29 - Intergenerational Transmission of Low-calorie Sweeteners in Breast Milk

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 29
Publication Number: 29.201

Janae T. Kuttamperoor, The George Washington University, Wayne, NJ, United States; Brooke Langevin, University of Maryland Baltimore School of Pharmacy, Baltimore, MD, United States; Jeanne Murphy, George Washington University School of Nursing, Baltimore, MD, United States; Dina H. Daines, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; John N. van den Anker, Children's National Health System, Washington, DC, United States; Mathangi Gopalakrishnan, University of Maryland School of Pharmacy, Baltimore, MD, United States; Allison Sylvetsky, The George Washington University, Washington, DC, United States

Presenting Author(s)

Janae T. Kuttamperoor, BA (she/her/hers)

Senior Research Assistant
The George Washington University
Wayne, New Jersey, United States

Background: Low-calorie sweeteners (LCS), such as sucralose and acesulfame-potassium (ace-K) are used as replacements for added sugars because they provide sweetness without calories. In the United States, 44% of lactating women consume beverages with LCS; yet LCS concentrations in breast milk transmitted to infants and effects of early life LCS exposure on infants’ future diet, weight, and health are not well understood.

Objective:

To measure the amount of sucralose and ace-K that reaches breast milk and maternal plasma at pre-specified, serial, timepoints for 72 hours, as well as infants’ plasma.

Design/Methods:

Mothers (n=22) were asked to avoid LCS and record their dietary intake one week prior to an in-person study visit. A blood and breast milk sample were collected from mothers at the start of the visit; after which, mothers drank 20 oz of diet cranberry juice, sweetened with sucralose and ace-K. Maternal plasma and breast milk samples were collected at standardized timepoints for 12 hours after diet beverage ingestion. One blood sample was also collected from the infant. The timing of the infant plasma sample collection was determined through a pharmacokinetic modeling approach to capture the entire time-course of both sweeteners after ingestion of the mothers’ breast milk. Mothers returned for follow-up visits on three consecutive days for additional breast milk and blood sample collections. One mother was excluded from analysis due to unusually high LCS concentrations at baseline, which decreased following diet beverage ingestion.

Results:

Ace-K rapidly transferred into breast milk with an average peak concentration of 414.45 ng/ml measured within 4 hours of diet beverage ingestion. Sucralose appeared in breast milk 1-2 hours after diet beverage ingestion with a mean peak concentration (7.19 ng/ml) detected 6-8 hours post-ingestion. Ace-K was detected in all infants’ plasma with an average peak concentration of 10.34 ng/ml approximately 5.5 hours after maternal ingestion of the diet beverage; however, sucralose was detected in only ten infants’ plasma approximately 6 hours after maternal ingestion of the diet beverage with a mean peak concentration of 3.20 ng/ml.

Conclusion(s):

Ace-K rapidly transfers from mothers’ breast milk into infants’ circulation; yet sucralose was detected in the circulation of some but not all infants. Validation of the present findings with a larger sample is needed along with further investigation of potential effects of LCS exposure via breast milk on infants’ taste preferences, appetite, gut microbiome composition, and cardiometabolic risk factors.