Are Artificial Sweeteners During Pregnancy Safe? | Plant Nutrition Wellness

July 29, 2022

The frenzy over using artificial sweeteners as a low-calorie alternative to sugar has been around for decades. Despite these years of use and research, whether or not they are safe or ‘healthy’ is still hotly debated. Determining the safety of artificial sweeteners during pregnancy only adds an extra layer of confusion into the mix.

If you’re confused about whether or not it is safe to use artificial sweeteners during pregnancy,  I don’t blame you. The current evidence pool is a topic of debate amongst health professionals and non-health professionals alike.

To ease your mind, we have sorted through the most recent evidence base from pregnancy nutritionists, pregnancy dietitians, and other expert sources. Here is what we found regarding whether you can add some artificial sweeteners into your pregnancy diet.

 

What are artificial sweeteners?

First, it’s essential to define what an artificial sweetener is, as this term doesn’t relate to all of our no-calorie sweeteners.

Despite often all being thrown together in the artificial sweetener bag, there are 3 types of no-calorie sweeteners currently used in our foods.

These include:

  • Artificial sweeteners e.g. sucralose, saccharin and aspartame
  • Sugar alcohols e.g. mannitol, sorbitol and xylitol
  • Novel sweeteners (often labelled as a more natural alternative) e.g. stevia and monk fruit

To focus on artificial sweeteners more specifically, these are ingredients made in labs out of chemicals. They are very sweet to taste yet very low in calories. In fact, they can be up to 600x sweeter than regular table sugar. This means that you need a much smaller amount to get the same level of sweetness.

Although made from chemicals, their use in food products is heavily regulated by all national food governing bodies, including Australia’s, to ensure that only those deemed safe are put on our shelves.

Here are a few specific artificial sweeteners you may come across when looking in the supermarket:

  • Aspartame (e.g. Equal)
  • Saccharin
  • Sucralose (e.g. Splenda)
  • Cyclamate
  • Acesulphame potassium or ‘Ace K’

 

are artificial sweeteners safe during pregnancy from a pregnancy dietitian

 

How do they compare to sugar alcohols?

Sugar alcohols are found in products such as sugar-free mints, gum and lollies. You can also find them down the ‘health food’ aisle in low-carb or sugar-free products such as protein bars.

You can easily spot them in the ingredients section by looking for an ‘ol’ at the end of the word. For example, sorbitol, mannitol, maltitol and xylitol as well as isomalt, which is the one exception to the rule.

Sugar alcohols are low in calories and not well absorbed by the body.

You may notice statements on the packaging of products they are found in such as, “high consumption may also have a laxative effect”.  Sugar alcohols can cause some unpleasant digestive side effects such as bloating, gas, diarrhoea and abdominal pain in some individuals.

 

What about stevia and monk fruit?

Novel sweeteners, such as stevia and monk fruit as well as the lesser-known tagatose, allulose and inulin, are often referred to as ‘natural sweeteners.’ They are typically derived from plant sources (e.g. the stevia plant) and are less processed than their alternatives such as artificial sweeteners and sugar alcohols.

 

Is it safe to use artificial sweeteners during pregnancy?

Most (but not all) artificial sweeteners have been deemed safe to use during pregnancy by Australia and New Zealand’s food safety governing body FSANZ (1).

Although they are marked as safe to consume, there is a growing body of evidence to suggest they may have some problematic side effects during pregnancy.

Most importantly, research has found that artificial sweeteners, such as saccharin, aspartame and potentially Ace K, cross the placenta (2, 3, 4). Just as your baby is exposed to the nutrients you consume that cross the placenta, they are likely also going to be exposed to these chemicals.

While research has been done to determine a safe level of these chemicals for adult consumption, there is nowhere near enough research currently to say that this is also safe for a foetus (5).

 

pregnancy dietitian and nutritionist, fertility dietitian

 

Additionally, a 2018 review from Cambridge University on the effect of sugar and alternative sweeteners during pregnancy on maternal and child health found that there is some evidence to suggest a negative impact of alternative sweeteners (such as artificial sweeteners) on infant outcomes.

This included increased risk of preterm birth, higher than average birth weight, and increased preference for sweet foods. So far, there is no information on the potential long-term risks of infant exposure to these chemicals. Ultimately, the study concluded that much more research is needed in the area (5).

An earlier Canadian review in 2014 had similar findings. They concluded that more research is needed to fully understand the effects of artificial sugar exposure to infants whilst in the womb. However, they did ultimately recommend that sugar substitutes can be consumed in “moderate amounts” as so far, no research has found strong evidence to suggest adverse effects (6).

 

Which artificial sweeteners during pregnancy are safe?

Most, but not all artificial sweeteners have been deemed safe during pregnancy.

Currently, the safe ones include:

 

Aspartame

Acceptable daily limit (ADI) – 40mg aspartame per kg body weight (7)

Although aspartame does cross the placenta during pregnancy, research has found that doses of up to 200mg per kg body weight (which is 5x the ADI) don’t lead to negative effects in offspring.

Based on these findings, having aspartame is not expected to be unsafe during pregnancy so long as intake is kept within the ADI (6).

However, women who suffer from phenylketonuria (a rare medical condition where the body can’t break down phenylalanine) should avoid aspartame. This is because phenylalanine is a digestive byproduct of aspartame which can become toxic when it accumulates in large amounts (8).

