Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 200, Washington, DC 20052, USA.
School of Nursing, The George Washington University, 1919 Pennsylvania Avenue NW, Suite 500, Washington, DC 20006, USA.
Nutrients. 2021 Sep 10;13(9):3154. doi: 10.3390/nu13093154.
Consumption of diet beverages (DB) containing low-calorie sweeteners (LCS) is widespread in the United States. LCS are ingested by nursing infants upon maternal DB consumption, which may impact infants' weight and health. This study aims to examine cross-sectional associations between infants' LCS exposure via maternal DB intake during lactation and infants' health outcomes. Six hundred and eighty-two mother-infant dyads at three months postpartum, from the Infant Feeding Practices Study II, 2005-2007, were included in the analysis. Maternal DB consumption during lactation was estimated using the serving size and frequency of DB consumption reported on the diet history questionnaire. Infants' LCS exposure was estimated by multiplying maternal DB consumption and breastfeeding intensity. Infant outcomes included weight, weight-for-age and BMI-for-age z-scores, overweight, and gastrointestinal (GI) symptoms including diarrhea, reflux, and vomiting. Associations between infants' LCS exposure and continuous and categorical outcomes were examined using linear and logistic regressions adjusting for confounders, respectively. Forty-three percent of lactating women reported DB consumption. While no significant associations were observed between infants' LCS exposure and BMI-for-age or risk of overweight, infants' LCS exposure was associated with a 2.78-fold increased risk of vomiting (95% confidence interval 1.05-7.34). Potential adverse effects of LCS exposure on GI symptoms require further study, and null findings on infant weight should be interpreted with caution, given the small sample size. Additional research is needed to inform recommendations for or against DB consumption during lactation.
在美国，人们广泛饮用含有低卡路里甜味剂（LCS）的饮料。哺乳期母亲饮用这些饮料后，婴儿会摄入 LCS，这可能会影响婴儿的体重和健康。本研究旨在探讨哺乳期母亲饮用含低卡路里甜味剂的饮料（DB）与婴儿健康结果之间的横断面关联。
本研究分析了 2005 年至 2007 年婴儿喂养实践研究 II 中 682 对母婴对，在产后三个月时纳入研究。通过饮食史问卷报告的 DB 消耗的份量和频率来估计哺乳期母亲 DB 的消耗。通过将母亲 DB 消费和母乳喂养强度相乘来估计婴儿的 LCS 暴露情况。婴儿的结果包括体重、体重与年龄比值和 BMI 与年龄比值的 Z 评分、超重以及胃肠道（GI）症状，包括腹泻、反流和呕吐。通过线性和逻辑回归分别调整混杂因素，来检验婴儿 LCS 暴露与连续和分类结果之间的关联。
43%的哺乳期妇女报告饮用 DB。虽然婴儿 LCS 暴露与 BMI 与年龄比值或超重风险之间没有显著关联，但婴儿 LCS 暴露与呕吐风险增加 2.78 倍相关（95%置信区间为 1.05-7.34）。LCS 暴露对 GI 症状的潜在不良影响需要进一步研究，鉴于样本量较小，对于婴儿体重的阴性结果应谨慎解释。需要进一步的研究来为哺乳期 DB 消费提供建议或反对意见。
