December 23, 2024

The First 1,000 Days: Limiting Sugar Before Age Two Reduces Lifelong Diabetes and Hypertension Risk

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Sugar has important negative effects for everyone, and children in particular. AI-generated image.

Nutrition is critical at any stage, but during the first 1,000 days of life — from conception to a child’s second birthday — it’s particularly influential. In this period, dietary habits lay the groundwork for lifelong health. This period is so important that studies suggest that poor early nutrition increases the risk of chronic diseases like diabetes and hypertension well into adulthood.

A new study used a natural experiment from mid-20th-century Britain, where sugar rationing was in effect until 1953. What it showed was sugar intake in the first 1000 days of life is linked to long-lasting health conditions. For instance, limiting sugar intake in early life cut the risk of developing type 2 diabetes by 35% and high blood pressure by 20%.

A rationing experiment

When World War II started, the UK was importing a great deal of its food. Around 70% of its cheese and sugar, some 80% of fruit, and most of its cereals and meat were imports. To survive prolonged shortages, Britain introduced rationing on various staples, including sugar. Children under two were entirely excluded from sugar rations, and adults were limited to just 40 grams per day. This is a sharp contrast to the current average adult consumption of over 80 grams daily.

When rationing ended in 1953, sugar intake doubled nearly overnight. This change effectively created two groups of children: those born before the end of rationing, who consumed very little sugar, and those born afterward, who experienced higher sugar levels early in life.

Public information poster detailing additional rations for pregnant women. Sugar was not included.

Researchers led by Tadeja Gračner from the University of Southern California used data from the UK Biobank to analyze the differences. Overall, Gracner’s team analyzed a sample of over 60,000 British adults born between 1951 and 1956.

By comparing the health outcomes of individuals born during the final years of sugar rationing to those born shortly after, researchers were able to explore how this early sugar exposure impacts the onset of chronic diseases such as type 2 diabetes and hypertension.

They found some notable differences. People conceived or born before sugar rationing ended showed markedly lower rates of type 2 diabetes and hypertension in adulthood. Specifically, adults exposed to sugar rationing in their first 1,000 days had a 35% lower risk of developing diabetes and a 20% reduced risk of hypertension compared to their counterparts born after rationing ended.

The less sugar, the better

It’s not just eating or not eating sugar, the quantity also matters.

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Researchers found that the less sugar people ate, the stronger the protective effects. While children who were exposed to rationing only in the womb showed some health benefits, those who also experienced rationing throughout infancy and early childhood fared even better.

Children who were only exposed to rationing while in utero showed some reduced risk for diabetes and hypertension. Still, the health benefits were substantially greater for those who continued to experience restricted sugar intake after birth. The most significant reductions in disease risk were observed in children with limited sugar intake beyond six months of age. This suggests that both in-utero and early-childhood diets play critical roles in shaping lifelong health.

The researchers also noted differences in disease onset.

Adults who experienced early-life sugar rationing were diagnosed with diabetes and hypertension several years later on average than others. For instance, individuals with prolonged sugar restriction in early life were diagnosed with diabetes roughly four years later than those exposed to higher sugar levels in infancy.

There are limitations to this study. For instance, the analysis is based on historical data, so there is no control group with whom diet could be monitored contemporaneously. However, the researchers controlled for factors such as family history of diabetes, parental cardiovascular disease, and geographic location. In addition, the researchers addressed potential concerns about the influence of socioeconomic factors on health outcomes. Both rationed and non-rationed cohorts were drawn from the UK Biobank, which includes participants from a range of socioeconomic backgrounds. However, taking all this into account, researchers say that sugar was the primary variable that changed significantly post-rationing, and they controlled for other food and nutrient intake during the study period.

Which, in light of previous research, makes perfect sense.

Sugar can be a problem for everyone — especially children

The findings aren’t surprising, the researchers say — it’s just that finding the data that can confirm this is not easy. This is why the British rationing system was so useful in this context.

Numerous studies have suggested the negative effects that sugar consumption may have on everything from the risk of cardiovascular disease to cognitive ability. Excessive sugar intake in childhood is linked to obesity, hyperactivity, and increased long-term health problems​ and experts suggest limiting sugar to reduce diseases in adults and children.

Yet, it’s striking to see just how big of an impact sugar can make, even decades later.

The results of this study underscore the importance of dietary guidelines that target sugar reduction for infants, toddlers, and pregnant women. Health experts have long warned of the links between sugar and chronic diseases, but this research shows that the timing of sugar exposure is equally important. For families, these findings emphasize the need to prioritize a balanced, low-sugar diet during a child’s earliest years, starting even before birth.

As the global burden of chronic diseases like diabetes and hypertension continues to grow, policymakers may use this research to support interventions that target early-life nutrition. Measures could include restricting sugar levels in baby foods, educating parents on healthy weaning practices, and regulating advertisements for sugar-laden foods targeted at young children.