In a recent study published in Nutrients, The researchers wanted to study the artificial sweetener content of food products commonly consumed by children (syrups, juices and soft drinks) and to check their parents’ knowledge of the declarations of these products.
Study: Consumption of artificial sweeteners through soft drinks in the preschool and school-age populationPhoto credit: WS-Studio/Shutterstock.com
Introduction
The study results indicate that more than half (54%) of the products consumed by children aged 1 to 14 contain artificial sweeteners.
Most parents (51%) are not aware of this fact because they do not carefully read the nutritional information or content declarations of the products they buy.
These findings highlight the need for tailored consumer education programs to inform parents about the potentially harmful effects of artificial sweeteners and other food choices on young children.
Background
An alarming and persistent public health problem is the growing number of overweight and obese people worldwide.
Recent reports suggest that more than half of European adults (53%) and almost a third of children (29%; age group – 6 to 9 years) are overweight (body mass index [BMI] (over 25) with the World Health Organization (WHO) estimating that 37 million children under five are overweight in 2022.
An abnormally high BMI has already been associated with an increased risk of chronic noncommunicable diseases, including diabetes, cancer and cardiovascular disease (CVD), making addressing this trend a crucial goal.
Poor dietary choices, combined with reduced physical activity habits, have been identified as the leading cause of obesity worldwide, with the WHO acknowledging the role of excessive sugar consumption in these outcomes and recommending that sugar should not account for more than 10% of individuals’ total daily caloric intake.
A recent trend among food manufacturers and “health conscious” consumers is to replace sugar-based sweeteners with artificial sweeteners.
Although sugar substitutes are touted as healthier alternatives to sugar, research on their physiological effects remains inconsistent, so the WHO recommends avoiding their consumption.
“…several studies highlight their possible harmful effects by increasing the risk of type 2 diabetes, cardiovascular diseases, premature mortality and changes in the gastrointestinal tract.”
About the study
Although Croatian cuisine follows the principles of the Mediterranean diet, known as the “gold standard” for healthy eating, the country has one of the highest proportions of overweight children in the world.
Previous research has suggested that soft drinks may be primarily responsible for these observations. However, no studies have assessed the percentage of children who consume these products or their parents’ ability to be aware of their potentially harmful effects.
This study aims to fill these knowledge gaps by means of a cross-sectional questionnaire survey conducted among two large preschools in Split, Croatia.
Parents of children studying at these institutions, selected at random, were given a personalized questionnaire containing information about their children’s eating habits and their awareness of the content of the food products they buy.
Additionally, parents’ attitudes toward obesity and artificial sweeteners were recorded using a 5-point Likert scale.
Common items identified through these questionnaires were grouped into six types (soft drinks, juices/nectars, syrups, instant drinks, protein drinks or chewing gum) and subjected to high-performance liquid chromatography (HPLC) to elucidate their chemical composition.
Statistical analyses included descriptive statistics for survey items and chi-square or Mann-Whitey U tests for between-group assessments. The Kolmogorov-Smirnov test was used for normality assessments.
Study results
Three hundred and twenty-three parents participated in the survey (89% female; median age 37 years), including parents of preschool-aged children (children aged 1–7 years; n = 250) and school-aged children (aged 7–14 years; n = 73).
Parents provided information on their wards’ dietary habits and demographic data (age, gender, BMI, parental education level, and physical activity).
Common item identification identified 90 food products including 35 soft drinks, 33 fruit juices, three syrups, five instant drinks, two protein drinks and 12 chewing gums.
BMI assessments revealed that most of the included children had a BMI below the ideal BMI recommended by WHO (83%; mean = 15.4 kg/m2). Physical activity assessments revealed that 33.2% of the children included did not participate in any form of physical activity.
HPLC assessments revealed that 54% of the 90 included products contained artificial sweeteners (75% of chewing gum, 21.2% of juices, 59% of soft drinks and 21.2% of nectars). Encouragingly, all but one of these food products had the identified sweeteners in their nutritional description.
Unfortunately, more than half (51%) of parents said they do not read food labels when making purchasing decisions and are therefore unaware of the sweetener content of these products.
Correlations between questionnaires and HPLC results reveal that 40% of children surveyed consume products containing artificial sweeteners on a daily basis.
Further data analysis showed a correlation between the frequency of soft drink or syrup consumption and increased BMI in the children surveyed.
Conclusions
The present study revealed that most Croatian soft drinks and other beverages contain varying concentrations of artificial sweeteners.
Even though most products list the presence of these sweeteners on their labels, most parents do not read product descriptions, making them unaware of the potentially harmful chemical composition of their children’s diet.
About 40% of the children surveyed consumed products containing sweeteners daily, and assessments of their BMI indicated a correlation between increasing BMI and frequency of beverage consumption.
These findings highlight the need for educational campaigns targeting parents to change their current dietary habits. The 1-14 age range represents a critical age for children’s growth and development, and suboptimal diets during these vital years can translate into chronic diseases in adulthood.
“It is very important, especially for young children, to change the perception of food acceptance and get used to eating normal foods, not too sweet, whether the sweetness comes from sugar or artificial sweeteners.”