Department of Obstetrics and Gynecology, Medical College of Wisconsin and Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI.
Clinical and Translational Science Institute of Southeast Wisconsin, Medical College of Wisconsin, Milwaukee, WI.
Am J Obstet Gynecol. 2020 Aug;223(2):211-218. doi: 10.1016/j.ajog.2020.03.034. Epub 2020 Apr 8.
In an effort to reduce sugar consumption to prevent diabetes mellitus and cardiovascular diseases, "sugar-free" or "no added sugar" products that substitute sugar with non-nutritive sweeteners (NNSs) (eg, Splenda, Sweet'N Low, and Stevia) have become increasingly popular. The use of these products during pregnancy has also increased, with approximately 30% of pregnant women reporting intentional NNS consumption. In clinical studies with nonpregnant participants and animal models, NNSs were shown to alter gut hormonal secretion, glucose absorption, appetite, kidney function, in vitro insulin secretion, adipogenesis, and microbiome dysbiosis of gut bacteria. In pregnant animal models, NNS consumption has been associated with altered sweet taste preference later in life and metabolic dysregulations in the offspring (eg, elevated body mass index, increased risk of obesity, microbiome dysbiosis, and abnormal liver function tests). Despite the accumulating evidence, no specific guidelines for NNS consumption are available for pregnant women. Furthermore, there are limited clinical studies on the effects of NNS consumption during pregnancy and postpartum and long-term outcomes in the offspring.
为了减少糖的摄入以预防糖尿病和心血管疾病，“无糖”或“无添加糖”的产品已经越来越受欢迎，这些产品用非营养性甜味剂（NNSs）（如 Splenda、Sweet'N Low 和甜菊糖）替代糖。在怀孕期间，这些产品的使用也有所增加，约有 30%的孕妇报告有意摄入 NNS。在非孕妇参与者和动物模型的临床研究中，NNS 被证明会改变肠道激素分泌、葡萄糖吸收、食欲、肾功能、体外胰岛素分泌、脂肪生成和肠道细菌的微生物失调。在怀孕的动物模型中，NNS 的摄入与后代日后甜味偏好的改变以及代谢失调有关（例如，体重指数升高、肥胖风险增加、微生物失调和肝功能异常测试）。尽管证据不断增加，但目前尚无针对孕妇 NNS 摄入的具体指南。此外，关于怀孕期间和产后 NNS 摄入的影响以及后代的长期结果的临床研究有限。