 

Sucralose

Acceptable daily limit (ADI) – 5mg sucralose per kg body weight (9)

So far to date, research has found no increased risk of any adverse effects to infants with high-dose sucralose exposure during pregnancy. However, these are only animal studies, which are not 100% comparable to humans.

It is recommended to keep intake below the ADI (6).

 

Acesulphame potassium or ‘Ace K’:

Acceptable daily limit (ADI) – 0-15mg Ace K per kg body weight (10)

There is currently very little research available on the safety of Acesulphame potassium, also known as Ace K, during pregnancy. Similarly to aspartame, there is research that suggests it crosses the placenta, meaning it is likely a growing baby will be exposed to it when eaten (11).

Animal studies have also found that foetuses exposed to the sweetener had an increased preference for sweet foods later in life compared to those who were not exposed. However, the mice in this study were fed Ace K in amounts far greater than the ADI (12)

Currently, having Ace K is considered safe during pregnancy so long as it is within the ADI (6). However, you will see above that in Australia the ADI ranges between zero to 15mg per kg body weight, making things a bit more confusing.

The safest bet is to keep intake of this one to an absolute minimum.

 

pregnancy dietitian on artificial sweteeners during pregnancy

 

Which artificial sweeteners are NOT safe during pregnancy?

In terms of the artificial sweeteners deemed UNSAFE during pregnancy, these include saccharin and cyclamate. These sweeteners should be avoided by all pregnant and lactating women.

 

Saccharin

Saccharin is well-known by researchers to cross the placenta during pregnancy (13).

One study even found that repeated intake by pregnant women can lead to a considerable amount of accumulation of the chemical in foetuses (14). As such, current guidelines recommend avoiding intake of saccharin during pregnancy to keep on the safe side (6).

 

Cyclamate

There is currently little research available regarding cyclamate use during pregnancy. It is currently recommended to be avoided during pregnancy as it is known to cross the placenta and accumulate in foetuses (15, 16).

NOTE: Both saccharin and cyclamate are deemed safe for use by the general public.

 

What about using sugar alcohols and novel sweeteners during pregnancy?

Similarly to artificial sweeteners, there is also little information available regarding the safety of sugar alcohols during pregnancy.

The current consensus is they are safe ‘when consumed in moderation’ (6). They fail to mention exactly how much ‘moderation’ refers to. This is another one we’d recommend keeping to a minimum. We also recommend discussing this with your pregnancy dietitian for individualised advice.

The same goes for novel sweeteners such as Stevia and monk fruit. Currently, there have only been rat studies testing the safety of Stevia during pregnancy. So far they have found no negative effects with consumption.

But again, rats are not humans, so this information does need to be taken with caution (6).

When it comes to monk fruit, even less research has been done regarding pregnancy. If you go by current government guidelines, both Stevia and monk fruit are considered to be safe during pregnancy. We recommend not to go too overboard, using it only in small amounts and only if needed (again it is recommended to speak to a dietitian for more individualised advice).

 

artificial sweeteners during pregnancy, adding artificial sweetener to coffee or tea

 

So, what’s the general consensus?

Ultimately, with the limited amount of research available to say whether artificial sweeteners during pregnancy are safe for you and your growing bub,  we believe that the best option is to avoid them as much as possible to air on the side of caution.

Instead, we recommend opting for a small amount of the real deal whether that be regular table sugar, maple syrup, agave or honey to help give your foods that added sweetness.

That being said, consuming the occasional artificial sweetener (except for saccharin and cyclamate) is likely nothing to stress about and has been deemed ‘safe’.  Plus, artificial sweeteners can play a helpful role in certain circumstances such as gestational diabetes where limiting sugar intake is crucial for your baby’s health.

If you want to optimise your diet during pregnancy, our pregnancy dietitian nutritionist Georgia D’Andrea is an expert in all things plant-based fertility, pregnancy and post-natal nutrition. You can book an appointment today.

 

References

  1. https://www.foodstandards.gov.au/consumer/additives/Pages/Sweeteners.aspx
  2. https://pubmed.ncbi.nlm.nih.gov/3756841/
  3. https://pubmed.ncbi.nlm.nih.gov/2862125/
  4. https://www.scielo.cl/pdf/ijmorphol/v28n3/art25.pdf
  5. https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/effects-of-consuming-sugars-and-alternative-sweeteners-during-pregnancy-on-maternal-and-child-health-evidence-for-a-secondhand-sugar-effect/2F31AE3E8099B7989ABB69F4E1EB97F5#ref55
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229159/
  7. https://www.foodstandards.gov.au/consumer/additives/aspartame/Pages/default.aspx
  8. http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/food-aliment/sugar_sub_sucre-eng.php
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982014/#:~:text=The%20acceptable%20daily%20intake%20(ADI,%2Fkg%20body%20weight%2Fday
  10. https://www.foodstandards.gov.au/code/applications/Documents/A1100%20Ace-K%20in%20Chewing%20Gum%20CFS.pdf
  11. https://www.scielo.cl/pdf/ijmorphol/v28n3/art25.pdf
  12. https://pubmed.ncbi.nlm.nih.gov/21653241/
  13. https://pubmed.ncbi.nlm.nih.gov/3756841/
  14. https://pubmed.ncbi.nlm.nih.gov/4999747/
  15. https://pubmed.ncbi.nlm.nih.gov/31358725/
  16. https://www.ajog.org/article/0002-9378(70)90449-7/pdf

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