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Is there an association between artificial sweetener consumption and assisted reproduction outcomes?

Published:November 28, 2017DOI:https://doi.org/10.1016/j.rbmo.2017.11.004

      Abstract

      Previous studies have suggested an association between high intake of sweetened beverages and a number of adverse health outcomes. In this cross-sectional study, we investigated the association between daily consumption of sweetened soft drinks or coffee and the outcome of intracytoplasmic sperm injection (ICSI) treatment. Patients (n = 524) were interviewed by a nutritionist before ICSI treatment, using a food frequency questionnaire. Regression analysis showed that consumption of ≥3 servings of regular soft drinks or any amount of diet soft drinks was associated with oocyte dysmorphism, diminished embryo quality on days 2 and 3 of culture, and a mild effect on blastocyst formation, implantation and pregnancy rate. Consumption of artificially sweetened coffee was negatively associated with embryo quality on days 2 and 3. However, consumption of coffee or soft drinks was not associated with the odds of live birth. Even so, patients should be advised about the potential negative effects of sugar and artificial sweeteners before attempting infertility treatment. This study is limited by the use of a non-validated food frequency questionnaire, lack of information on quantity of sweeteners consumed, and lack of data on glucose levels in blood serum or follicular fluid. Further investigation is warranted.

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      References

        • Andraweera P.H.
        • Dekker G.A.
        • Thompson S.D.
        • North R.A.
        • McCowan L.M.
        • Roberts C.T.
        • Consortium S.
        The interaction between the maternal BMI and angiogenic gene polymorphisms associates with the risk of spontaneous preterm birth.
        Mol. Hum. Reprod. 2012; 18: 459-465
        • Andrews J.E.
        • Ebron-McCoy M.
        • Schmid J.E.
        • Svendsgaard D.
        Effects of combinations of methanol and formic acid on rat embryos in culture.
        Teratology. 1998; 58: 54-61
        • Barker D.J.
        The origins of the developmental origins theory.
        J. Intern. Med. 2007; 261: 412-417
        • Barker D.J.
        • Bagby S.P.
        • Hanson M.A.
        Mechanisms of disease: in utero programming in the pathogenesis of hypertension.
        Nat. Clin. Pract. Nephrol. 2006; 2: 700-707
        • Blackburn G.L.
        • Kanders B.S.
        • Lavin P.T.
        • Keller S.D.
        • Whatley J.
        The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight.
        Am. J. Clin. Nutr. 1997; 65: 409-418
        • Block G.
        Foods contributing to energy intake in the US: data from NHANES III and NHANES 1999–2000.
        J. Food Compost Anal. 2004; 17: 439-447
        • Braga D.P.
        • Halpern G.
        • Setti A.S.
        • Figueira R.C.
        • Iaconelli Jr., A.
        • Borges Jr., E.
        The impact of food intake and social habits on embryo quality and the likelihood of blastocyst formation.
        Reprod. Biomed. Online. 2015; 31: 30-38
        • Brown R.J.
        • Walter M.
        • Rother K.I.
        Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion.
        Diabetes Care. 2009; 32: 2184-2186
        • Brown-Woodman P.D.
        • Huq F.
        • Hayes L.
        • Herlihy C.
        • Picker K.
        • Webster W.S.
        In vitro assessment of the effect of methanol and the metabolite, formic acid, on embryonic development of the rat.
        Teratology. 1995; 52: 233-243
        • Burbacher T.M.
        • Grant K.S.
        • Shen D.D.
        • Sheppard L.
        • Damian D.
        • Ellis S.
        • Liberato N.
        Chronic maternal methanol inhalation in nonhuman primates (Macaca fascicularis): reproductive performance and birth outcome.
