by Bianca Garilli, ND, IFMCP
Within the past few decades the rates of obesity, metabolic syndrome and diabetes throughout the world have risen dramatically. Although there are many potential causes for this rise, one such contributor may be increased antenatal intake of sugary drinks.1 Intake of as little as 0.6 servings per day (standard deviation of 0.9 servings) of sugar-sweetened beverages (SSBs) during pregnancy has been associated with adiposity in mid-childhood (median age of 7.7 years) with the greatest association being seen with SSB intake during second trimester. The association was due primarily to maternal intake and to high fructose corn syrup (HFCS) sugary soda consumption rather than naturally occurring fructose found in fruit drinks or juice.2
Fructose is a monosaccharide and a natural component of the human diet; it occurs naturally in berries and many fruits such as cherries, raisins and apples and comprises about 40% of honey. Combining fructose with glucose creates the well-known disaccharide sucrose molecule or table sugar; fructose is also found in a variety of syrups including high fructose corn syrups (HFCS) where it may be present in levels ranging between 45-55% of the product.3 Recent data continues to link excess HFCS consumption to rising levels of obesity and metabolic syndrome which, in turn, may give rise to a variety of other chronic illnesses including osteoarthritis, fatty liver, stroke, and asthma.
More recently however, emerging evidence indicates that maternal consumption of high sugar and fructose containing drinks may increase risk of childhood asthma, regardless of whether the child is obese or has metabolic syndrome. This is a startling finding pointing towards the possibility that sugar-sweetened, fructose-containing drinks may be altering signaling mechanisms for increased inflammation through other mechanisms besides elevated levels of adipose tissue. A study conducted with various departments from Brigham and Women’s Hospital, Harvard Medical School, and Harvard Pilgrim Health Care Institute in Boston, Massachusetts was published in the Annals of the American Thoracic Society. Through this study researchers found a link between maternal intake of high-fructose, corn syrup-sweetened beverages with increased mid-childhood prevalence of asthma indicating a need to educate women during childbearing years on the importance of removing SSBs and fructose-containing drinks from their diet during pregnancy. This increased association was also seen between young childhood SSB and fructose intake and mid-childhood asthma risk.4
Why is this Clinically Relevant?
- SSB and fructose-containing drink consumption should be discouraged in all women during childbearing years
- HCPs should ask about SSB and fructose-containing drink consumption during clinic visit and offer non-sugar and non-fructose based options as substitutes
- Childhood intake of SSB and fructose containing drinks should be limited or completely eliminated to further reduce risk of mid-childhood obesity, metabolic syndrome and asthma
- Rodriguez L et al. Maternal fructose intake induces insulin resistance and oxidative stress in male, but not female, offspring. Journal of Nutrition and Metabolism. 2015;2015:158091.
- Gillman MW et al. Beverage intake during pregnancy and childhood adiposity. Pediatrics. 2017;140(2):e20170031.
- Ziesenitz SC. Foods, Nutrients and Food Ingredients with Authorised EU Health Claims: Volume 2, 2015.
- Wright LS et al. Prenatal and early life fructose, fructose-containing beverages and midchildhood asthma. Ann Am Thorac Soc. 2018;15(2):217-224.