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Diet beverage intake during pregnancy increases childhood obesity risk

High-risk children born to women with gestational diabetes who consumed artificially sweetened beverages during pregnancy were significantly more likely to be large-for-gestational age and be overweight or obese at age 7 years, according to a study by the NIH published in the International Journal of Epidemiology.

“Due to the health concern related to sugar-sweetened beverages in the general population, artificially sweetened beverages have been considered as potential healthier alternatives, although emerging evidence has suggested the contrary,” Yeyi Zhu, PhD, from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and colleagues wrote.

“However, epidemiological data on [artificially sweetened beverage] consumption during pregnancy in relation to offspring longitudinal growth and obesity risk over life span are limited,” they added.

Zhu and colleagues performed a prospective study of 918 mothers with gestational diabetes from the 1996 to 2002 Danish National Birth Cohort to evaluate their intake of artificially sweetened beverages and sugar-sweetened beverages during pregnancy and its effect on offspring growth through age 7 years. They used a food frequency questionnaire to assess maternal dietary intake during pregnancy which was completed at week 25 of pregnancy. At birth, 5 months, 12 months and 7 years, the BMI z-scores (BMIZ) and overweight/obesity status of the offspring were calculated.

Artificially sweetened beverages were consumed by approximately half of participants, with 9% reporting daily consumption. Compared with mothers who never consumed artificially sweetened beverages, those who consumed such beverages daily during pregnancy were 60% more likely to have offspring who were large-for-gestational age (adjusted RR = 1.57; 95% CI, 1.05-2.35 at birth) and twice as likely to have overweight or obese children at age 7 years (aRR = 1.93; 95% CI, 1.24-3.01). In addition, these offspring had a higher BMIZ (adjusted beta = 0.59; 95% CI, 0.23-0.96).

Per-serving-per-day substitution of artificially sweetened beverages with water during pregnancy was associated with a 17% reduction in the risk for offspring being overweight or obese at age 7 years (aRR = 0.83; 95% CI, 0.76-0.91). However, there was no benefit for substituting sugar-sweetened beverages for artificially sweetened beverages (aRR = 1.14; 95% CI, 1-1.31).

The researchers noted that their findings do not verify that maternal artificially sweetened beverage consumption is the cause of weight gain in offspring, as they did not account for other factors that could influence weight gain, such as breastfeeding, diet and physical activity levels.

However, Zhu and colleagues conclude that their results “further raise the questionability of promoting [artificially sweetened beverages] as ‘healthier’ alternatives for [sugar-sweetened beverages], particularly among high-risk pregnant women. Future studies among other populations with longer follow up beyond early childhood are warranted.” – by Alaina Tedesco

Disclosure: The researchers report funding from the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the NIH.