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Science Supports Safety of Low-Calorie Sweeteners in Pregnancy

AJCN Study Regarding Pre-term Labor and Diet Soft Drinks Misleading

Atlanta (July 8, 2010) – A new study, “Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study of 59,334 Danish pregnant women,” published in the July online (ahead of print) edition of the American Journal of Clinical Nutrition regarding the use of diet soft drinks during pregnancy ignores the weight of the scientific literature and provides misleading conclusions.

The use of low-calorie sweeteners in pregnancy has been well studied both in humans and in animals. Before approving the currently available low-calorie sweeteners, the U.S. Food and Drug Administration (FDA) determined that the low-calorie sweeteners are safe for all populations, including special groups such as the elderly, children, and pregnant and lactating women. Further, leading health groups such as the American Dietetic Association and American Diabetes Association support the safe use of low-calorie sweeteners during pregnancy.

The following outlines the Calorie Control Council’s concerns regarding the study:

  • Multi-generational studies have found no adverse effects on the mother or developing baby related to the use of low-calorie sweeteners.
  • Less than five percent of the women in the study experienced pre-term labor and one-third of those were medically induced. Moderate preterm delivery (defined as delivery between 32 and 34 weeks) was less than one percent and early pre-term delivery (prior to 32 weeks) was less than half a percent.
  • We question the merging of the three highest intake groups into one group in data analysis since such a procedure tends to enhance statistical significance. Given the large sample size, this merging of groups might predispose their analysis to biologically meaningless statistical significance.
  • Even though smoking and socioeconomic status were entered in the multivariate analysis as adjustment variables, we note that there was a relatively “high” prevalence of smoking during pregnancy and also, women using diet beverages also smoked on a daily basis and this accounted for 12-31 percent of those women. Smoking has been linked to adverse outcomes in pregnancy including pre-term labor. Further, these same women were more likely to be part of a lower socioeconomic group (94 percent or higher), which can also play a role in prenatal care and appropriate treatment.
  • The study is epidemiological in nature and cannot show cause and effect. The authors note, “As with all observational studies, we cannot exclude that our findings may be a result of unidentified and unadjusted confounders.”

Beth Hubrich, a dietitian with the Council noted, “This study may unduly alarm pregnant women. While this study is counter to the weight of the scientific evidence demonstrating that low-calorie sweeteners are safe for use in pregnancy, research has shown that overweight and obesity can negatively affect pregnancy outcomes. Leading health groups support the use of low-calorie sweeteners in pregnancy. Further, low-calorie sweeteners can help pregnant women enjoy the taste of sweets without excess calories, leaving room for nutritious foods and beverages without excess weight gain – something that has been shown to be harmful to both the mother and developing baby.”

faq2Do you have questions about low-calorie sweeteners? Want to learn more about maintaining a healthy lifestyle? You asked and we listened. Our resident Registered Dietitians answered the most popular questions about low-calorie sweeteners.

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