Non-Nutritive Sweetener Exposure Begins Early in Life

Authors

• EM Conway
• ET Beulick
• EL Ball
• AC Sylvetsky
• AB Courville
• PJ Walter
• H Cai
• MA Hoskin
• MA Clark
• RL Hanson
• WC Knowler
• KI Rother

Abstract

Objectives: We set out to determine how many pregnant Native American women consume non-nutritive sweeteners (NNS), to study the relationship between NNS reported in dietary recalls and NNS present in maternal blood and breast milk, and to investigate whether NNS cross the placenta causing intrauterine exposure. Methods: We obtained biospecimen samples (maternal blood, urine, breast milk and infant cord blood) from participants who were enrolled in the Phoenix site of LIFE-Moms, a multi-center study of behavioral and lifestyle interventions in overweight/obese pregnant women. Participants completed multiple study visits throughout their pregnancy including each trimester, at birth, and post-partum. The visits entailed collection of various biospecimens and dietary recalls (Automated Self-Administered Recall System (ASA24)). NNS (acesulfame-potassium, sucralose, and saccharin) were quantified in blood and breastmilk by liquid chromatography-mass spectrometry. Results: Of 129 blood samples in 65 women, 103 samples (79.8%) were NNS positive (92.3% of women). Of 22 breast milk samples, 77.3% contained NNS. In 19 participants with a dietary recall before providing breast milk, 7 reported NNS intake; however, 15 samples contained NNS (positive predictive value of reporting NNS = 100%, negative predictive value = 21%). Of 21 cord blood samples, 71.4% were NNS positive. Conclusions: Contrary to the assumed lower frequency of NNS consumption in pregnant Native American women, we found no difference in reported consumption compared to the general population (~25%). The high prevalence of NNS in cord blood and breast milk demonstrates early perinatal exposure and warrants investigation into the clinical relevance.

Scientific Focus Area: Health Disparities

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