Artificial sweeteners may help reduce sugar intake, but too much can lead to health issues over time.
Artificial sweeteners (ASs) have become a staple in the modern diet, especially for individuals looking to reduce their sugar intake while maintaining a sweet taste in their food and drinks. These sugar alternatives offer high sweetness with minimal calories, making them particularly attractive to people managing conditions like type 2 diabetes or those aiming to avoid weight gain. However, the long-term effects of AS consumption, especially during pregnancy, have been a subject of ongoing research, with some studies raising concerns about potential risks to both the mother and the unborn child.
One recent study published in Nutrients investigated the relationship between artificial sweetener intake and adverse pregnancy outcomes (APOs) using Mendelian randomization (MR). This research method helps identify causal associations by using genetic variants, allowing for a clear understanding of whether AS consumption directly influences pregnancy outcomes, or if other factors, such as underlying health conditions, might play a role.
Researchers gathered genome-wide association study (GWAS) data from the publicly available IEU Open GWAS Project and analyzed the data using various methods to identify any significant correlations between AS intake and adverse outcomes and discovered some interesting facts. One-third of participants in the Randomized Control Trial of Low Glycemic Index Diet in Pregnancy reported using ASs, and more than half continued their use even when advised to follow a low-glycemic diet.
The impact of AS consumption on pregnancies has been examined in several observational studies, with mixed results. Some have linked AS use to low birth weight, preterm delivery, and gestational diabetes, while others have found no significant complications. However, observational studies are often limited by confounding factors, such as maternal body mass index (BMI) or pre-existing conditions like diabetes, making it difficult to determine whether the sweeteners themselves are harmful or if the risks are related to other aspects of the mothers’ health.
Another notable finding in the current study was that AS consumption in tea was linked to an increased risk of ectopic pregnancy in a univariable MR analysis. However, after adjusting for maternal BMI and the presence of type 2 diabetes, the multivariable MR results indicated that AS consumption in cereal was actually associated with a 67% reduced risk of ectopic pregnancy. This suggests that the form in which ASs are consumed, along with other health factors, may influence pregnancy outcomes.
The study also found that AS consumption in cereal was linked to an 89% reduction in the risk of placenta previa, a condition where the placenta covers the cervix, potentially leading to complications during delivery. On the other hand, consuming ASs in coffee appeared to increase the risk of premature rupture of membranes (PROM) by 62%. Interestingly, the risk of PROM was already known to be higher in individuals who drink three or more cups of coffee daily during the first trimester, so this finding highlights the importance of understanding how different AS-containing foods and beverages may affect pregnancy.
Despite these associations, the study did not find evidence linking AS consumption to gestational diabetes, weight gain, or pre-eclampsia, conditions that have been suggested in previous research. This lack of association was notable, given that ASs are often used by people with or at risk of diabetes. It also highlights the need for further research to clarify the complex relationships between AS consumption, metabolic health, and pregnancy outcomes.
Sources:
Relationship between intake of artificial sweeteners and adverse pregnancy outcomes
Artificial Sweetener and the Risk of Adverse Pregnancy Outcomes: A Mendelian Randomization Study
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