Experts recommend caution on the use of non-sugar sweeteners

Despite ongoing concerns about the health impacts of non-sugar sweeteners such as aspartame, sucralose and stevia, these sweeteners are increasingly found in a variety of foods and beverages, including those aimed at children. A viewpoint published in JAMA Pediatrics by three experts on the topic emphasizes that research on the health effects of non-sugar sweeteners in children is urgently needed.

"Given the continued uncertainty about their role in the diet and accumulating evidence suggesting the potential for unfavorable health effects, a cautious approach to non-sugar sweeteners is warranted—especially when it comes to children," said lead author of the viewpoint, Allison Sylvetsky, an associate professor of exercise and nutrition sciences at the George Washington University Milken Institute School of Public Health. Sylvetsky and co-authors propose that the US Food and Drug Administration restrict use of non-sugar sweeteners in food and beverage products marketed to children until there is more definitive evidence of benefit or harm.

Studies in adults demonstrate links between consumption of non-sugar sweeteners and type 2 diabetes, cardiovascular disease and all-cause mortality. However, few researchers have examined health impacts of non-sugar sweeteners when used by children.

At the same time, more and more foods and beverages with non-sugar sweeteners are consumed by children.

Parents often do not realize that products contain non-sugar sweeteners, Sylvetsky says. Parents may choose foods and beverages with non-sugar sweeteners thinking they are healthier, she adds.

Instead of choosing such products, Sylvetsky suggests parents focus on the healthfulness of the overall diet and choose fresh fruit and veggies, whole grains and limit provision of foods and beverages high in added sugars. Instead of buying fruit drinks sweetened with non-sugar sweeteners, stick to water or other unsweetened alternatives, she says.

In addition to Sylvetsky, Natalia Rebolledo at the University of Chile and James Krieger at the University of Washington were co-authors of the piece.