Abstract

Introduction: Research has highlighted the rising consumption of low-calorie sweeteners (LCSs) and their possible negative health implications. While the American Academy of Pediatrics advises against beverages with LCSs for children under 5y, little is known about current consumption patterns among infants and young children in the United States. Objectives: To estimate the prevalence, frequency, and top sources of LCS intake among U.S. infants and young children and to investigate associations between LCS consumption and energy and macronutrient intake. Methods: We used one 24-h dietary recall from 3117 children aged 0-5y in the National Health and Nutrition Examination Survey (NHANES) 2013-18 to describe the prevalence and their frequency of consuming foods and beverages containing LCSs. We also compared total energy and macronutrient intake as a proportion of total energy intake (TEI) between LCS consumers and non-consumers. Complex survey procedures and sample weights were applied for all analyses. F-tests were used to compare consumption estimates across sociodemographic subgroups. Results: Thirty percent of all U.S. children aged 0-5y consumed foods and/or beverages with LCSs, including 17.5% of infants (0-1y), 34.3% of toddlers (2 and 3y), and 34.5% of preschoolers (4 and 5y). Prevalence of LCS consumption tended to be highest among non-Hispanic Blacks children and those from households with higher educational attainment or a higher family income. Among consumers, mean frequency of any LCS product, LCS beverages (LCSBs) only, and LCS foods (LCSFs) only was 1.4, 1.4, and 1.1 times/day, respectively, and did not differ by age. The most consumed of all LCSBs were fruit drinks (71.9%) and the most consumed of all LCSFs was yogurt (not-Greek) (59.5%). Compared to non-consumers, LCS consumers had higher intake of total energy, 1516 vs. 1316 kcal/day (p<.0001), carbohydrates, 54.0% vs 52.4% TEI (p=.0005), and added sugar, 3.3% vs. 2.1% TEI (p<.0001) but significantly lower intake of total fat and saturated fat, 33.1% vs 34.9% TEI (p<.0001) and 12.0% vs 13.1% TEI (p<.0001), respectively. Conclusions: LCS consumption is prevalent among infants and young children in the U.S. and fruit drinks and yogurt are the main sources. These results highlight the need for further research to understand long-term implications of this consumption. Funding sources: None.

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