Council responds to study on artificial sweeteners

by Jeff Gelski
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ATLANTA — Beth Hubrich, the executive director of the Calorie Control Council, defended the safety of artificial sweeteners after a study appearing on-line June 30 in the American Journal of Clinical Nutrition found an association between intake of artificially sweetened soft drinks and the risk of preterm delivery. The study concluded that daily intake of artificially sweetened soft drinks may increase the risk of preterm delivery, but further studies are needed to reject or confirm these findings.

Ms. Hubrich, a registered dietitian, said the Food and Drug Administration makes certain artificial sweeteners are safe for the general population before approving them. The F.D.A. also examines the effects of the artificial sweeteners on special at-risk groups, such as the elderly, children and pregnant and lactating women, Ms. Hubrich said.

“Low-calorie sweeteners have been very, very thoroughly studied both in humans and in animals,” Ms. Hubrich told Food Business News.

The Calorie Control Council, Atlanta, is an international association that represents the low-calorie and reduced-fat food and beverage industry.

The study appearing in the American Journal of Clinical Nutrition involved researchers from the Department of Nutrition, Harvard School of Public Health in Boston along with the Centre for Fetal Programming, Division of Epidemiology, Statens Serum Institute in Copenhagen, Denmark, and the Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences at the University of Iceland in Reykjavik, Iceland. The European Union Integrated Research Project EARNEST supported the study.
Researchers analyzed 59,334 women from the Danish National Birth Cohort (1996-2002) and used a food-frequency questionnaire to assess soft drink intake in mid-pregnancy. Preterm delivery of less than 37 weeks was the primary outcome measure.

In comparison with women who did not drink artificially sweetened carbonated soft drinks, the adjusted odds ratio for women who consumed one or more servings a day was 1.38. The corresponding odds ratio for women who consumed four or more servings of artificially sweetened carbonated soft drinks a day was 1.78.

The association was observed for normal weight women and overweight women. Researchers observed a stronger increase for early preterm and moderately preterm delivery than with late-term delivery. The researchers found no association for sugar-sweetened carbonated soft drinks or for sugar-sweetened noncarbonated soft drinks.

Ms. Hubrich said the study’s headline of “Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study of 59,334 Danish pregnant women” was misleading. She said less than 5% of the 59,334 women went into preterm labor and a third of those were induced medically.

She also took exception to the study’s statement, “The safety of artificial sweeteners has been disputed, and consequences of high intakes of artificial sweeteners for pregnant women have been minimally addressed.” She said again that the F.D.A. examines data and studies before approving artificial sweeteners.

In a statement released July 1, the Calorie Control Council said leading health groups such as the American Dietetic Association and the American Diabetes Association support the safe use of low-calorie sweeteners during pregnancy. The statement added the study in question was epidemiological in nature and thus cannot show cause and effect, and that other multi-generational studies in humans have found no adverse effects on the mother or developing baby related to the use of low-calorie sweeteners.

According to the study’s authors, recent studies have suggested that both artificially sweetened soft drinks and sugar-sweetened soft drinks might be associated with hypertension, which is a known risk factor for preterm delivery.

Thorhallur Ingi Halldorsson, a doctor in the Division of Epidemiology at Statens Serum Institut and a co-author of the study, told Food Business News, “Most studies have focused on other outcomes, and preterm delivery has not received much attention. It was more indirect evidence that was the catalyst for us to look at this outcome. Most studies conducted so far have dealt with carcinogenic effects, which is a very difficult outcome to study.”

Dr. Halldorsson added, “Finally, I would like to add that our findings should be interpreted with caution. However, I think that more studies should be conducted using observational data as it is a necessary complement to animal studies, which have their own limitations.

“Not many observational studies have been conducted, except for cancer-related outcomes, with respect to artificial sweeteners, and I think some of the controversies surrounding the use of certain sweeteners might be eliminated by this approach — claims of adverse effects when most likely there are none. This approach might also be helpful in identifying sub-groups where intake of these sweeteners should perhaps be avoided or limited.”

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