A natural experiment arising from the UK's post-WWII sugar rationing demonstrated that restricting added sugar intake during the first 1,000 days of life was associated with significant reductions in type 2 diabetes mellitus and hypertension risk, according to research published in Science.
The study analyzed data from 60,183 UK Biobank participants born between 1951-1956, comparing those exposed to sugar rationing in early life with those born after rationing ended in September 1953. Among the participants, aged 51-66 when surveyed, 3,936 were diagnosed with diabetes and 19,644 with hypertension.
The researchers found exposure to sugar rationing from conception through early childhood was associated with:
- 35% reduction in type 2 diabetes mellitus (T2DM) risk
- 20% reduction in hypertension risk
- 4-year delay in T2DM onset
- 2-year delay in hypertension onset
In-utero exposure alone showed significant protective effects, reducing the risk of T2DM and hypertension while delaying the onset of both conditions.
During the rationing period, sugar consumption was limited to approximately 41 g daily for adults, aligning with current dietary guidelines. When rationing ended, consumption nearly doubled, reaching about 80 g per day by 1954. The study noted that current US data shows pregnant and lactating women consume more than 80 g daily, and over 70% of infant and toddler foods contain added sugars.
Additional health outcomes included a 30% decrease in obesity risk with in-utero and first-year exposure, and a 2 percentage point lower prevalence of high waist-to-height ratios. Women demonstrated greater postnatal health benefits than men for T2DM risk reduction.
The researchers controlled for potential confounders by examining other foods de-rationed during the same period and found that sugar consumption accounted for 77% of the post-rationing caloric increase. They also analyzed conditions unlikely to be affected by sugar intake, such as type 1 diabetes, trauma-triggered depression, menarche, and myopia, finding no significant differences between cohorts.
The study's limitations included right censoring, lack of pre-study mortality information, and UK Biobank's tendency toward healthier, wealthier participants. However, the quasi-experimental design and large sample size strengthened the findings' potential causality.
The results remained consistent across various analytical specifications and when adjusted for food affordability, providing evidence supporting current dietary guidelines recommending zero added sugars during early life, the researchers noted.
