Early-Life Sugar Restriction Reduces T2D, Hypertension Risk

TOPLINE:

Exposure to sugar rationing in the womb and in early childhood may lower the risk for type 2 diabetes (T2D) and hypertension later in life, with the protective effects most pronounced when sugar restriction lasts more than 6 months after birth.

METHODOLOGY: 

• Dietary exposures in the first 1000 days after conception can affect adult health, but little is known about the effect of excessive sugar consumption by US children from the maternal diet in utero and while breastfeeding, as well as through infant formula and solid foods.
• This study used a natural experiment to assess the effect of early-life sugar exposure on the later risk for T2D and hypertension, comparing adults conceived shortly before and after September 1953, the end of World War II sugar rationing in the United Kingdom, when sugar consumption nearly doubled.
• Overall, 60,183 participants from the UK Biobank born between October 1951 and March 1956 were included; adults conceived in the 1000 days prior to September 1953 were defined as “rationed” (n = 38,155).
• Exposure to sugar rationing was classified as never, in utero only, and in utero plus 6, 12, 18, or 24 months postnatally. The never-rationed reference group was defined as adults born between July and December 1954.
• The primary outcomes were T2D (n = 3936) and hypertension (n = 19,644) diagnoses and their age of onset.

TAKEAWAY:

• The risk for T2D or hypertension decreased with the duration of exposure to sugar rationing, ranging from in utero to age 2, compared with the never-rationed reference group.
• Exposure to sugar rationing from conception through at least 19 months postnatally led to the greatest reduction in the risk for T2D and hypertension — 38% (hazard ratio [HR], 0.62; 95% CI, 0.55-0.69) and 21% (HR, 0.79; 95% CI, 0.74-0.85), respectively.
• Individuals exposed to sugar rationing in utero and for more than a year after birth experienced roughly a 4- and 2-year delay in the diagnosis of T2D and hypertension, respectively.
• In utero exposure to sugar rationing alone accounted for about one third of the total reduction in the risk for T2D and hypertension; however, the effect was most prominent when rationing continued beyond 6 months of age.

IN PRACTICE:

“The sugar allowance then aligned with today’s limits set by the US, World Health Organization, and American Heart Association dietary guidelines,” the authors wrote. “While we did not directly evaluate these guidelines, our findings imply that adhering to them early in life could provide substantial health benefits.” 

SOURCE:

This study was led by Tadeja Gracner, Center for Economic and Social Research, University of Southern California, Los Angeles, and RAND Corporation, Santa Monica, California, and was published online in Science, with a related news article.

LIMITATIONS:

Study limitations included the potential for unobservable differences between cohorts conceived during and after rationing. The UK Biobank is not nationally representative and includes wealthier, healthier individuals; therefore, the results may not be generalizable to other populations. Moreover, no pre-study mortality information was available.

DISCLOSURES:

This study was supported by grants from the National Institutes of Health. The authors declared that they had no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.