        Neurotoxicol. Teratol. 2004; 26: 639-650
        • Chattopadhyay S.
        • Raychaudhuri U.
        • Chakraborty R.
        Artificial sweeteners—a review.
        J Food Sci Technol. 2014; 51: 611-621
        • Cutfield W.S.
        • Hofman P.L.
        • Mitchell M.
        • Morison I.M.
        Could epigenetics play a role in the developmental origins of health and disease?.
        Pediatr. Res. 2007; 61: 68R-75R
        • Dhingra R.
        • Sullivan L.
        • Jacques P.F.
        • Wang T.J.
        • Fox C.S.
        • Meigs J.B.
        • D'Agostino R.B.
        • Gaziano J.M.
        • Vasan R.S.
        Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community.
        Circulation. 2007; 116: 480-488
        • Englund-Ogge L.
        • Brantsaeter A.L.
        • Haugen M.
        • Sengpiel V.
        • Khatibi A.
        • Myhre R.
        • Myking S.
        • Meltzer H.M.
        • Kacerovsky M.
        • Nilsen R.M.
        • Jacobsson B.
        Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study.
        Am. J. Clin. Nutr. 2012; 96: 552-559
        • Ferreira R.C.
        • Halpern G.
        • Figueira Rde C.
        • Braga D.P.
        • Iaconelli Jr., A.
        • Borges Jr., E.
        Physical activity, obesity and eating habits can influence assisted reproduction outcomes.
        Womens Health (Lond). 2010; 6: 517-524
        • Fowler S.P.
        • Williams K.
        • Resendez R.G.
        • Hunt K.J.
        • Hazuda H.P.
        • Stern M.P.
        Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain.
        Obesity (Silver Spring). 2008; 16: 1894-1900
        • Gardener H.
        • Rundek T.
        • Markert M.
        • Wright C.B.
        • Elkind M.S.
        • Sacco R.L.
        Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study.
        J. Gen. Intern. Med. 2012; 27: 1120-1126
        • Halldorsson T.I.
        • Strom M.
        • Petersen S.B.
        • Olsen S.F.
        Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women.
        Am. J. Clin. Nutr. 2010; 92: 626-633
        • Hutson J.R.
        • Lubetsky A.
        • Eichhorst J.
        • Hackmon R.
        • Koren G.
        • Kapur B.M.
        Adverse placental effect of formic acid on hCG secretion is mitigated by folic acid.
        Alcohol. 2013; 48: 283-287
        • Ludwig D.S.
        Artificially sweetened beverages: cause for concern.
        JAMA. 2009; 302: 2477-2478
        • Lutsey P.L.
        • Steffen L.M.
        • Stevens J.
        Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study.
        Circulation. 2008; 117: 754-761
        • Magnuson B.
        Aspartame–facts and fiction.
        N. Z. Med. J. 2010; 123: 53-57
        • Mattes R.D.
        • Popkin B.M.
        Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms.
        Am. J. Clin. Nutr. 2009; 89: 1-14
        • Nettleton J.A.
        • Lutsey P.L.
        • Wang Y.
        • Lima J.A.
        • Michos E.D.
        • Jacobs Jr., D.R.
        Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).
        Diabetes Care. 2009; 32: 688-694
        • Ng S.W.
        • Popkin B.M.
        Monitoring foods and nutrients sold and consumed in the United States: dynamics and challenges.
        J. Acad. Nutr. Diet. 2012; 112 (e44): 41-45
        • Olivier B.
        • Serge A.H.
        • Catherine A.
        • Jacques B.
        • Murielle B.
        • Marie-Chantal C.L.
        • Sybil C.
        • Jean-Philippe G.
        • Sabine H.
        • Esther K.
        • Perrine N.
        • Fabienne R.
        • Gerard S.
        • Irene M.
        Review of the nutritional benefits and risks related to intense sweeteners.
        Arch Public Health. 2015; 73: 41
        • Pepino M.Y.
        • Bourne C.
        Non-nutritive sweeteners, energy balance, and glucose homeostasis.
        Curr. Opin. Clin. Nutr. Metab. Care. 2011; 14: 391-395
        • Phelan S.
