Artificial sweeteners, also known as sugar substitutes, are chemicals that are many times sweeter than table sugar so smaller amounts are needed to create the same level of sweetness. The sweeteners approved by the Food and Drug Administration include the following: saccharin, aspartame, acesulfame potassium, sucralose, stevia, neotame and advantame. People choose to use these chemicals to avoid the bad effects known to happen with nutritive sweeteners such as sugar. The initial worry about using these chemicals was the concern about the possibility of causing cancer but studies have not shown that to be a risk.
However there is still much unknown about their use regarding their impact on appetite and taste preference, how much is used in the pediatric population, and their impact on pediatric obesity, metabolic syndrome, attention-deficit/hyperactive disorder and autism. Recently a policy statement was published in Pediatrics by the Committee on Nutrition with the following findings and recommendations.
Key findings are the following: FDA approved nonnutritive sweeteners are 180-20,000 times sweeter than sugar; long-term safety of their use in children has not been studied; consumer products containing these agents has quadrupled over the past several years; maybe their use will reduce weight gain and promote weight loss and they recommend that FDA require labels to list the type and amount of these sweeteners.
They also give the following advice for health care providers to give to parents. Nonnutritive sweeteners are FDA approved for human use under the category as Generally Recognized As Safe (GRAS). A GRAS designation is based on the idea of an acceptable dietary intake. At this point in time it is not possible to measure how much an individual consumes daily. Data suggest nonnutritive sweeteners help with weight stabilization and/or weight loss in the short term but long-term data is lacking. There is high-quality evidence that suggest there is no association between nonnutritive sweetener use in children and attention deficit hyperactivity disorder (ADHD). The National Institute of Heath describes concerns of the effect of the sweeteners on healthy gut microbes that help digest food and use glucose. This might lead to weight gain. There is concern that the intensely sweet taste of artificial, low calorie sweeteners can lead to a “sweet tooth” or preference for sweet things.
When children grow up eating a lot of sweet foods they tend to develop a preference for sweets. If given a variety of healthy foods such as fruits and vegetables early in life, they’ll develop a liking for them also.
The key to good health is eating a well-balanced diet with a variety of foods and getting plenty of physical activity
Sally Robinson, MD Clinical Professor
Keeping Kids Healthy
1/3/2019
Also See: UTMB Pediatrics - Pediatric Primary Care