The Effects of Non-Nutritive Sweetener Consumption in the Pediatric Populations: What We Know, What We Don't, and What We Need to Learn.

Betty Shum,Senta Georgia

doi:10.3389/fendo.2021.625415

Abstract

Childhood obesity is increasing at an alarming rate in the United States. This trend carries serious risk of children developing obesity-related diseases including Type 2 diabetes and cardiovascular disease. Non-nutritive sweeteners (NNS) are used as substitution for table sugar as a way to prevent weight gain. Their consumption is ubiquitous in adults and children; however the long-term health outcomes of chronic NNS consumption in children are unclear. Conflicting observational studies suggest that children consuming NNS are at risk of obesity and development of type 2 diabetes, while others concluded some benefits in weight reduction. Here, we review the physiological mechanisms that can contribute to the negative metabolic effects of NNS. We will focus on how NNS alters the sweet perception leading to increase caloric consumption, how NNs alters the gut microbiota, and how NNS may disrupt glucose homeostasis and initiate a vicious cycle of pancreatic endocrine dysfunction. Studies focused on the pediatric population are limited but necessary to determine whether the potential weight loss benefits outweigh the potential negative metabolic outcomes during this critical development period.

Highlights

Childhood obesity is one of the most serious public health concerns, affecting 1 in 5 children and adolescents in the United States [1]
Animal studies suggest that the possible mechanisms for these metabolic outcomes include modifying the cephalic phase response to sweet taste with caloric intake and alteration in reward pathways
Studies must be conducted in pediatric populations to understand how the physiological mechanisms that nutritive sweeteners (NNS) promotes can change the reward behavior system and lead to increased consumption of sweet taste and high calorie foods

Summary

Introduction

Childhood obesity is one of the most serious public health concerns, affecting 1 in 5 children and adolescents in the United States [1]. A recent study has demonstrated that there is a difference in the microbiota of normal weight children compared to those who are overweight with an increase in Firmicutes and a decrease in Bacteroidetes, but did not assess NNS consumption [44].

Results

Conclusion