A recently published statement by the AAP has found that the long term safety of artificial sweeteners for children is unclear. The American Academy of Pediatricians says there is insufficient evidence about the long-term safety of artificial sweeteners in children and adolescents and calls on food manufacturers to be more transparent about the presence of these substances on food labels. The statement, published online October 28 in Pediatrics, provides an overview of US Food and Drug Administration (FDA)–approved artificial sweeteners, describes research about their benefits and potential adverse effects in children and adolescents, and makes recommendations for researchers, policy makers, and healthcare providers.
Artificial sweeteners have been approved by the FDA as long ago as 1958. Currently, saccharin, aspartame, acesulfame potassium, sucralose, neotame, and advantame have received approval from the FDA as food additives. Two other artificial sweeteners, stevia and monk fruit extract, have received the FDA designation of “generally recognized as safe”; such products do not require approval. Since their inception artificial sweeteners have been under scrutiny. A small number of studies have found certain sweeteners unsafe in rodent test subjects but typically in doses well above what is typically found in food. Still questions remain on their safety when consumed over long periods of time. Several studies have provided a weak association between a heavy consumption of aspartame and the development of certain cancers.
The AAP committee reviewed research articles on the use of artificial sweeteners by children and adolescents that were published within the past 10 years through August 20, 2018. Only six high-quality, randomized controlled trials about the use of artificial sweeteners by children were published during that period, they note. The AAP committee also notes that not only are more children and adolescents consuming artificial sweeteners, but they are also consuming a larger quantity of these sweeteners in the absence of strong scientific evidence to refute or support the safety of these agents. Most consumption of artificial sweeteners occurs through diet sodas; however, the number of foods that contain at least one artificial sweetener has quadrupled during the past several years. How much children are actually consuming remains unknown because manufacturers are not required to list the amount of artificial sweetener per serving on package labels.
Artificial sweeteners are thought to increase weight loss by decreasing caloric intake. But weight loss is likely to be small. In fact, some evidence suggests that artificial sweeteners may actually promote weight gain. Artificial sweeteners are 180 to 20,000 times sweeter than table sugar, and they may increase preferences for sugary foods, though evidence is inconclusive. They may also leave people feeling less satisfied, resulting in their eating more in the long run. In animal studies, artificial sweeteners have been linked to glucose intolerance, insulin resistance, and diabetes. Long-term effects on weight management, metabolic function, and other cardiovascular diseases in humans remain unknown.
So with weak evidence on the long term safety of consuming artificial sweeteners the best advice is to keep our children away from them as much as possible. The easy is avoid all soda including diet. Outside of that look at labels to see if artificial sweeteners are listed and avoid those as well.