Consumption of Low-Calorie Sweeteners among Children Aged 6 Months to 5 Years in the United States, NHANES 2017-2020

Authors

Xinyu Zhu, Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States.
Allison C. Sylvetsky, Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States.
Hanqi Luo, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Terryl J. Hartman, Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States; Winship Cancer Institute, Emory University, Atlanta, GA, United States.
Jean A. Welsh, Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States; Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States; Children's Healthcare of Atlanta, Atlanta, GA, United States. Electronic address: jwelsh1@emory.edu.

Document Type

Journal Article

Publication Date

9-7-2024

Journal

The Journal of nutrition

DOI

10.1016/j.tjnut.2024.08.028

Keywords

dietary patterns; low-calorie sweeteners; national nutrition surveillance; pediatrics

Abstract

BACKGROUND: Although the American Academy of Pediatrics advises against low-calorie sweeteners (LCS) consumption by children <5 y due to potential health and development concerns, the extent of this consumption among these children is unknown. OBJECTIVES: The objective of this study was to describe the intake, sources, and dietary patterns associated with LCS consumption among United States infants and preschoolers. METHODS: We used cross-sectional 24-h dietary recall data (day 1) among 1497 children aged 6 mo to 5 y from the National Health and Nutrition Examination Survey 2017-2020 prepandemic. Complex survey procedures and sampling weights were applied to compare LCS consumption patterns (prevalence and frequency [times/day] of any LCS, any LCS-containing beverages [LCSBs], and any LCS-containing foods [LCSFs], with each occurrence of consumption = 1 "serving") across demographic subgroups and to assess the associated nutrients and % of total energy intake (TEI). RESULTS: Thirty-one percent of children aged 6 mo to 5 y consumed ≥1 LCSB and/or LCSF on a given day. The prevalence of LCS consumption increased with age, 10.5% (6 to <12 mo) to 34.3% (2-5 y). Among LCS consumers, mean serving frequency was 1.4 times/d, with no differences by age or sex. Of all LCSBs servings consumed, 64.0% were fruit drinks; 57.8% of all LCSFs servings were non-Greek yogurt. As consumption levels increased from no LCS to >1 serving/d, intake of the following also increased: total sugar (+1.8% TEI, P-trend = 0.04), added sugar (+1.1%, P-trend = 0.048), sodium (+304 mg, P-trend = 0.04), and fiber (+0.8 g, P-trend = 0.01). In contrast, protein intake was lower (-0.7% TEI, P-trend = 0.02). Those consuming 1 LCS serving/d consumed more total energy than LCS nonconsumers (1606 compared with 1401 kcal), but TEI did not increase further with >1 LCS serving/d (1607 kcal). LCS consumption was not associated with carbohydrate or fat intake. CONCLUSIONS: LCS consumption, primarily from fruit drinks and non-Greek yogurt, is prevalent among United States preschoolers, and this consumption is associated with greater intake of total sugar, added sugar, and sodium.

APA Citation

Zhu, Xinyu; Sylvetsky, Allison C.; Luo, Hanqi; Hartman, Terryl J.; and Welsh, Jean A., "Consumption of Low-Calorie Sweeteners among Children Aged 6 Months to 5 Years in the United States, NHANES 2017-2020" (2024). GW Authored Works. Paper 5664.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5664

Department

Exercise and Nutrition Sciences