Intergenerational transmission of sucralose and acesulfame-potassium from mothers to their infants via human milk: a pharmacokinetic study

Authors

Allison C. Sylvetsky, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States. Electronic address: asylvets@gwu.edu.
Janae T. Kuttamperoor, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Brooke Langevin, Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD, United States.
Jeanne Murphy, School of Nursing, George Washington University, Washington, DC, United States.
Kathleen F. Arcaro, Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA, United States.
Simona Smolyak, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, United States.
Peter J. Walter, Clinical Mass Spectrometry Laboratory, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, United States.
Hongyi Cai, Clinical Mass Spectrometry Laboratory, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, United States.
Dina H. Daines, Department of Obstetrics and Gynecology, George Washington University, Washington, DC, United States.
John N. van den Anker, Division of Clinical Pharmacology, Children's National Hospital, Washington DC, United States.
Mathangi Gopalakrishnan, Center for Translational Medicine, University of Maryland School of Pharmacy, Baltimore, MD, United States.

Document Type

Journal Article

Publication Date

8-5-2024

Journal

The American journal of clinical nutrition

DOI

10.1016/j.ajcnut.2024.08.001

Keywords

beverages; breastfeeding; human milk; infant feeding; intergenerational transmission; lactation; low-calorie sweeteners; nonnutritive sweeteners; pharmacokinetics

Abstract

BACKGROUND: Low-calorie sweetener (LCS) consumption is prevalent among lactating mothers, yet infants' exposure to LCS in human milk is not well-characterized. OBJECTIVES: Conduct a pharmacokinetic study of sucralose and acesulfame-potassium (ace-K) in mothers' milk and plasma over 72 h and in infants' plasma. METHODS: Following baseline blood and milk collection, mothers (n = 40) consumed 20 oz of diet cranberry juice containing sucralose and ace-K. Blood samples were collected from the mother 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, and 72 h after beverage ingestion, and milk was expressed at 1, 2, 3, 4, 6, 8, 12, and 24 h postingestion. One blood sample was collected from each infant, the timing of which was determined using pharmacokinetics model-based simulation. Concentration-time profiles of LCS from the mother's plasma and milk were analyzed using noncompartmental methods. RESULTS: Ace-K rapidly entered human milk with the largest observed concentration of 373.0 (coefficient of variation 69%) ng/mL first detected 4 h following diet beverage ingestion. Sucralose appeared in human milk 1-2 h after diet beverage ingestion with the largest observed concentration of 7.2 (coefficient of variation 63%) ng/mL first detected 7 h postingestion. The mean 24-h milk to plasma ratio of ace-K was 1.75 [standard deviation (SD) 1.37] with a mean relative infant dose of 1.59% (SD 1.72%). Ace-K was detected in all infants' plasma with an mean concentration of 9.2 (SD% 14.8) ng/mL ∼6 h after maternal beverage ingestion. The mean 24-h milk to plasma ratio of sucralose was 0.15 (SD 0.06) with a mean relative infant dose of 0.04% (SD 0.02%). Sucralose was detected in only 15 infants' plasma, and the mean concentration was 5.0 (SD% 7.1) ng/mL ∼5 h after diet beverage ingestion. CONCLUSIONS: Ace-K rapidly transfers from human milk into infants' circulation whereas sucralose was detected at much lower concentrations and in some but not all infants. Future research should investigate the effects of early-life sucralose and ace-K exposure via human milk on infants' health. This trial was registered at clinicaltrials.gov as NCT05379270.

APA Citation

Sylvetsky, Allison C.; Kuttamperoor, Janae T.; Langevin, Brooke; Murphy, Jeanne; Arcaro, Kathleen F.; Smolyak, Simona; Walter, Peter J.; Cai, Hongyi; Daines, Dina H.; van den Anker, John N.; and Gopalakrishnan, Mathangi, "Intergenerational transmission of sucralose and acesulfame-potassium from mothers to their infants via human milk: a pharmacokinetic study" (2024). GW Authored Works. Paper 5515.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5515

Department

Exercise and Nutrition Sciences