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Editorial |

Maternal Consumption of Artificially Sweetened Beverages and Infant Weight Gain Causal or Casual?

Mark A. Pereira, PhD1; Matthew W. Gillman, MD, SM2,3
[+] Author Affiliations
1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
2Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
3Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts
JAMA Pediatr. 2016;170(7):642-643. doi:10.1001/jamapediatrics.2016.0555.
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In adults and children, artificial sweeteners, also known as nonnutritive sweeteners, may increase the risk of obesity and metabolic disorders. Much research on nonnutritive sweeteners has focused on artificially sweetened beverages (ASBs) for several reasons: their consumption has increased over the last 30 years, they are the largest single contributor to overall intake of nonnutritive sweeteners,1,2 and they are a counterpart to the oft-implicated sugar-sweetened beverages (SSBs). Sweet taste is usually accompanied by energy intake, but this link is uncoupled by ASBs. Rodent36 and small acute human7,8 experiments suggest that when oral or gut receptors are exposed to artificial sweeteners, hormonal signals between the gut and the brain may stimulate appetite and lead to weight gain. Investigators have also raised the possibility that artificial sweeteners may alter the gut microbiome in ways that are linked to cardiometabolic risk.6 Some epidemiologic studies9,10 have shown that the higher the consumption of ASBs, the higher the subsequent risk of developing obesity and type 2 diabetes, yet the evidence is far from conclusive. Results of observational studies conflict with each other, and to our knowledge, no intervention trials in humans have found an obesogenic effect of consuming ASBs.11

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