Are Artificial Sweeteners and Sugar Substitutes Safe During Pregnancy? (2023)

That morning coffee at home, that cereal bowl, that vending machine snack bar at work — the amount of artificial sweeteners and sugar substitutes in your diet can add up quickly. And it's only 10 o'clock!

You probably already know that eating too much sugar during pregnancy can increase your risk of weight gain and tooth decay. And monitoring your sugar intake during pregnancy is crucial if that's the casegestational diabetes. But is it safe to replace refined sugars in your diet with artificially sweetened foods and drinks?

Here's the rundown of low-calorie and no-calorie sugar substitutes (plus other natural sweeteners) and their place when you're pregnant.

What is a sugar substitute?

Sugar substitutes come in many different forms, but they are all designed to sweeten our food and drink. Nutritious sweeteners — like honey, agave, and high fructose corn syrup — provide energy in the form of carbohydrates and contain calories.

All those diet and zero calorie products you see on the shelves? They contain non-nutritive sweeteners that are very low-calorie or even zero-calorie. Think no-added or no-sugar yogurts and coffee creamers, not to mention low-calorie ice creams, candies, and drinks.

However, nutritious and non-nutritious are just one way of distinguishing between sweeteners.

(Video) Can I have artificial sweeteners during pregnancy

Categories of sugar substitutes

  • Artificial sweeteners:Think of the little pastel packets you often see in restaurants and cafes. Artificial sweeteners are also used in many processed foods and soft drinks. Examples of sugar substitutes approved by the US Food and Drug Administration (FDA) include acesulfame, aspartame, neotame, saccharin, and sucralose.
  • Natural sweeteners:Think honey, coconut sugar, maple syrup. While they're advertised as "healthier options" over table sugar or other sugar substitutes because they may contain trace minerals or antioxidants, they do contain sugar and, consequently, calories. (Stitch image of Buddy the Elf dousing spaghetti in maple syrup.) Of course, natural sugar has a variety of uses in home cooking and is often found in processed foods as "added sugar."
  • Novel sweeteners:Stevia is the only novel sweetener approved by the FDA. It's low in calories, and some studies even say that novel sweeteners can lower blood pressure. What's the catch? The way novel sweeteners are made (i.e., their formula) is changing, and they may contain other types of sugar substitutes.
  • Zuckeralkohole (Polyole):Technically, sugar alcohols aren't sugars, they're carbohydrates found naturally in certain fruits and vegetables — although they're also found in many processed foods. (And despite their name, these sugars are alcohol-free.) Food labels may use the general term "sugar alcohol" or list the specific name, such as sorbitol. Sugar alcohols consumed in large quantities can have a laxative effect.

It's important to know that manufacturers aren't required to say how much sugar substitute is actually in a product, although they are required to list it as an ingredient, so always read your food labels carefully.

Which Sugar Substitutes Are Unsafe During Pregnancy?

Cyclamate was banned in the US in 1970 after being linked to cancer, but the artificial sweetener is still used in some other countries. Attention when traveling abroad!

Which sugar substitutes are safe during pregnancy?

When used in moderation, most pregnant women can safely use all FDA-approved nutritive and nonnutritive sweeteners.

However, the truth is that sugar substitutes for pregnant women can be a bit mixed. Although they are mostly considered safe, consuming many artificial sweeteners can increase your baby's risk of becoming overweight later in life.

More research is needed to fully understand how artificial sweeteners and sugar substitutes affect a baby's development in the womb. Here's what you need to know about the different types of artificial sweeteners and sugar substitutes you might see on food and drink labels. They include:

Aspartame (Equal, NutraSweet) during pregnancy

According to the FDA, aspartame is safe for use during pregnancy and while breastfeeding. A packet or two of the blue stuff every now and then is fine (so yes, a small piece of sugar-free gum is safe).

(Video) Sweeteners during pregnancy: are they safe?

Simply avoid consuming aspartame in large amounts during pregnancy, and avoid it altogether ifPhenylketonurie(PKU), a rare genetic disease, is on your medical record. Your doctor may also recommend avoiding aspartame if you have high levels of phenylalanine in your blood.

Advent in pregnancy

Adventame is actually 100 times sweeter than aspartame - a pretty sweet sweetener! In 2014, the FDA approved Advantame as a non-nutritive sweetener and flavor enhancer in foods in general, except meat and poultry, in the United States. In moderation it is safe during pregnancy.

coconut sugar during pregnancy

Coconut blossom sugar, a natural sweetener, is a safe substitute for sugar during pregnancy. It is also called coconut palm sugar and looks like brown sugar with small lumps. It may contain small amounts of minerals and antioxidants, but at the end of the day, it's not that different from cane sugar.

