Why You Might Want to Avoid Black Licorice Candy If You're Pregnant

If your pregnancy cravings commonly include chewy candy, you'll want to read this: A 2017 Finnish study confirmed that pregnant people should avoid consuming large amounts of black licorice. The reason? The study links excess fetal exposure to glycyrrhizin, the sweetener derived from licorice root that's found in licorice candy, to cognitive issues later in childhood.

If you're a fan of fruity or red licorice candy like Twizzlers and Red Vines, you're A-OK! While made similarly to its black counterpart, red "licorice" candy doesn't actually contain any licorice root or licorice root components like glycyrrhizin. The same goes for licorice-like products that don't contain real licorice root (anise oil is commonly used for its licorice-like smell and taste).

So what's the deal with licorice and pregnancy? Read on to learn about what the research says about licorice root in pregnancy and how it might affect children who were exposed to it in the womb.

How Much Is Too Much Licorice?

In the 2017 study, researchers from the University of Helsinki compared 378 children of gestational parents who had consumed varying amounts of licorice candy during pregnancy. For purposes of the study, a "large amount" was defined as more than 500 milligrams of glycyrrhizin or 250 grams of black licorice candy per week.

To put those numbers into context, experts say that adults over 40 can only safely consume around 56 grams of black licorice daily, which is about 2 ounces. Experts say that more than that amount could be harmful in as little as two weeks. For example, studies have found that two weeks of daily black licorice consumption in otherwise healthy adults increased blood pressure.

While the amount of black licorice candy that the study found was associated with negative effects when consumed during pregnancy was significantly more than what's considered safe in non-pregnant adults, experts don't know what amount may be safe to consume during pregnancy. In light of that, it might be a good idea for pregnant people to avoid the stuff altogether—at least until after giving birth.

Pregnant people in Finland (a country with one of the highest rates of licorice consumption) are reportedly already made aware of this: The country's National Institute for Health and Welfare lists licorice as "not recommended" to consume during pregnancy in their published guidelines.

The Risks of Licorice Root and Black Licorice Candy

Licorice root (the root of the Glycyrrhiza uralensis or Glycyrrhiza glabra plants) has a long history of use in traditional medicine and culinary culture. For example, it is used in Chinese medicine to treat gastrointestinal and respiratory issues. Licorice root is also used in the making of licorice candy for its distinct flavor (similar to that of anise or fennel) and sweetness.

Black licorice candy has developed a reputation for being dangerous after several high-profile medical cases in which people ate large amounts of black licorice and died shortly after. The problem? The active ingredient in black licorice: glycyrrhizic acid (also known as glycyrrhizin). Glycyrrhizic acid is naturally found in licorice root and is a potent sweetener that's at least 30 times sweeter than sucrose. This makes it a desirable food additive for candy makers.

Glycyrrhizin is safe to consume in small amounts, and you can find it in everything from supplements and herbal teas to candy and even craft beers. The maximum allowable level of glycyrrhizin is 16% for hard candy and 3.1% for soft candy, according to the Food and Drug Administration (FDA). (The maximum in other foods is much less: from 0.05% to 0.15%.) If consumed in moderation and according to serving sizes listed on packages, black licorice candy shouldn't pose a health problem to anyone.

The problem is that glycyrrhizic acid has a long half-life, which means it takes a long time to break down and leave the body. If someone eats black licorice every day, that acid sticks around, allowing it to build up quickly. That build-up of acid can lead to a condition called pseudohyperaldosteronism. Licorice-induced pseudohyperaldosteronism causes a drop in potassium levels, an increase in blood pressure, and other problems.

Adverse events associated with licorice root and glycyrrhizin, in particular, most often result in hypertension (high blood pressure) crises, which have sometimes resulted in the following:

• Blurred vision
• Headache
• Heart failure
• Pulmonary edema (fluid in the lungs)
  
• Seizure
• Stroke

As a result of the 2017 Finnish study, we now know that large amounts of glycyrrhizin are linked to long-term negative effects in children who were exposed to it through their gestational parent's diet during pregnancy.

How Black Licorice Affects Kids Who Were Exposed During Pregnancy

According to the study, fetal exposure to high levels of glycyrrhizin (through black licorice in the gestational parent's diet) correlated with lower cognitive test scores and impaired performance on tests measuring memory capacity later on in childhood.

The pregnant participants reported to researchers the brand of licorice candy they ate and how much per week. Once their babies were born, researchers waited approximately 12 years to track their growth and health to see any differences between kids exposed to low versus high levels of black licorice during fetal development. The study did not track other potential food sources of glycyrrhizin.

Lower IQs

Children exposed to high levels of black licorice in utero scored significantly lower than kids exposed to low levels of black licorice on IQ scales including verbal, word generation, memory, and more.

Higher rates of ADHD symptoms

Kids whose gestational parent consumed high levels of black licorice during pregnancy showed more symptoms of attention-deficit/hyperactivity disorder (ADHD) and ADHD-like issues than their peers.

Higher rates of mental health conditions

Children who were exposed to higher levels of black licorice also experienced higher rates of mental health and behavioral issues, including anxiety, oppositional defiance, and conduct problems.

Early puberty

One surprising outcome of the study is that children assigned female at birth (AFAB) who were exposed to higher levels of black licorice matured faster than those exposed to lower levels of black licorice.

AFAB children whose gestational parent consumed high amounts of licorice root in pregnancy were documented as having the following:

• Statistically higher weight, height, and BMI scores than expected
• Earlier menstruation
• Earlier body hair growth
• Earlier breast development

The study noted, however, that those assigned male at birth (AMAB) did not mature faster or slower than their peers.