Department of Nutrition, Faculty of Medicine, University of Chile, Av. Independencia 1027, Independencia, Santiago 8380453, Chile.
Institute of Nutrition and Food Technology (INTA), University of Chile, Av. El Líbano 5524, Macúl, Santiago 7830490, Chile.
Nutrients. 2023 May 29;15(11):2518. doi: 10.3390/nu15112518.
Studies on the effects of non-nutritive sweeteners (NNSs) among pregnant women are scarce and have produced mixed results. One of the major challenges is to accurately assess NNS intake, especially in countries that have implemented policies to prevent obesity and where many foods and beverages have been progressively reformulated to partially or totally replace sugar with NNSs. This study aimed to develop and assess the relative validity of a food frequency questionnaire (FFQ) for use in pregnant women. We developed an FFQ to examine the intake of seven NNSs (acesulfame-k, aspartame, cyclamate, saccharin, sucralose, steviol glycosides, and D-tagatose). This questionnaire was piloted in 29 pregnant women (median age = 31.2 y; 25th-75th percentile: 26.9-34.7) to assess NNS intake over the previous month, compared to 3-day dietary records (3-DR). The validity of this dietary method was assessed using Spearman's correlation coefficient, Lin´s concordance correlation coefficient (CCC), and Bland-Altman plots. Spearman's correlations between the FFQ on NNSs and 3-DR ranged from 0.50 for acesulfame K to 0.83 for saccharin. CCC ranged between 0.22 and 0.66. The Bland-Altman plots showed an overestimation of saccharin, sucralose, and steviol glycosides intake by the FFQ on NNSs compared with 3-DR, and an underestimation of acesulfame K and aspartame. Overall, the NNSs most frequently consumed were sucralose, and none of the participants exceeded the acceptable daily intake for any of the NNSs evaluated. The FFQ on NNSs seems to be reasonably valid in the assessment of NNSs among pregnant women.
关于孕妇中非营养性甜味剂（NNSs）影响的研究很少，且结果不一。主要挑战之一是准确评估 NNS 摄入量，特别是在已经实施预防肥胖政策的国家，许多食品和饮料已逐步进行配方调整，用 NNS 部分或全部替代糖。本研究旨在开发和评估一种用于孕妇的食物频率问卷（FFQ）的相对有效性。我们开发了一个 FFQ 来检测七种 NNS（乙酰磺胺酸钾、阿斯巴甜、环已基氨基磺酸钠、糖精、三氯蔗糖、甜菊糖苷和 D-塔格糖）的摄入量。该问卷在 29 名孕妇（中位数年龄=31.2 岁；25-75 百分位数：26.9-34.7）中进行了试点，以评估过去一个月的 NNS 摄入量，与 3 天饮食记录（3-DR）进行比较。使用 Spearman 相关系数、Lin 的一致性相关系数（CCC）和 Bland-Altman 图评估这种饮食方法的有效性。FFQ 与 3-DR 之间的 NNS 相关系数范围从乙酰磺胺酸钾的 0.50 到糖精的 0.83。CCC 范围在 0.22 到 0.66 之间。Bland-Altman 图显示，与 3-DR 相比，FFQ 对 NNS 中糖精、三氯蔗糖和甜菊糖苷的摄入量存在高估，而对乙酰磺胺酸钾和阿斯巴甜的摄入量存在低估。总体而言，孕妇最常消费的 NNS 是三氯蔗糖，且没有参与者超过所评估的任何 NNS 的可接受日摄入量。NNSs 的 FFQ 在评估孕妇 NNSs 方面似乎具有相当的有效性。
