Format

Send to

Choose Destination
Pediatrics. 2016 Mar;137(3):e20153603. doi: 10.1542/peds.2015-3603. Epub 2016 Feb 25.

Early Exposure to Nonnutritive Sweeteners and Long-term Metabolic Health: A Systematic Review.

Author information

1
College of Medicine.
2
George & Fay Yee Center for Healthcare Innovation, College of Pharmacy, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and.
3
George & Fay Yee Center for Healthcare Innovation.
4
Departments of Human Nutritional Sciences.
5
Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network.
6
George & Fay Yee Center for Healthcare Innovation, Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada;
7
George & Fay Yee Center for Healthcare Innovation, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network meghan.azad@umanitoba.ca.

Abstract

CONTEXT:

Nonnutritive sweetener (NNS) consumption is increasing among children, yet its long-term health impact is unclear, particularly when exposure occurs during early life.

OBJECTIVE:

To synthesize evidence from prospective studies evaluating the association of early-life NNS exposure and long-term metabolic health.

DATA SOURCES:

Medline, Embase, and Cochrane Library (inception to July 2015).

STUDY SELECTION:

We aimed to include randomized controlled trials (RCTs) evaluating NNS-based interventions and prospective cohort studies reporting NNS exposure among pregnant women, infants, or children (<12 years of age), with a minimum study duration of 6 months.

DATA EXTRACTION:

The primary outcome was BMI; secondary outcomes included growth velocity, overweight/obesity, adiposity, and adverse metabolic effects. Study quality and risk of bias were evaluated using validated assessment tools.

RESULTS:

We identified 6 eligible cohort studies and 2 RCTs (n = 15,641 children). Half of the cohorts reported increasing weight gain or fat mass accumulation with increasing NNS intake, and pooled data from 2 cohorts showed a significant correlation with BMI gain (weighted mean correlation 0.023, 95% confidence interval 0.006 to 0.041). RCTs reported contradictory effects on weight change in children receiving NNSs. No eligible studies evaluated prenatal or infant NNS exposure.

LIMITATIONS:

Meta-analysis was limited because of the small number of eligible studies and heterogeneity of populations and outcomes.

CONCLUSIONS:

There is limited and inconsistent evidence of the long-term metabolic effects of NNS exposure during gestation, infancy, and childhood. Further research is needed to inform recommendations for the use of NNSs in this sensitive population.

PMID:
26917671
DOI:
10.1542/peds.2015-3603
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center