed a correlation between the consumption of non-sugar sweeteners and cardiometabolic disorders such as type 2 diabetes, cardiovascular disease and all-cause mortality. Yet, few researchers have examined its health impacts on children.

Are non-sugar sweeteners healthier?
Ongoing concerns about the health impacts of aspartame, sucralose and stevia from the scientific community have yet to be noticed. At the same time, sweeteners are continuously used in various foods and beverages, including those aimed at children.

The researchers’ perspective, titled “Non-sugar sweeteners: Time for Transparency and Caution,” has been published in JAMA Pediatrics and stresses the importance of more health research.

“Non-sugar sweeteners are widely found in products marketed to children and their consumption among children is increasing. This trend is expected to continue considering the continued public health emphasis on reducing added sugar intake. Yet research about the health effects of non-sugar sweeteners among children is currently lacking,” Sylvetsky explains.

The main reason children consume artificial sweeteners is that parents are unaware that the products contain the sweeteners and that they choose foods and beverages because they think it’s healthier.

“One of the biggest gaps in this area (of research) is the need to better assess exposure to non-sugar sweeteners. Because the amount of non-sugar sweeteners added to food and beverage products is not publicly available, it is difficult to monitor exposure, which is a barrier to investigating their effects,” she says.Researchers are calling for more studies about the health effects of non-sugar sweeteners on children.

“It is important to conduct research that better reflects how non-sugar sweeteners are consumed in real life. Non-sugar sweeteners is an umbrella term for a variety of different compounds, yet little research to date has compared the effects of the different types on non-sugar sweeteners and dietary and health outcomes.” 

Cultivating healthy habits
Sylvetsky recommends parents focus on the healthfulness of the overall diet of their children and select fresh fruit and vegetables and whole grains while limiting foods high in added sugar. Instead of buying fruit drinks sweetened with non-sugar sweeteners, parents should stick to water or other unsweetened alternatives.

“Some ways for parents to avoid providing products with non-sugar sweeteners for their children are to carefully read the ingredients lists on packaged products, provide their children with plain water and add fresh fruit to water or add a splash of 100% fruit juice to make water more fun,” Sylvetsky explains.

“Given the continued uncertainty about their role in the diet and accumulating evidence suggesting the potential for unfavorable health effects, a cautious approach to non-sugar sweeteners is warranted — especially when it comes to children.” 

Many studies evaluating the role of non-sugar sweeteners in diet and health focus on diet beverages, while non-sugar sweeteners are found in various food and beverage products. 

Meanwhile, the World Health Organization said the long-term use of non-sugar sweeteners does not have long-term benefits in reducing body weight and may have undesirable effects, such as the risk of type 2 diabetes, cardiovascular diseases and premature mortality in adults. 

By Inga de Jong