Are low-calorie sweeteners an appropriate aid in battling childhood obesity?

By Nelda Mercer, MS, RD, FADA
Low-calorie sweeteners an aid in battling childhood obesity
Today, nearly one in three American children are overweight or obese. That’s triple the rate over the past 30 years and for African American and Hispanic children the numbers are even higher.
August 15, 2011

The Facts:
Today, nearly one in three American children are overweight or obese.(1) That’s triple the rate over the past 30 years.(2) And, for African American and Hispanic children the numbers are even higher, where 40% of children are overweight or obese.(3) It is predicted that if this trend continues 1/3 of all children born in 2000 or later will suffer from diabetes at some point in their lives and many other will face chronic obesity-related health problems like heart disease, high blood pressure, cancer, and asthma.(4, 5, 6)
 
The Problem:
Lifestyle changes have led to children moving less and eating more calorie-dense, nutrient-poor foods. According to First Lady Michelle Obama’s “Let’s Move” campaign facts, 30 years ago kids ate just one snack a day, now they are trending toward 3 snacks, resulting in an additional 200 calories a day. Portion sizes have also exploded; they are now 5 times bigger than in years past and the average American now eats 15 more pounds of sugar a year than in 1970.(6)
However, depriving children of certain foods or beverages is not the answer. Deprivation promotes cravings and a preoccupation with food. Consequently, children are primed to develop an unhealthy relationship with food which in later life can express itself as disordered eating.
 
The Solution:
Small steps over time can yield big results. Childhood is an excellent time for parents to teach balance and moderation. Making subtle substitutions using low calorie sweeteners in place of sugar is an effective way to decrease calorie intake without depriving children of favorite foods or beverages. This is one tool to help manage energy intake and allow overweight children to gradually grow into a normal weight for height. For example, if yogurt is one part of the daily diet, simply substituting flavored yogurt sweetened with aspartame in place of sugar saves approximately 90 calories per serving. In a year’s time this daily substitution alone would add up to a negative 32,850 calories, equivalent to 9 pounds in body weight. Similarly, substituting one diet drink in place of a daily sugar sweetened beverage can save up to 150 calories a day, the equivalent of 15 pounds over the course of a year!
 
But are low-calorie sweeteners safe?
Aspartame safety has been reviewed, repetitively, by regulatory authorities around the globe, including The US Food and Drug Administration, The European Food Safety Authority, and The Joint Expert Committee on Food Additives of The United Nations Food and Agriculture Organizations and The World Health Organization. In addition, highly respected independent health organizations like The American Medical Association, The American Dietetic Association, The American College of Obstetricians and Gynecologists, The American Academy of Pediatrics, Committee on Nutrition, and The American Cancer Society have recognized the safety of aspartame in all population groups including children, pregnant women, diabetics, etc.
 
The “Acceptable Daily Intake” (ADI) provides a science-based estimate of use level of ingredient that produces no adverse health effects using a 100-fold safety factor based on “No-Observed Effect Level” (NOEL), and a daily consumption deemed to be safe over a lifetime. The ADI for aspartame is set at 50 mg/kg/body weight/day. Actual consumption among those who use aspartame isn’t even close to this level. For example, among heaviest users (including children) -- those at the 90th percentile of consumption -- intake is only 10.4 mg/kg/day.  Average consumption (among users) is estimated at less than 5 mg/kg/day for all ages.(7)
 
Bottom line:
The best approach for managing children’s weight is to decrease portion size, encourage children to eat a variety of healthy foods (vegetables, fruits, low fat dairy, lean meats, whole grains) and allow them to enjoy special treats on occasion. Increasing active play time and decreasing TV and video game screen time along with getting adequate sleep are other important parts of the balancing act to keep body weight in check and allow for healthy growth and development.
 
Nelda Mercer, MS, RD, FADA provides expert counsel to the Aspartame Resource Center.
 
References:

  1. Ogden, C.L., Carroll, M., Curtin, L., Lamb, M., Flegal, K.(2010).Prevalence of High Body Mass Index in US Children and Adolescents 2007-2008. Journal of American Medical Association, 303(3), 242-249.
  2. Ogden C.L., Flegal K.M., Carroll M.D, et al.(2002).Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of the American Medical Association, 288(14), 1728-32;
  3. Ogden C.L., Carroll M.D., Curtin LR, et al.(2010).Prevalence of high body mass index in US children and adolescents, 2007-2008. Journal of the American Medical Association, 303(3); 242-9.
  4. Anderson S.E., Whitaker R.C.(2009). Prevalence of obesity among US preschool children in different racial and ethnic groups. Archives of Pediatrics and Adolescent Medicine, 163(4), 344-8.
  5. Centers for Disease Control and Prevention, National Center for Health Statistics.(2007).
  6. National Diabetes Surveillance System.Incidence of Diabetes: Crude and Age-Adjusted Incidence of Diagnosed Diabetes per 1000 Population Aged 18-79 Years, United States, 1980-2009. Retrieved August 12, 2011 from: http://www.cdc.gov/diabetes/statistics/incidence/fig2.htm.
  7. Gilliland, F.D., Berhane, K., Islam, T., et al.(2003).Obesity and the risk of newly diagnosed asthma in school-age children. American Journal of Epidemiology, 158(5), 406-15.
  8. Learn the Facts:  The epidemic of Childhood Obesity, and Health Problems and Childhood Obesity. Retrieved August 12, 2011 from http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity
  9. Magnuson et al., Critical Reviews in Toxicology 37:629, 2007.


Are low-calorie sweeteners an appropriate aid in battling childhood obesity?

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