Evidence does not prove any direct relationship between consumption of diet drinks during pregnancy and higher infant weight

ISA statement in response to the study published in JAMA Pediatrics regarding diet drinks’ consumption in pregnancy and infant BMI

The International Sweeteners Association (ISA) has reviewed the results of the observational study by Azad et al. entitled ‘’Association between artificially sweetened beverage consumption during pregnancy and infant body mass index (BMI)’ published on 9th May in JAMA Pediatrics1, and supports that there is no evidence to prove any direct link between the consumption of low calorie sweetened beverages by women during pregnancy and an increased risk of being overweight in infancy or childhood.

Indeed, the authors acknowledge study limitations such as the observational nature of the study, which cannot prove a causal association. As with all observational studies, the possibility that the results might be influenced by residual and unmeasured confounding factors cannot be excluded. Further study limitations include the potential for error in self-reported dietary outcomes, as the food frequency questionnaire (FFQ) used in this study has not been validated for beverage intake.

Consumption of low calorie sweeteners is safe during pregnancy, based on recent safety assessments by the European Food Safety Authority (EFSA)2,3, and there is no evidence that the daily use of foods or drinks containing them could have any effect on child’s health or BMI. The variety of foods and drinks sweetened with low calorie sweeteners can help satisfy a pregnant woman’s taste for sweetness whilst adding few or no calories. Besides, a considerable number of studies have found that being overweight or gaining a lot of weight during pregnancy increase the risk for childhood obesity later in life4,5, therefore low calorie sweeteners should be seen as a positive dietary alternative for pregnant women who want to manage their energy intake and weight gain during pregnancy or have been diagnosed with gestational diabetes6.

You may find interesting information about the use of low calorie sweeteners during pregnancy in the ISA factsheet ‘Sweet talk on pregnancy and childhood: How can low calorie sweeteners help?’ by clicking here.

Women who are pregnant should consult with their doctor or healthcare professional for further information on pregnancy.

  1. Azad MB, Sharma AK, de Souza RJ, et al. Association Between Artificially Sweetened Beverage Consumption During Pregnancy and Infant Body Mass Index. JAMA Pediatr. 2016;170(7):662–670. doi:10.1001/jamapediatrics.2016.0301
  2. Statement of EFSA on the scientific evaluation of two studies related to the safety of artificial sweeteners. EFSA Journal 2011;9(2):2089 [16 pp.].
  3. Scientific Opinion on the re-evaluation of aspartame (E951) as a food additive. EFSA Journal 2013;11(12):3496 [263 pp.].
  4. Fuemmeller FB et al. Childhood Obesity. May 2016, ahead of print. doi:10.1089/chi.2015.0253.
  5. Lifschitz C. Pediatric Gastroenterol Hepatol Nutr. 2015 Dec; 18(4): 217-23. doi: 10.5223/pghn.2015.18.4.217. Epub 2015 Dec 23.
  6. Fitch C et al. J Acad Nutr Diet. 2012 May;112(5):739-58. doi: 10.1016/j.jand.2012.03.009. Epub 2012 Apr 25.