Children whose sugar consumption was restricted during their first 1 000 days after conception had up to 35% less chance of developing type 2 diabetes and as much as 20% less risk of hypertension as adults, researchers have suggested.
In a study using contemporary data from the UK Biobank to investigate the effect of those early-life sugar restrictions on health outcomes of adults conceived in the UK just before and after the end of wartime sugar rationing, they said a low-sugar diet in utero and in the first two years of life can meaningfully reduce the risk of chronic diseases in adulthood.
The findings, they said, provide compelling new evidence of the lifelong health effects of early-life sugar consumption.
Published in Science, the study suggested that low sugar intake by the mother before birth was enough to lower risks, but continued sugar restriction after birth increased the benefits.
Taking advantage of an unintended “natural experiment” from World War II, researchers at the USC Dornsife College of Letters, Arts and Sciences, McGill University in Montreal, and the University of California, Berkeley, examined how sugar rationing during the war influenced long-term health outcomes.
The United Kingdom introduced limits on sugar distribution in 1942 as part of its wartime food rationing programme. Rationing ended in September 1953.
“Studying the long-term effects of added sugar on health is challenging,” said study corresponding author Tadeja Gracner, senior economist at the USC Dornsife Centre for Economic and Social Research.
“It is hard to find situations where people are randomly exposed to different nutritional environments early in life and then to follow them for 50 to 60 years. The end of rationing provided us with a novel natural experiment to overcome these problems.”
Sugar intake during rationing was about eight teaspoons (40g) per day on average. When rationing ended, sugar and sweets consumption skyrocketed to about 16 teaspoons (80g) per day.
Notably, rationing did not involve extreme food deprivation overall. Diets generally appeared to have been, in fact, within today’s guidelines set by the World Health Organisation (WHO), which recommend no added sugars for children under two and not more than 12 teaspoons (50g) of added sugar daily for adults.
The immediate and large increase in sugar consumption but no other foods – after rationing ended – created an interesting natural experiment: individuals were exposed to varying levels of sugar intake early in life, depending on whether they were conceived or born before or after September 1953.
Those conceived or born just before the end of rationing experienced sugar-scarce conditions, compared with those born just after who were born into a more sugar-rich environment.
The researchers then identified those born around this time in the UK Biobank data collected more than 50 years later. Using a very tight birth window around the end of sugar rationing allowed the authors to compare midlife health outcomes of otherwise similar birth cohorts.
While living through the period of sugar restriction during the first 1 000 days of life substantially lowered the risk of developing diabetes and hypertension, for those who were later diagnosed with either of those conditions, onset of disease was delayed by four years and two years, respectively.
Notably, exposure to sugar restrictions in utero alone was enough to lower risks, but disease protection increased post-natally once solids were probably introduced.
The magnitude of this effect is meaningful as it can save costs, extend life expectancy and, perhaps more importantly, quality of life, said the researchers.
Experts’ concerns continue to mount about children’s long-term health as they consume excessive amounts of added sugars during their early life, a critical period of development.
Adjusting this consumption, however, is not easy – added sugar is everywhere, even in baby and toddler foods, and children are bombarded with TV ads for sugary snacks, the researchers said.
“Parents need information about what works, and this study provides some of the first causal evidence that reducing added sugar early in life is a powerful step towards improving children’s health over their lifetimes,” noted study co-author Claire Boone of McGill University and the University of Chicago.
This study is the first of a larger research effort exploring how early-life sugar restrictions affected a broader set of economic and health outcomes in later adulthood, including education, wealth, and chronic inflammation, cognitive function and dementia.
Study details
Exposure to sugar rationing in the first 1000 days of life protected against chronic disease
Tadeja Gracner, Claire Boone, and Paul Gertler.
Published in Science on 31 October 2024
Abstract
We examined the impact of sugar exposure within 1000 days since conception on diabetes and hypertension, leveraging quasi-experimental variation from the end of the United Kingdom’s sugar rationing in September 1953. Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-rationing. Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, we found that early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by four and two years. Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began. In-utero sugar rationing alone accounted for about one third of the risk reduction.
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