Ashleigh E Reid1, Bhupendrasinh F Chauhan2, Rasheda Rabbani3, Justin Lys3, Leslie Copstein3, Amrinder Mann3, Ahmed M Abou-Setta3, Michelle Fiander3, Dylan S MacKay4, Jonathan McGavock5, Brandy Wicklow5, Ryan Zarychanski6, Meghan B Azad7. 1. College of Medicine. 2. George & Fay Yee Center for Healthcare Innovation, College of Pharmacy, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and. 3. George & Fay Yee Center for Healthcare Innovation. 4. Departments of Human Nutritional Sciences. 5. Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network. 6. George & Fay Yee Center for Healthcare Innovation, Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; 7. George & Fay Yee Center for Healthcare Innovation, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada; and Pediatrics and Child Health, and Manitoba Developmental Origins of Chronic Diseases in Children Network meghan.azad@umanitoba.ca.
Abstract
CONTEXT: Nonnutritive sweetener (NNS) consumption is increasing among children, yet its long-term health impact is unclear, particularly when exposure occurs during early life. OBJECTIVE: To synthesize evidence from prospective studies evaluating the association of early-life NNS exposure and long-term metabolic health. DATA SOURCES: Medline, Embase, and Cochrane Library (inception to July 2015). STUDY SELECTION: We aimed to include randomized controlled trials (RCTs) evaluating NNS-based interventions and prospective cohort studies reporting NNS exposure among pregnant women, infants, or children (<12 years of age), with a minimum study duration of 6 months. DATA EXTRACTION: The primary outcome was BMI; secondary outcomes included growth velocity, overweight/obesity, adiposity, and adverse metabolic effects. Study quality and risk of bias were evaluated using validated assessment tools. RESULTS: We identified 6 eligible cohort studies and 2 RCTs (n = 15,641 children). Half of the cohorts reported increasing weight gain or fat mass accumulation with increasing NNS intake, and pooled data from 2 cohorts showed a significant correlation with BMI gain (weighted mean correlation 0.023, 95% confidence interval 0.006 to 0.041). RCTs reported contradictory effects on weight change in children receiving NNSs. No eligible studies evaluated prenatal or infant NNS exposure. LIMITATIONS: Meta-analysis was limited because of the small number of eligible studies and heterogeneity of populations and outcomes. CONCLUSIONS: There is limited and inconsistent evidence of the long-term metabolic effects of NNS exposure during gestation, infancy, and childhood. Further research is needed to inform recommendations for the use of NNSs in this sensitive population.
CONTEXT: Nonnutritive sweetener (NNS) consumption is increasing among children, yet its long-term health impact is unclear, particularly when exposure occurs during early life. OBJECTIVE: To synthesize evidence from prospective studies evaluating the association of early-life NNS exposure and long-term metabolic health. DATA SOURCES: Medline, Embase, and Cochrane Library (inception to July 2015). STUDY SELECTION: We aimed to include randomized controlled trials (RCTs) evaluating NNS-based interventions and prospective cohort studies reporting NNS exposure among pregnant women, infants, or children (<12 years of age), with a minimum study duration of 6 months. DATA EXTRACTION: The primary outcome was BMI; secondary outcomes included growth velocity, overweight/obesity, adiposity, and adverse metabolic effects. Study quality and risk of bias were evaluated using validated assessment tools. RESULTS: We identified 6 eligible cohort studies and 2 RCTs (n = 15,641 children). Half of the cohorts reported increasing weight gain or fat mass accumulation with increasing NNS intake, and pooled data from 2 cohorts showed a significant correlation with BMI gain (weighted mean correlation 0.023, 95% confidence interval 0.006 to 0.041). RCTs reported contradictory effects on weight change in children receiving NNSs. No eligible studies evaluated prenatal or infant NNS exposure. LIMITATIONS: Meta-analysis was limited because of the small number of eligible studies and heterogeneity of populations and outcomes. CONCLUSIONS: There is limited and inconsistent evidence of the long-term metabolic effects of NNS exposure during gestation, infancy, and childhood. Further research is needed to inform recommendations for the use of NNSs in this sensitive population.
Authors: Meghan B Azad; Ahmed M Abou-Setta; Bhupendrasinh F Chauhan; Rasheda Rabbani; Justin Lys; Leslie Copstein; Amrinder Mann; Maya M Jeyaraman; Ashleigh E Reid; Michelle Fiander; Dylan S MacKay; Jon McGavock; Brandy Wicklow; Ryan Zarychanski Journal: CMAJ Date: 2017-07-17 Impact factor: 8.262
Authors: Anisha Mahajan; Jess Haines; Alex Carriero; Jaimie L Hogan; Jessica Yu; Andrea C Buchholz; Alison M Duncan; Gerarda Darlington; David W L Ma Journal: Nutrients Date: 2022-05-17 Impact factor: 6.706