According to Gram Research analysis, a 2026 nested case-control study of 194 pregnant women found that higher blood levels of polyols—natural sweeteners like sorbitol and erythritol—were associated with a 71% increased risk of delivering large babies and a 52% increased risk of gestational diabetes. The research suggests pregnant women may benefit from limiting polyol-containing foods and beverages.
A new study found that pregnant women with higher levels of polyols—natural sweeteners like sorbitol and erythritol found in many foods—had a significantly higher risk of gestational diabetes and delivering larger-than-average babies. Researchers analyzed blood samples from nearly 200 pregnant women and discovered that women with the highest polyol levels were 71% more likely to have large babies and 52% more likely to develop gestational diabetes. The findings suggest that while these sweeteners are considered safe, their consumption during pregnancy may warrant closer attention, especially for women already at risk.
Key Statistics
A 2026 nested case-control study of 194 pregnant women found that a one-standard-deviation increase in maternal serum polyol levels was associated with 71% higher odds of delivering large-for-gestational-age infants (OR 1.71, 95% CI: 1.22-2.40).
According to research reviewed by Gram, the same 2026 study of 194 pregnant women found that elevated polyol levels increased the odds of gestational diabetes by 52% (OR 1.52, 95% CI: 1.09-2.14).
A 2026 population-based nested case-control study found that babies born to mothers with higher serum polyol levels weighed approximately 95 grams (3.4 ounces) more than babies of mothers with lower polyol levels.
Among 194 pregnant women in a 2026 study, erythritol and sorbitol showed significant associations with large-for-gestational-age births, while xylitol and maltitol did not demonstrate significant associations.
The Quick Take
- What they studied: Whether natural sweeteners called polyols (found in sugar-free foods and some fruits) in a pregnant woman’s blood are connected to gestational diabetes and babies born larger than normal.
- Who participated: 194 pregnant women matched by age and weight, comparing those who developed gestational diabetes with those who didn’t. The study looked at their blood samples and birth outcomes.
- Key finding: Women with higher blood levels of polyols had 71% higher odds of delivering large babies and 52% higher odds of developing gestational diabetes during pregnancy.
- What it means for you: If you’re pregnant or planning to become pregnant, this research suggests limiting foods and drinks with polyol sweeteners (sorbitol, erythritol, xylitol, maltitol) may be wise, particularly if you have risk factors for gestational diabetes. Talk to your doctor about your diet.
The Research Details
This was a nested case-control study, which means researchers looked backward at medical records and blood samples from pregnant women. They compared two groups: women who developed gestational diabetes during pregnancy and women who didn’t. The groups were matched by age and body weight to make the comparison fair.
Researchers measured four types of polyols (sorbitol, erythritol, xylitol, and maltitol) in the women’s blood using advanced laboratory equipment called gas chromatography with mass spectrometry. This is like a highly precise chemical fingerprinting method that can detect tiny amounts of these sweeteners.
They then used statistical analysis to see if higher polyol levels were connected to gestational diabetes and to babies born weighing more than the 90th percentile for their gestational age (or over 4000 grams). They adjusted their analysis to account for other factors that might affect the results, like age, weight, and other health conditions.
This research approach is important because it looks at actual blood measurements rather than just asking women what they ate. People often forget what they consumed, but blood tests show what actually entered their bodies. By matching women on age and weight, the researchers made sure differences in outcomes weren’t simply due to these factors. This type of study is stronger than surveys but not as definitive as a randomized controlled trial.
Strengths: The study used precise laboratory measurements and matched participants carefully. The sample size was reasonable for this type of study. Limitations: The study is relatively small and only looked at one population at one time point. It shows association, not that polyols definitely cause these problems. The study couldn’t prove cause-and-effect, only that higher polyol levels were present in women who had these complications.
What the Results Show
Among the 194 women studied, about 24% had babies that were larger than normal. Women with higher polyol levels in their blood were significantly more likely to be in this group. For every standard increase in polyol levels, the odds of having a large baby increased by 71%, and the odds of developing gestational diabetes increased by 52%.
When researchers looked at individual sweeteners, erythritol and sorbitol showed the strongest connections to large babies. Xylitol and maltitol didn’t show significant associations. This suggests that not all polyols affect pregnancy the same way.
Babies born to mothers with higher polyol levels weighed about 95 grams (roughly 3 ounces) more on average than babies of mothers with lower polyol levels. Additionally, mothers with higher polyol levels showed signs of greater insulin resistance, a condition where the body doesn’t respond well to insulin, which is a hallmark of gestational diabetes.
