Consumed by at least one out of four children, artificial or non-nutritive sweeteners are a growing part of US diets. A new American Academy of Pediatrics (AAP) policy statement sheds light on how these non-nutritive sweeteners may affect children's weight, taste preferences, the risk for diabetes, and long-term safety. The AAP policy statement 'The Use of Non-nutritive Sweeteners in Children', published in the Journal November 2019 Pediatrics, suggests that the amount of these no or low-calorie sweeteners should be mentioned on product labels so families and researchers can better assess as to how much children are consuming and any possible health effects.
"Looking at the evidence, we found there's still a lot to learn about the impact of non-nutritive sweeteners on children's health," said Carissa Baker-Smith, MD, MPH, FAAP, lead author of the AAP policy statement and an associate professor of pediatrics at the University of Maryland School of Medicine.
"We need more research into the use of non-nutritive sweeteners and the risk for obesity and Type 2 diabetes, especially in children. Considering how many children are regularly consuming these products - which have become ubiquitous -- we should have a better understanding of how they impact children's long-term health."
To mimic the taste of sucrose (table sugar) without adding calories, non-nutritive sweeteners were introduced into the food supply more than 60 years ago. There are about 8 non-nutritive sweeteners that are approved by the US Food and Drug Administration (FDA).
Saccharin, aspartame, acesulfame-potassium, sucralose, neotame, and advantame are approved as food additives, while stevia and Luo Han Guo (monk fruit) are approved under the 'generally recognized as safe' (GRAS) designation. These products are 180 to 20,000 times sweeter than sugar.
As per the AAP, the majority of short-term studies suggest that substituting a non-nutritive sweetener for sugar may promote small amounts of weight loss in children and reduce weight gain. But at the same time, the data is limited.
There are also some studies that suggest links between the use of non-nutritive sweetener and changes in the gut microbiome, as well as in the taste preferences and appetite, which may affect blood sugar levels and lead to insulin resistance, diabetes, metabolic syndrome and weight gain. However, findings remain inconsistent.
Since these sweeteners are now so widely available and consumed, the AAP recommends manufactures to report non-nutritive sweetener content on labels, rather than just listing them among ingredients.
"It is currently hard to know how much non-nutritive sweetener is in a product since manufacturers aren't required to specify," Dr Baker-Smith said.
"Listing the amount of non-nutritive sweetener a product contains would help families and researchers understand how much is actually being consumed by individuals and populations and further evaluate potentially related health effects," Dr Baker-Smith said.
Knowing the amounts of non-nutritive sweeteners in products would also help ensure children's consumption remains below acceptable daily intake levels, Dr Baker-Smith said.
If you want to ditch refined sugar and looking for alternatives, here is a list of 4 natural sweeteners:
(Note: The list of natural sweeteners is not part of the study.)