Low/no calorie sweeteners are safe for pregnant women

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ISA statement in response to study by Palatnik et al.

Brussels, 8th April 2020*: The International Sweeteners Association (ISA) responds to a new literature review by Palatnik et al., in which the authors discuss selected studies looking at the use of low/no calorie sweeteners in pregnancy.1 Contrary to the claims by Palatnik et al., the safety of low/no calorie sweeteners, including during pregnancy, has been repeatedly and consistently confirmed by food safety authorities around the world.2

For a low/no calorie sweetener to be approved for use on the market, it must first undergo a thorough safety assessment by the competent food safety authority. The most prominent scientific regulatory bodies around the world have consistently confirmed that low/no calorie sweeteners are safe for use, also during pregnancy. These include, for example, the Joint Expert Scientific Committee on Food Additives (JECFA)3 of the United Nations Food & Agriculture Organization (FAO) and of the World Health Organization (WHO), the European Food Safety Authority (EFSA)4 and the US Food and Drug Administration (FDA).5

The new publication by Palatnik et al. ignores the results of key studies required by regulatory agencies and which show no effect on pregnancy, growth, and development. Furthermore, allegations of effects on the gut microbiota have not been confirmed, as demonstrated in a recent comprehensive review of studies on this subject.6

At a time when obesity and non-communicable diseases including diabetes and dental diseases remain major global health challenges, and in light of current public health recommendations to reduce overall sugar intake, low/no calorie sweeteners can be helpful in creating healthier food environments. They provide people with a wide choice of sweet-tasting options with low or no calories, and thus can be a useful tool, when used in place of sugar and as part of a balanced diet, in helping reduce overall sugar and calorie intake, as well as in managing blood glucose levels, including for pregnant women who may be at risk of gestational diabetes.7 Low/no calorie sweeteners are also not fermentable by oral bacteria, which means that they do not contribute to tooth demineralisation, which is one of the reasons for tooth decay.7

*updated 9th April 2021

  1. Palatnik A, Moosreiner A, Olivier-Van Stichelen S. Consumption of Non-Nutritive Sweeteners in Pregnancy. Am J Obstet Gynecol. 2020; 223(2): P211-P218
  2. Pyrogianni V. Letter to the editors regarding the article “Consumption of non-nutritive sweeteners in pregnancy”. Am J Obstet Gynecol. 2020; 223(5): P776-777
  3. http://www.fao.org/food/food-safety-quality/scientific-advice/jecfa/en/
  4. http://www.efsa.europa.eu/en/topics/topic/sweeteners
  5. https://www.fda.gov/food/food-additives-petitions/high-intensity-sweeteners
  6. Lobach A, Roberts A, Rowland I. Assessing the in vivo data on low/no-calorie sweeteners and the gut microbiota. Food and Chemical Toxicology 2019; 124: 385-399
  7. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076. http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2012:136:0001:0040:en:PDF