Artificial sweeteners are food additives that are used as sugar substitutes. They are used in over 1500 food products such as soft drinks, candy, and desserts. Pregnant women, in an effort to avoid sugar, often turn to these sweeteners. The fact that they are so ubiquitous makes the question of their safety to mother and baby all the more relevant.
Nutritive and Non Nutritive Sweeteners
- Sweeteners that contain calories are called nutritive sweeteners. Examples include sugars such as sucrose (table sugar), fructose (fruit sugar), honey, corn syrup, and dextrose.
- All these sweeteners are safe but do contain calories.
- Women with gestational diabetes and insulin resistence should limit the use of nutritive sweeteners.
- A group of nutritive sweeteners, sugar alcohols, are technically sugar free.(they are not sugar). Examples include sorbitol, mannitol, and xylitol. They do have calories and can contribute to weight gain.
Nonnutritive sweeteners are those that have no calories and are generally 200 to 300 times sweeter than sugar. They are added in a small quantities to food and are approved for use in reduced calorie foods and drinks. The safety of the nonnutritive sweeteners in pregnancy is not well researched.
Are these products OK to use in pregnancy?
The problem in pregnancy is that substances cross the placenta easily and can rapidly accumulate in fetal tissue from repeated maternal ingestion. In addition their clearance in the fetus is slower compared to maternal clearance.
Those that are considered safe include
- Aspartame ( Equal, Nutrasweet)
- Sucrolose (Splenda)
- Acesulfate Potassium (Sunett))
Can I use saccharin?
The main cause for concern in saccharine was a study that found an increase in bladder tumors in rats that were fed excessive doses. The FDA had a ban on its use in 1977. Further research in humans at normal consumption quantities have not shown this to be true. The Council on Scientific Affairs of the American Medical Association in 1985 cautions that “careful consideration of saccharin use by young children and pregnant women.” Warning labels on all saccharin containing foods state ”use of this product may be hazardous to your health. This product contains saccharin, which has been determined to cause cancer in laboratory animals.” Because of this obstetricians do not recommend use during preconception and periconception periods and recommend alternative ways to limit sugar consumption.
What are the facts on aspartame?
This is used as a sweetener in soft drinks, cereals, desserts, and dairy products. The substance is not stable in heat and in liquid forms.
The main concern for aspartame involved reports of central nervous damage, brain lesions, seizures, blindness, cognitive and behavioral changes seen in rodents that were fed excessive doses. The breakdown products of aspartame are aspartate, phenylalanine, and methanol, each of which in excessive amounts can be a source of concern in laboratory animals. None of these problems have been substantiated in humans. The FDA considers aspartame safe for use in pregnancy and during lactation and recommends limiting consumption to moderate levels. Women that have an inherited disorder called PKU (phenylketonuria), where they normally have difficulty in clearing phenylalanine from regular food ingestion, should carefully consider limiting this additive from their regular food intake. All children are tested for PKU at birth.
What about sucrolose?
This is a nonnutritive sweetener that is made from sugar.It contains no calories. It has been approved as an additive to many food products and beverages. It can also be used as a “table-top” sweetener. The FDA deems sucrolose to be safe during pregnancy.
Summary
- Pregnant women should limit their sugar intake especially if they have insulin resistance or gestational diabetes or are concerned about their weight gain.
- When resorting to artificial sweeteners, only those deemed safe should be used.
- Be aware that nutritive sweeteners, contain no sugar but do have calories.
- The nonnutritive sweeteners that are safe in pregnancy (aspartame and sucrolose) should also be used in moderation and long term high dose ingestion should be avoided until further research appears.
- In addition, as in all products, individuals with sensitivity should avoid it.
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