If a parent is concerned about a child’s weight, Dr. Sylvetsky said in an email, “I would encourage replacement of sugar-sweetened beverages with unsweetened alternatives such as plain water, rather than simply switching from sugar-sweetened beverages to diet beverages containing nonnutritive sweeteners. An occasional sweet beverage, whether sugar-sweetened or diet, is fine, but the focus should really be on improving the overall diet.”
“What we want to instill is not, replace sugary food with nonnutritive sweeteners, but teach healthier behaviors,” Dr. Baker-Smith said. “Exercise 150 minutes out of the week, choose vegetables at meals, and fruit, appropriate portion size, not an adult-size plate.” She doesn’t see the nonnutritive sweeteners as necessarily beneficial over the long term.
“We should go back to the way we thought about sweets a long time ago, as a treat,” Dr. Baker-Smith said. “One sweet, once a week, not every meal.” And in that context, stick to real sugar for the treats, and avoid all sweetened beverages. That’s what she tries to do for herself and her own kids, she said. “I have gone to avoiding nonnutritive sweeteners for my own family, and I want parents to make the choice for themselves.”
The other message to parents is that to make these choices, we have to read labels — and the labels don’t have enough information. Because six of the eight sweeteners approved by the Food and Drug Administration are considered food additives, manufacturers are required only to state on the label that they are present, not to specify the quantity. Better, clearer labeling would help, she said. “This policy statement is really advocating that the F.D.A. make it clear how much nonnutritive sweetener is in each product, so parents can make informed decisions.”
These sweeteners turn up in an increasing number of places, from toothpaste to breakfast pastries. “If a product says low sugar or sugar-free, that likely means it contains a nonnutritive sweetener,” Dr. Baker-Smith said. “We have to all be aware of how much we’re taking in.”