Gebremichael Bereket, Lassi Zohra S, Begum Mumtaz, Zhou Shao Jia
Department of Food and Nutrition, School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, South Australia, Australia.
Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
Matern Child Nutr. 2025 Jan;21(1):e13737. doi: 10.1111/mcn.13737. Epub 2024 Sep 30.
We examined the association between low-calorie sweeteners (LCS) consumption during preconception, pregnancy, and breastfeeding and child health outcomes. A systematic search of electronic databases in PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, the Cochrane Library, Scopus, Web of Science, PsycINFO, ProQuest Health and Medical, ClinicalTrials.gov, and Google Scholar was conducted up to 21 September 2023. A random effects model with restricted maximum likelihood estimation was used for the meta-analysis. Seventeen eligible studies were included. The standardised mean difference (SMD) and 95% confidence interval (CI) in birth weight between those who frequently consumed LCS (≥1 serve/day) during pregnancy and those who did not consume LCS was 0.04 (0.00, 0.08) (four cohort studies). Any LCS consumption during pregnancy compared with no consumption was not associated with birth weight [SMD (95% CI) = 0.03 (-0.03, 0.08)] (four cohort studies). Any LCS consumption during pregnancy was not associated with body mass index z-scores. The weighted mean difference (95% CI) was 0.00 (-0.05, 0.06) at birth, 0.06 (-0.29, 0.40) at 6 months, -0.04 (-0.19, 0.10) at 1 year, 0.00 (-0.16, 0.17) at 3 years, and 0.10 (-0.15, 0.34) at 7 years of the child age, compared with no intake (five cohort studies). The odds of being overweight at 1 year among children exposed to LCS during pregnancy was 1.19 (OR [95% CI]: 1.19 [0.81, 1.58]) compared with unexposed children (two cohort studies). The effect sizes were not precise for all the outcomes as the 95% CI indicated the effect estimates could range from small protective to a higher risk. The effect of LCS consumption on child behaviour and cognition was inconsistent. There is not enough evidence to confirm LCS consumption during pregnancy affects birth weight and risk of overweight in children. However, frequent consumption increased birth weight and the risk of overweight at different ages, though the effects were imprecise. More robust research evidence is required as the quality of evidence is low.
我们研究了孕前、孕期和哺乳期食用低热量甜味剂（LCS）与儿童健康结局之间的关联。截至2023年9月21日，我们对PubMed、Embase、护理学与健康相关文献累积索引、考克兰图书馆、Scopus、科学网、PsycINFO、ProQuest健康与医学、ClinicalTrials.gov和谷歌学术等电子数据库进行了系统检索。荟萃分析采用了限制最大似然估计的随机效应模型。纳入了17项符合条件的研究。孕期经常食用LCS（≥1份/天）的人群与未食用LCS的人群相比，出生体重的标准化平均差（SMD）和95%置信区间（CI）为0.04（0.00，0.08）（四项队列研究）。孕期食用任何LCS与未食用相比，与出生体重无关[SMD（95%CI）=0.03（-0.03，0.08）]（四项队列研究）。孕期食用任何LCS与体重指数z评分无关。与未摄入相比，儿童出生时的加权平均差（95%CI）为0.00（-0.05，0.06），6个月时为0.06（-0.29，0.40），1岁时为-0.04（-0.19，0.10），3岁时为0.00（-0.16，0.17），7岁时为0.10（-0.15，0.34）（五项队列研究）。与未接触LCS的儿童相比，孕期接触LCS的儿童1岁时超重的几率为1.19（OR[95%CI]：1.19[0.81，1.58]）（两项队列研究）。由于95%CI表明效应估计值范围从小的保护作用到较高风险，所有结局的效应大小都不精确。LCS消费对儿童行为和认知的影响不一致。没有足够的证据证实孕期食用LCS会影响儿童的出生体重和超重风险。然而，频繁食用会增加出生体重以及不同年龄段超重的风险，尽管影响不精确。由于证据质量较低，需要更有力的研究证据。