The study found that elevated polyol levels were also associated with higher insulin resistance scores (measured by HOMA-IR), suggesting these sweeteners may affect how the body processes blood sugar. This connection between polyol levels and insulin resistance helps explain why higher polyol levels were linked to gestational diabetes.
Previous research has raised questions about artificial and natural sweeteners during pregnancy, but studies on polyols specifically have been limited. This is one of the first studies to measure actual blood levels of polyols and connect them to pregnancy complications. The findings align with growing concerns that even ’natural’ sweeteners may not be neutral during pregnancy, when the body’s metabolism is particularly sensitive.
The study only included women from one population and one time period, so results may not apply everywhere. The sample size was modest (194 women), which means the findings need confirmation in larger studies. The study shows association but cannot prove that polyols cause gestational diabetes or large babies—only that they’re connected. Women’s diets weren’t directly measured, only the polyol levels in their blood at one point in time. The study couldn’t account for all possible factors that might influence the results.
The Bottom Line
Moderate confidence: Pregnant women, especially those at risk for gestational diabetes, should consider limiting foods and beverages containing polyol sweeteners (sorbitol, erythritol, xylitol, maltitol). This includes many sugar-free candies, gums, and diet products. Discuss your sweetener intake with your healthcare provider, particularly if you have risk factors like family history of diabetes or overweight.
This research is most relevant for pregnant women, women planning pregnancy, and healthcare providers caring for pregnant patients. It’s particularly important for women with risk factors for gestational diabetes, including those who are overweight, have a family history of diabetes, or are over age 35. Women without risk factors should still discuss this with their doctor but may have more flexibility.
Gestational diabetes typically develops in the second or third trimester, so reducing polyol intake early in pregnancy may be most protective. Benefits of dietary changes would likely appear in improved blood sugar control during routine pregnancy screening tests, typically done around 24-28 weeks of pregnancy.
Frequently Asked Questions
Are sugar-free sweeteners safe during pregnancy?
This 2026 study suggests polyol sweeteners (sorbitol, erythritol, xylitol, maltitol) may not be neutral during pregnancy. Women with higher blood levels had 71% higher odds of large babies and 52% higher odds of gestational diabetes. Discuss sweetener choices with your healthcare provider.
What foods contain polyols that pregnant women should avoid?
Polyols are found in sugar-free candies, gums, diet sodas, and some fruits like avocados and stone fruits. Check product labels for sorbitol, erythritol, xylitol, and maltitol. This study suggests limiting these during pregnancy, especially if you have diabetes risk factors.
Does eating polyols during pregnancy cause gestational diabetes?
This study shows association, not cause-and-effect. Women with higher polyol levels had higher gestational diabetes risk, but the study cannot prove polyols caused it. Other factors may be involved. More research is needed to establish direct causation.
How much do babies weigh when mothers consume polyols during pregnancy?
In this 2026 study of 194 women, babies born to mothers with higher polyol levels weighed about 95 grams (3.4 ounces) more on average than babies of mothers with lower polyol levels. About 24% of babies in the study were classified as large-for-gestational-age.
Should all pregnant women eliminate polyol sweeteners?
This study suggests caution rather than complete elimination. Women at higher risk for gestational diabetes—including those who are overweight, over 35, or have family history of diabetes—should particularly limit polyols. Discuss your individual situation with your healthcare provider.
Want to Apply This Research?
- Log daily intake of sugar-free products and polyol-containing foods (diet sodas, sugar-free candy, some fruits like avocado and stone fruits). Track alongside weekly blood glucose readings if available, noting any patterns between polyol consumption and blood sugar levels.
- Replace polyol-sweetened products with naturally sweet options like fresh fruit, or use small amounts of regular sugar in moderation rather than sugar-free alternatives. Set a weekly goal to reduce purchases of diet products and sugar-free foods.
- Weekly check-ins on polyol product consumption, monthly review of blood glucose trends if monitored, and discussion with healthcare provider at each prenatal visit about dietary choices and any new symptoms of high blood sugar (increased thirst, frequent urination).
This research shows an association between polyol levels and pregnancy complications but does not prove causation. Individual pregnancy risks vary widely based on genetics, overall health, and lifestyle factors. Pregnant women should not make significant dietary changes without consulting their healthcare provider. This information is for educational purposes and should not replace professional medical advice. If you have concerns about gestational diabetes or your baby’s size, discuss them with your obstetrician or midwife.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.