        • Lang W.
        • Jordan D.
        • Wing R.R.
        Use of artificial sweeteners and fat-modified foods in weight loss maintainers and always-normal weight individuals.
        Int. J. Obes. (Lond). 2009; 33: 1183-1190
        • Piernas C.
        • Ng S.W.
        • Popkin B.
        Trends in purchases and intake of foods and beverages containing caloric and low-calorie sweeteners over the last decade in the United States.
        Pediatr Obes. 2013; 8: 294-306
        • Rogers P.J.
        • Hogenkamp P.S.
        • de Graaf C.
        • Higgs S.
        • Lluch A.
        • Ness A.R.
        • Penfold C.
        • Perry R.
        • Putz P.
        • Yeomans M.R.
        • Mela D.J.
        Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies.
        Int. J. Obes. (Lond). 2016; 40: 381-394
        • Scholl T.O.
        • Sowers M.
        • Chen X.
        • Lenders C.
        Maternal glucose concentration influences fetal growth, gestation, and pregnancy complications.
        Am. J. Epidemiol. 2001; 154: 514-520
        • Schulze M.B.
        • Manson J.E.
        • Ludwig D.S.
        • Colditz G.A.
        • Stampfer M.J.
        • Willett W.C.
        • Hu F.B.
        Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women.
        JAMA. 2004; 292: 927-934
        • Serván P.R.
        • Poyatos R.S.
        • Rodríguez J.S.
        Low and no calorie sweeteners (LNCS); myths and realities.
        Nutr. Hosp. 2014; 30: 49-55
        • Shim J.S.
        • Oh K.
        • Kim H.C.
        Dietary assessment methods in epidemiologic studies.
        Epidemiol Health. 2014; 36: e2014009
        • Spencer M.
        • Gupta A.
        • Dam L.V.
        • Shannon C.
        • Menees S.
        • Chey W.D.
        Artificial sweeteners: a systematic review and primer for gastroenterologists.
        J Neurogastroenterol Motil. 2016; 22: 168-180
        • Swithers S.E.
        Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements.
        Trends Endocrinol. Metab. 2013; 24: 431-441
        • Sylvetsky A.
        • Rother K.I.
        • Brown R.
        Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions.
        Pediatr. Clin. North Am. 2011; 58 (xi): 1467-1480
        • Sylvetsky A.C.
        • Welsh J.A.
        • Brown R.J.
        • Vos M.B.
        Low-calorie sweetener consumption is increasing in the United States.
        Am. J. Clin. Nutr. 2012; 96: 640-646
        • Tate D.F.
        • Turner-McGrievy G.
        • Lyons E.
        • Stevens J.
        • Erickson K.
        • Polzien K.
        • Diamond M.
        • Wang X.
        • Popkin B.
        Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial.
        Am. J. Clin. Nutr. 2012; 95: 555-563
        • Trocho C.
        • Pardo R.
        • Rafecas I.
        • Virgili J.
        • Remesar X.
        • Fernandez-Lopez J.A.
        • Alemany M.
        Formaldehyde derived from dietary aspartame binds to tissue components in vivo.
        Life Sci. 1998; 63: 337-349
        • Winkelmayer W.C.
        • Stampfer M.J.
        • Willett W.C.
        • Curhan G.C.
        Habitual caffeine intake and the risk of hypertension in women.
        JAMA. 2005; 294: 2330-2335

      Biography

      Amanda S Setti obtained her BSc degree in 2005 at Universidade de Santo Amaro, a specialist degree in human assisted reproduction in 2007 at Associação Instituto Sapientiae, and her MSc degree in 2015 at Faculdade de Ciências Médicas da Santa Casa de São Paulo. At present she is a scientific researcher for the Fertility Medical Group and Associação Instituto Sapientiae in Sao Paulo, Brazil.
      Key message
      Women consuming regular or diet soft drinks are at increased risk of oocyte dimorphisms, diminished embryo quality and a mild negative effect on blastocyst formation, implantation and pregnancy rates. Unfavourable embryo development was observed in women consuming artificially sweetened coffee.