Are You What Your Mother Ate: Maternal Artificially‐Sweetened Beverages Intake During Pregnancy and Offspring Growth and Obesity Through Age 7 Years?

Background Artificial‐sweeteners are widely replacing caloric sweeteners, but emerging experimental data have linked them to metabolic perturbations. Epidemiologic data on long‐term intergenerational impact of artificially‐sweetened beverage (ASB) consumption during pregnancy on offspring obesity risk are lacking. We prospectively investigated intake of ASBs and sugar‐sweetened beverages (SSBs) during pregnancy in relation to offspring growth through age 7 years among high‐risk children born to women with gestational diabetes, serving as a unique model to study early origins of obesity. Methods In a prospective study of 918 mother‐singleton child dyads from the Danish National Birth Cohort, maternal dietary intake was assessed by a food frequency questionnaire during pregnancy. Offspring body mass index z‐scores (BMIZ) and overweight/obesity status were derived using weight and length/height measured at birth, 5 and 12 months, and 7 years. Linear regression and Poisson regression with robust standard errors were used, adjusting for major maternal and offspring risk factors. Results Approximately half of women reported consuming ASBs during pregnancy and 9% consumed daily. Compared to never consumption, daily ASB intake during pregnancy was positively associated with offspring large‐for‐gestational age [adjusted relative risk (aRR) 1.57; 95% CI: 1.05, 2.35], and BMIZ (adjusted β 0.59; 95% CI: 0.23, 0.96) and overweight/obesity (aRR 1.93; 95% CI; 1.24, 3.01) at 7 years. Further, per‐serving‐per‐day substitution of ASBs with water during pregnancy was related to a significantly lower risk of overweight/obesity at 7 years (aRR 0.83; 95% CI: 0.76, 0.91), whereas SSB substitution with ASBs was not related to a lower risk (aRR 1.14; 95% CI: 1.00, 1.31). Conclusions We observed positive associations between intrauterine exposure to ASBs and birth size and risk of overweight/obesity at 7 years. Findings further raise the questionability of promoting ASBs as “healthier” alternatives for SSBs, particularly among high‐risk pregnant women. Future studies with longer follow up beyond early childhood are warranted. Support or Funding Information The study is funded by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract # HHSN275201000020C). The DNBC is supported by grants from The Danish Research Council # 09‐067124 (Center for Fetal Programming) and 09‐075611.