Early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by 4 and 2 years.
In a recent study published in Science, researchers investigated how exposure to sugar in early life, specifically the first 1000 days, impacts the risk of developing hypertension and diabetes.
Their findings indicate that sugar rationing during this period significantly reduces the risk of developing these conditions and can also delay their onset.
Background
The first 1000 days of life, from conception to the age of two, is known to be crucial for long-term health, and poor diet during this time has been linked to negative health outcomes into adulthood. While animal studies show lasting harm from early-life sugar, human evidence is limited, with past human studies focused mainly on extreme conditions (e.g., famine) and maternal health factors.
Current dietary recommendations note that no added sugar should be consumed during this time. However, studies from the United States suggest that a majority of infants and toddlers have excessive sugar intakes, attributable to sugary foods and maternal diets, with most eating sweetened foods every day. Researchers have also found that pregnant and lactating American women’s sugar intake is over triple the recommended amount of 80g per day.
About the study
In this study, researchers used the end of sugar rationing in the United Kingdom in 1953 as a natural experiment, comparing adults conceived just before it ended (who would have had lower exposure to sugar) with those conceived immediately after (theorized to have higher exposure).
They hypothesized that sugar restriction during early life would reduce the risk of developing hypertension and type 2 diabetes mellitus (T2DM) and that longer exposure to sugar rationing, particularly during gestation and early childhood, would be associated with greater health benefits.
Data was obtained from the UK BioBank, which provided outcomes related to hypertension and T2DM in more than 500,000 participants, and the National Food Survey (NFS), which included 60,183 adults, of whom 38,155 were exposed to sugar rationing.
Exposure to sugar restriction was classified as ‘in utero and postnatal months,’ ‘in utero,’ and ‘never.’ Diagnoses of hypertension and T2DM and age at onset were the primary outcome variables.
Researchers used statistical models to compare the hazard rates for hypertension and T2DM in the rationed and non-rationed groups, adjusting for birth season, location, health history of parents, and genetic risk of obesity, and also conducted sensitivity analyses to avoid biases and confirm the accuracy of the model.
Findings
After sugar rationing in the UK ended in 1953, adult sugar intake nearly doubled, with children’s consumption also showing large increases. Calorie intakes also exhibited large increases, driven primarily by increased sugar consumption. Increased sugar intake was linked to poorer oral health in children.
Researchers also identified clear links between sugar restriction in early life and chronic disease. Early-life exposure to low sugar during rationing reduced the risk of hypertension and T2DM by 20% and 35%, respectively. The onset period for the diseases was reduced by about two years for hypertension and four years for T2DM.
The risk of T2DM and hypertension was lowest in adults with prolonged exposure to sugar rationing, especially after six months of age. Each additional month of rationing further reduced disease risk. In-utero exposure alone accounted for a significant portion of reduced disease risk.
Researchers considered other foods that were also de-rationed during this time, such as meat and butter, but found that these had minimal impacts on chronic disease risk or overall changes in diet. Higher consumption of canned fruits may have been a contributor to higher intake of sugar.
Conclusions
Overall, the delayed hypertension and T2DM diagnoses in rationed groups indicate the potential benefits of sugar restriction, with in-utero rationing leading to lower waist-to-height ratios and reduced obesity. The validity of the findings is strengthened by the fact that no effects were seen for unrelated conditions like myopia or trauma-linked depression.
Restricting sugar intake in utero contributed to a significant reduction in disease risk, supporting the “fetal origins hypothesis.” Early-life sugar exposure impacts lifelong sweetness preferences, increasing T2DM and hypertension risk. Postnatal sugar restriction had a notable protective effect, particularly for women.
These findings suggest that following current guidelines for dietary sugar during early life could have significant health implications, aligning with results from diabetes prevention interventions. They add to the evidence in support of policies targeting limiting sugar in foods for infants, such as stricter market regulations and taxes on sugar.
Further research is needed to explore optimal levels of sugar consumption during pregnancy, lactating, and early feeding stages to promote long-term health benefits.
