Trends in Low-Calorie Sweetener Consumption Among Pregnant Women in the United States

BACKGROUND: Minimizing consumption of added sugars is recommended to prevent excessive weight gain among pregnant women. A common approach to lowering sugar intake is the use of low-calorie sweeteners (LCSs), yet little is known about LCS use during pregnancy or its effects on infant weight and health. OBJECTIVE: The aim of the study was to investigate temporal trends in LCS consumption by source (foods, beverages, or packets) among pregnant women in the United States from 1999 to 2014 and to compare recent LCS consumption patterns across sociodemographic subgroups and product categories. METHODS: Data were collected from pregnant women aged 20–39 y (n = 1,265) who participated in the NHANES from 1999–2000 through 2013–2014. Prevalence of LCS consumption was assessed using two 24-h dietary recalls. Analytical procedures for complex survey design were used, and sampling weights were applied to estimate national prevalence of LCS use. Rao–Scott modified chi-square tests were used to compare consumption prevalence across sociodemographic subgroups, and logistic regression was used to examine trends in LCS use over time. RESULTS: The prevalence of LCS consumption among pregnant women increased by approximately 50% rising from 16.2% in 1999–2004 to 24.0% in 2007–2014, P = 0.04, with the highest prevalence observed in 2005–2006 (38.4%). This trend was driven predominantly by increases in LCS beverage use (9.9% in 1999–2004 compared with 18.3% in 2007–2014, P = 0.02). Prevalence of LCS consumption was highest among non-Hispanic white women and increased with education and income. No differences were observed based on prepregnancy weight status or trimester of pregnancy. CONCLUSIONS: Approximately one-quarter of pregnant women in the United States reported consumption of LCS during at least 1 of 2 dietary recalls. Given the widespread LCS consumption during pregnancy, research to elucidate potential effects of early life LCS exposure on taste preferences, weight trajectory, and risk of later metabolic disease is needed.