Fruit juice concentrates during pregnancy

Fruit juice concentrates are found in all types of commercial products — including cookies, cereal, granola bars, toasts, yogurt, and soft drinks — and are safe to consume during pregnancy.

Being liquid fruit juice concentrates, substituting fruit juice concentrates for granulated sugar in recipes requires a bit of know-how — but it's definitely safe. You have to pick recipes that call for a significant amount of liquid and then use the juice concentrate for that liquid as well as the sugar. White grape juice concentrate, for example, has a sweeter, less fruity flavor and tastes most like sugar when it's being baked.

Neotame (Newtame) during pregnancy

Neotame is a non-nutritive sweetener approved by the FDA in 2002 for use as a "general sweetener and flavor enhancer" in foods (except meat and poultry). It is used as a sugar substitute in some baked goods and there is no evidence of any risk to pregnant women.

(Video) Are artificial sweeteners okay during pregnancy? - Dr. Gauri Rokkam

Mannitol during pregnancy

Although mannitol provides fewer calories than sugar, it is poorly absorbed by the body. Like sorbitol, it's safe in moderation, although too much can cause an upset stomach.

Monk fruit extract during pregnancy

Monk fruit is a small green gourd native to southern China. It is classified by the FDA as "Generally Recognized as Safe" or GRAS. It is 150 to 200 times sweeter than sugar and contains zero calories.

Saccharin (Sweet 'N Low, Necta Sweet) during pregnancy

Although the FDA considers saccharin safe for the general public, some countries have banned the artificial sweetener.

The Academy of Nutrition and Dietetics (AND) says saccharin can cross the placenta and stay in the baby's tissues, and the long-term effects, if any, are unknown. Pregnant women should avoid this artificial sweetener whenever possible.

sorbitol during pregnancy

Sorbitol, a nutritious sweetener and sugar alcohol, is okay for women to take during pregnancy. But while it can't harm your baby, it can have uncomfortable gastrointestinal effects on you. In large doses, sorbitol can cause stomach upset and diarrhea — something no pregnant woman wants to have.diarrhea during pregnancy, aside from being uncomfortable, it can interfere with the absorption of vital nutrients and lead to dehydration.

Sucralose (Splenda) during pregnancy

The FDA says sucralose is safe for everyone, including pregnant women. It's sugar, so to speak. At least that's how it starts before it's chemically processed into a form your body can't absorb, making it calorie-free.

(Video) The Problem with Stevia

It's approved for use in baked goods, so it's ready to serve your needsdesire for pregnancyof sugar-free chocolate cake. You can also find it in soft drinks, chewing gum, coffee and tea products, icing, frozen dairy desserts, fruit juices and sweet sauces. Before consuming all those tasty treats, think about everything in moderation.

Stevia during pregnancy

Stevia is a zero-calorie sweetener derived from a South American shrub. In sachet, drop, or even plant form, it's a favorite of nutritionists, often used in soft drinks and juices. The FDA says steviol glycosides — chemicals derived from the stevia leaf and used as novel sweeteners — are generally recognized as safe, but stevia has not been approved by the FDA as a non-nutritional sweetener; it is considered a dietary supplement.

Although experts say stevia may not increase sugar cravings the way other artificial sweeteners do (it doesn't raise your blood sugar or adversely affect your taste buds), it's best to consult with your doctor before using it.

Tagatose during pregnancy

Tagatose is also considered a novel sweetener due to its manufacture. It is made from the lactose in dairy products. (Now do you understand where the "roar" is coming from?)

The FDA classifies tagatose as a "Generally Recognized Substance as Safe" (GRAS), meaning it has been deemed safe for everyone -- including pregnant women.

Xylitol during pregnancy

Xylitol, a sugar alcohol, is commonly found in chewing gum, toothpaste, and candy and is considered safe in moderate amounts during pregnancy. So a couple of xylitol-sweetened gums a day is fine — but you might not want to chew five.

(Video) The Benefits of Sugar Substitutes During Pregnancy

Xylitol has 40 percent fewer calories than pure sugar (sucrose) and has been shown to prevent tooth decay - good if it's in your toothpaste!

So what is the take away? More research is needed on how different sweeteners affect pregnancy. Think about which sweeteners you like best and what your body tolerates well. Ultimately, the many types of FDA-approved sweeteners have similar health effects on you and your baby.

From the What to Expect editorial team andHeidi Murkoff,author ofWhat to expect when you are pregnant. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions, and reputable healthcare organizations. Learn how we keep our content accurate and up to date by reading ourmedical review and editorial guidelines.


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